Years ago I developed sciatica as a consequence of a martial arts injury. I had seen a number of doctors who finally diagnosed it as an entrapment syndrome involving the piriformis muscle and the sciatic nerve. I tried, unsuccessfully, all of the conservative methods to treat it, including physical therapy, massage, manipulation—you name it. Finally, it looked like I would either have to live with the pain or have surgery—for which there was no guarantee of success. As it happened, one day I wandered into a yoga class at the Ann Arbor YMCA.
I remember being impressed by how different (and difficult) a yoga class was, even though I was used to hard physical training from playing sports; we were working with the body in ways I had never experienced and using precise movements and muscular engagements I hadn’t seen in other exercise methods. Not only did I feel great after my first class but also, to my surprise, the next day I noticed that my sciatic pain was greatly improved. Putting two and two together, I started going regularly to classes at YMCA (and later, the basement of a church). As long as I went to class, my sciatica no longer bothered me. With this in mind, let’s take a look at piriformis syndrome.
Piriformis syndrome is characterized by buttock and/or hip pain that may radiate into the leg as a form of sciatica. This syndrome is thought to result from spasm of the piriformis which causes irritation of the sciatic nerve as it passes across (or through) the muscle. Spasm in the piriformis can be precipitated by an athletic injury or other trauma. The mainstay of treatment involves stretching the piriformis and its neighboring external hip rotators, with surgery to release the muscle reserved for recalcitrant cases. Click here to review the anatomy and biomechanics of the piriformis muscle.
Tightness or asymmetries in the piriformis muscle can create rotational pelvic imbalances. This, in turn, can lead to imbalances further up the spinal column, through the process of "joint rhythm". Click here to learn more about lumbar pelvic rhythm in our previous blog post on Preventative Strategies for Lower Back Strains. Below in the links is a reference to an article from the Osteopathic literature addressing this subject in relation to the piriformis muscle.
Click here for the rest of the article