Hello, Dr. Kelly here. Have you heard of Piriformis Syndrome?
The Piriformis Muscle is a small muscle with a big role. It is located deep in the buttock, behind the gluteus maximus. It originates from the sacrum (the base of the spine) and attaches to the top of the femur (thigh bone). The sciatic nerve runs underneath it.
When the piriformis becomes tight, inflamed, or spasms, it can compress or irritate the sciatic nerve, resulting in piriformis syndrome. The Gluteus Medius Muscle, you may hear me refer to it as Glut med, is another muscle located in your buttock region. Both Piriformis syndrome and glut med dysfunction are two commonly overlooked causes of hip pain, lower back discomfort, and sciatic nerve irritation.
The piriformis muscle helps with external rotation of the hip, stabilization of the pelvis during movement and assisting with abduction of the thigh when the hip is flexed.
Piriformis Syndrome Symptoms
Deep, aching pain in the buttock, Pain radiating down the back of the leg (often stopping at the knee), Numbness, tingling, or burning sensations. Here is the big one – Increased discomfort when sitting, climbing stairs, or running.
A common cause of Piriformis Syndrome is weakness in surrounding muscles, particularly the glut med muscle. Biomechanical issues like overpronation or leg length discrepancies can also cause piriformis issues. That is one of the reasons why I look at your feet when I adjust or why I love the pelvic stabilizer orthotics.
Glut Med is the pelvic stabilizer. It is one of the three main gluteal muscles, situated on the outer surface of the pelvis. It Abduction of the thigh, stabilizes the pelvis during walking or running and prevents the pelvis from dropping to the opposite side when weight-bearing.
This is so critical: When the glut med is weak or not firing properly, it leads to hip drop and compensatory strain on surrounding muscles — including the piriformis. This often results in a chain reaction of poor movement patterns, instability, and eventually, pain.
Is it making sense as to why I ask about what is more tender, Lumbars, Glut med, Piriformis, Hamstring?
Glut Med Dysfunction Symptoms
Hip pain or tenderness, Poor balance or single-leg stability, A waddling or limping gait, Lower back pain or IT band tightness, Overuse of the piriformis or TFL (tensor fasciae latae)
Many people with piriformis syndrome also show signs of glute med dysfunction. Addressing both muscles together often leads to the most effective and lasting relief.
What Do You Do About It?
- Reducing tension in the piriformis is often the first step: Gentle stretching: Seated or lying piriformis stretches, Foam rolling, massage, and heat. Avoid aggressive stretching if the nerve is irritated — stick to gentle, sustained holds.
- Strengthen the Gluteus Medius: Clamshells, Side-lying leg raises, Monster walks with a resistance band, Single-leg bridges, and Standing hip abductions. Focus on quality of movement and control. It’s not about how many reps you do — it’s about doing them correctly and building endurance over time!
- Improve Pelvic and Core Stability: My favorite- Dead bugs! Bird-dogs, Side planks. Your hips don’t operate in isolation. Core muscles, especially the transverse abdominis and obliques, play a role in supporting pelvic alignment and stability. These exercises help build a strong foundation and prevent recurrence.
- Address Biomechanical Issues: Foot position, gait mechanics, and leg length differences can all influence hip and glute function.
- Get Orthotics (if needed): Address lumbar mobility if tightness is contributing. Don’t forget about nutrition. It is important to be giving your body all the nutrients you need to heal. Inflammatone and Collagen are both very beneficial.
You can reach out by responding to this post or text us if you want more info on the stretches and exercises that help Pirformis syndrome or Glut med dysfunction, or if you want a link to the nutrition support, I recommend. Even better, ask me about it at your next visit to Tree of Life Wellness Center.
Yours in Health Naturally,
Dr. Kelly