The Most Important Muscle You’ve Never Heard Of…Part 4 – The Piriformis

The piriformis muscle is a very important muscle that lies deep in your buttocks.  Oftentimes, runners are affected by stress and injury to this muscle, but it can definitely be a problem for everyone.  As seen in the picture above, it sits just on top of the sciatic nerve.  In approximately 15% of people, the sciatic nerve actually travels right through the muscle!!!  Could you imagine???  Anytime that muscle becomes inflamed or injured, pressure can be applied on the nerve causing a host of issues.

The main function of the piriformis muscle is lateral (external) rotation of the hip when the hip is extended.  Think of it this way…when standing, the piriformis acts to rotate your leg so that the toe points away from the body.  Other lateral rotators of the hip include the superior gemellus , obturator externus, obturator internus, inferior gemellus and quadratus femoris.  When learning these muscles in Anatomy class, we used this pneumonic…”please send out information quickly”.  P for piriformis; S for superior gemellus; O for both obturators; I for inferior gemellus; and Q for quadratus femoris.  When the hip is flexed, however, the piriformis has a different action.  It actually abducts the femur (thigh bone) meaning it brings the femur away from the body.  Abduction of the thigh with hip flexion is a very important movement during the gait cycle when walking by shifting the body weight to the opposite side of the foot that is lifted which prevents falling. 

Injury to the piriformis muscle can lead to trigger point formation.  When trigger points are formed, pain manifests.  The figure above demonstrates referral patterns of pain when the trigger points are active.  Also, depending on the severity of injury, an inflamed piriformis muscle can apply pressure to the sciatic nerve causing sciatica symptoms to occur.  This is called Piriformis Syndrome.  As seen in the figure, irritation of the piriformis can refer pain to the sacroiliac region of the low back which can make diagnosis of the syndrome difficult.  If the sciatic nerve is involved, you will experience pain down the back of the leg into the calf and maybe even all the way into the foot.  If the syndrome goes untreated, numbness, tingling and weakness may happen as well. 

Due to the action of the muscle itself, symptoms worsen with prolonged sitting and with activity…such as running, especially uphill.  There are a wide variety of risk factors that may increase the likelihood of developing piriformis syndrome:

- running
- sedentary jobs where you sit most of the day, especially in a chair where your knees sit higher than your hips
- having a longer second toe
- overpronation of the foot during the gait cycle (see the figure above – the arch flattens too much causing the foot to roll inward)
- one leg longer than the other which throws your pelvis off balance
- misalignment of your sacroiliac joint (GO SEE YOUR CHIROPRACTOR!!!)

There are also a wide variety of causes of piriformis syndrome:

- a direct blow to the muscle
- running
- sitting on your foot
- catching yourself from falling or other sudden muscle overload
- car accidents, especially when hit from the driver’s side
- twisting while lifting a heavy object

There are several different ways to attack piriformis syndrome.  There is not one treatment better than another, but combining treatments like moist heat, myofascial release, stretching and chiropractic adjustments  seems to help the most.  Moist heat helps to penetrate deeper into the muscle to promote blood flow into the affected area.  This can help to relax the tissue and speed healing times.  Apply the heat for about 20 minutes then you can move on to stretching and myofascial release.  Using a foam roller or a tennis ball are great ways to apply pressure to the existing trigger points to relieve the tension and relax the muscle, thus reducing symptoms.  Do this for a few minutes 3-4 days per week.  Stretching the piriformis can also help relax the muscle.  There are a few different version of the stretch so be sure to find the one best suited for you.  Hold the stretch for about 10 seconds.  You want to feel a light stretch without pain.  If you feel pain, back off on the stretch.  Always stretch both sides…even if only one side is bothering you!  Supplement these great at-home exercises with consistent chiropractic adjustments.  Not only will the adjustment help to realign the pelvis, it will reset your central nervous system and relieve pressure from nerves and improve the function of the muscles those nerves supply.  At Pro Chiropractic, we also have a state of the art dynamic gait scanning system that can help us to determine how your feet move throughout your gait cycle and allow us to create custom orthotics to fix any issues…such as over pronation!!!  We can also correct a leg length deficiency with orthotics by adding a heel lift if necessary. 

 

 

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

 





Did you know…? Chiropractic Edition–Volume 2

 

·      Did you know…that chiropractors search for the underlying causes of symptoms instead of just treating the symptoms?

