Piriformis syndrome is not your most common sports injury but when an athlete has the condition it definitely affects sports performance.
The small piriformis muscle lies deep within the hip and buttocks region and lies very close to the sciatic nerve. The condition becomes evident when this muscle becomes tight or spasms causing compression and irritation of the sciatic nerve.
From an anatomy standpoint the sciatic nerve is the main nerve feeding the lower extremity.
In this article we will discuss causes, symptoms, treatment and prevention of this condition. After reading the article you will have an understanding of how piriformis syndrome directly affects sports performance.
The condition is a result of a tightening or spasm of this small buttocks muscle. Any sport that requires a lot of running, change of position or weight bearing can trigger this. Such sports as football, basketball, soccer and track fall into this category. The piriformis muscle reacts to overload when (1) running on a hard or uneven surface (2) starting an exercise program after a long lay off (3) increasing the intensity or duration of your workout too fast (4) worn out or ill fitting athletic shoes and (5) even when a person is sedentary and sits for long periods.
There are also biomechanical stresses that affect this muscle. This includes (1) poor body and foot mechanics (2) gait deviations (running with toes pointed out) and (3) poor sitting posture. Many back conditions also affect this muscle due to pain, muscle weakness and tightness. You can definitely see from the causes above how piriformis syndrome affects sports performance.
The classic symptom is pain experienced deep within the buttocks or gluteal region. Often pain will radiate down the leg coinciding with numbness and tingling. Secondary symptoms are stiffness, weakness and restricted mobility in the buttocks and leg.
Like any other soft tissue injury the R.I.C.E. (rest, ice, compression and elevation) methods should be implemented for the first 24-48 hours. With the reduction of acute pain physical therapy can be started.
The therapist will usually start with the use of modalities to include ultrasound, electrical stimulation and cold laser. These modalities will soothe the inflammation, reduce muscle spasms and promote healing. Physical therapists can use a technique called iontophoresis which drives in anti-inflammatory medication via electrical impulses or phonophoresis via sound waves.
On a side note botox injections have been used here by physicians to relieve the muscle tightness and compression on the sciatic nerve. Studies have shown botox to be more effective than corticosteroids.
Therapists often perform deep tissue massage to reduce chance of scarring in the gluteal region. Most important is that the patient is supervised in a proper stretching and strengthening program for this particular condition. The therapist will also guide you on how to build up the endurance and durability of the gluteal region and involved leg.
It is extremely important to keep a good avenue of communication with the physical therapist when there are questions regarding sports performance.
(1) complete and proper warm up so as to prepare muscles for activity (2) make sure you give your muscles rest and recovery time after vigorous physical activity (3) be consistent with a strengthening and conditioning program especially for the lower back, hips and buttocks region (4) perform a structured stretching routine daily and (5) good posture and body mechanics. With proper diagnosis and treatment there is no reason for piriformis syndrome to be dreaded!