Vancouver-based chiropractor Dr. Aaron Case provides tips on how to prevent and treat piriformis syndrome

Common in endurance athletes like runners and cyclists, piriformis syndrome occurs when the piriformis muscle, located deep in the buttocks, is tight, inflamed, and has a trigger point that refers pain down the back of the thigh.

“This often results in impingement of the sciatic nerve and can cause radiating pain down the back of the leg,” says Dr. Aaron Case, a Vancouver-based chiropractor and Active Release Techniques (ART) therapist.

While the causes of piriformis syndrome vary, according to Dr. Case, it’s commonly caused by “overuse due to compensation for underuse of other hip and gluteal muscles, or tightness of the inner leg muscles putting extra load on the piriformis.”

Since piriformis syndrome can be confused with a disc bulge, lower back and spinal problems or a hamstring strain, Dr. Case recommends reviewing your symptom history with a practitioner. This may be followed by range of motion testing and orthopedic tests of the lower back, leg, and hip.

To treat the injury, Dr. Case recommends stretching, foam-rolling, massage, active or myofascial release, and needling, depending on the severity of the case. Most importantly, however, patients should include active treatment to strengthen the hip stability muscles.

To prevent piriformis syndrome, Dr. Case encourages athletes to take “down weeks,” replace regular training with occasional cross training and include resistance training and stretching for the hip. A gradual increase in strength training is also important.