When you go see a medical doctor for a musculoskeletal complaint, they aren’t the least bit interested in what caused it.  They only care about relieving symptoms, usually with medications); which is great for now…but what happens when those symptoms return a few weeks later?  Or when those medications they gave you cause side effects for which you need more medication?  The chiropractors at Pro Chiropractic care about your symptoms, of course, but we look deeper to determine what is actually causing those symptoms to manifest and we address that.  Do you have low back pain?  That low back pain might not even be from a low back issue.  It may be because your big toe isn’t working the way it’s supposed to which wreaks havoc on the biomechanics of the other joints in your feet, ankles, knees and hips; and because your body is an expert at overcompensating, that pain can manifest in your low back.  Fix the biomechanical issue in the big toe and “voilà”…no more low back pain.

 ·    Did you know…that one of the most important times for a woman to seek chiropractic care is when she is pregnant?

When a woman is pregnant, the baby’s health is directly tied to the mother’s.  If the mother is not eating properly, the baby can be malnourished.  If the mother is not taking care of her body physically, the baby can suffer.  If the mother’s nervous system is not functioning optimally, it can impair the development of the baby.  How can the mother keep her nervous system as healthy as possible?  Go see a chiropractor!  That’s what we do!  We can also give advice on nutrition and exercise.  Receiving consistent spinal adjustments during pregnancy will relieve pressure and irritation on the spinal cord, allowing the nervous system to function without interruption which helps baby as well!  During pregnancy, the body releases a hormone called Relaxin which causes laxity in the pelvic ligaments to prepare the body for the birthing process.  If left unchecked, the ligaments may stretch too much and cause pain and instability in the sacroiliac joints and become a chronic problem after the baby is born.  Chiropractic care during pregnancy can also help reduce labor time, the need for medications during labor, and back pain during the pregnancy. 

·      Did you know…that chiropractic doesn’t actually cure anything?

It’s true!  Chiropractic care doesn’t cure anything.  YOU DO!  Now don’t get me wrong…chiropractic care plays an important role in your health and recovery, it just won’t get rid of cancer or arthritis or any other systemic disease.  Chiropractic care DOES, however, ensure that your nervous system is functioning at an optimum level so that your body, as it is designed to do, can heal itself!  How amazing is that?!?  If your body is firing on all cylinders, it has an amazing ability to heal and to fight off potential disease.  Have you ever noticed that when you are worn out, over stressed, or in pain that you seem to be more susceptible to getting a cold or other common infections?  When your nervous system is impaired, it can negatively affect your immune system which is your body’s defense against disease.  Restoring function to your nervous system through chiropractic care will help rebuild your body’s defenses and promote health within the entire body!

·      Did you know…there are common triggers for migraines?

“Migraine” seems to be the catch-all term for severe headaches, but a migraine headache is not as common as people think.  They have very specific symptoms.  Migraines are typically unilateral, or only affect one side of the head, described as throbbing or pulsating, aggravated by physical activity, and last anywhere from 2 to 72 hours.  There are many different types of migraines, each with its own specific criteria for diagnosis.  The two most common types are classic migraine and common migraine.  A classic migraine is distinguished from a common migraine by the fact that it is preceded by an aura.  The aura can be a disturbance in vision, hearing or overall affect.  Some see spots, zig zagging lines or experience blurring vision, which others notice sensitivity to loud noises or nausea.  Many migraine sufferers say the headaches are triggered by specific things; including foods, beverages, stress, and even smells.  The five most common migraine triggers are:

1. Chocolate

2. Alcohol

3. Perfume

4. Bright lights

5. Changes in weather

·      Did you know…that the human body is about 60% water?

Hydration is a very important part of our health because over half of our body is made up of water.  Staying hydrated has many benefits including weight loss, increased energy, relieving headaches, and helping with digestive issues.  Drinking water replaces high calorie drinks, such as soda and alcohol, with a zero calorie, zero fat, zero carb and zero sugar alternative.  It also acts as an appetite suppressant because it fills the stomach.  This all helps with losing weight.  Are you feeling fatigued, weak, or dizzy?  Drink more water!  If you feel thirsty, you are already dehydrated. And dehydration can sap up your energy and make you feel tired.  It can also cause headaches.  So before you reach of that bottle of ibuprofen or Tylenol…try drinking a glass of water first.  Have you noticed that you’re a little stopped up?  You might not be drinking enough water.  Your digestive system relies heavily on water, and fiber, to move the food through your intestines and absorb the nutrients needed to survive.  If your body is dehydrated, it will pull the water from your digestive tract to use in more important systems which can leave you constipated.  Drinking a glass of water with every meal and carrying a water bottle with your during the day are two simple ways to help you stay hydrated!

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-388-9915 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.