Piriformis trigger points cause pain and tightness in the tailbone and buttocks [1]. Fortunately, they can be released in two steps: 1) targeted deep tissue massage and 2) stretching.
Read on to learn what Piriformis trigger points are, their pain pattern and symptoms, and most importantly how to release them.
- Muscle Anatomy
- Pain Pattern
- Symptoms
- How To Release & Pain Relief
- Prevention
Piriformis Muscle
1. Piriformis Trigger Point Muscle Anatomy
Piriformis is a deep outer glute muscle. When tight, Piriformis can cause many issues including sciatica, duck feet, and tailbone pain.
Anatomically, Piriformis is the largest of the deep external hip rotators (muscles that twist your leg to point your toe outward) and causes a ton of pain when tight. Check out comedian Sinbad's bit on the Piriformis muscle here!
Piriformis Muscle [1]: The Piriformis muscle from a posterior/rear view
2. Piriformis Trigger Point Pain Pattern:
The pain pattern caused by Piriformis trigger points tends to be felt most strongly in the tailbone and/or outer buttocks. In addition, pain, numbness, and tingling can be felt in the glute and radiating down the leg (see next section "Symptoms").
Piriformis trigger point-pain often feels nagging and constant in the regions below. Although Piriformis trigger points are often caused by a single, high-impact event (such as lifting a couch, making a hard cut in sports, etc.), it is usually made worse by sedentary activities like sitting [2].
Piriformis Trigger Point Referred Pain Pattern [1]
3. Piriformis Trigger Point Pain Symptoms:
Aside from pain in the regions above, the chief symptom of Piriformis trigger points is sciatica. Sciatica is the constriction of the large sciatic nerve that runs from the tailbone, underneath the Piriformis, and all the way down the leg to the foot. When the Sciatic nerve gets compressed by a tight Piriformis - numbness, tingling, and/or pain can be felt in the outer leg and foot.
More on Piriformis Syndrome exercises at this link.
Sciatica From Piriformis Trigger Points [2]
Other symptoms of Piriformis trigger points and tightness, described by Travell & Simons [1], include:
- "Patients may report a sharp pain on occasion, but often they describe their symptoms as an ache" [1] p. 1369.
- "Patients may also report a loss in their hip range of motion or flexibility into internal rotation and adduction" [1] p. 1369.
- The symptoms are likely aggravated in the seated position (learn how to sit with Piriformis Syndrome) [1] p. 1369.
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Tenderness and irritation in the Sciatic Notch around the Piriformis [1] p. 1369.
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Dull, nagging pain in the region described above
4. How To Release Piriformis Trigger Points
The solution to releasing Piriformis trigger points is targeted, intentional deep tissue massage. This can be done by the hands of a professional, or by a purposefully made tool at home like QL Claw.
After Piriformis is successfully released with massage, we highly encourage stretching (see "Piriformis Trigger Point Prevention" below) to further relieve pressure, and strengthening to ensure Piriformis trigger points do not come back.
How To Release Piriformis Trigger Points with QL Claw:
Placement: While lying on your back, place your tailbone on the flat ramped portion of the QL Claw - this acts as your shelf. Turn the trigger/knuckle portion of the Claw to rest on the Piriformis muscle - this acts as your releasing agent (designed to mimic a PT's knuckle, thumb, or elbow in a clinic). It may take a second to find the Piriformis - but as a clue, it will likely be the most tender spot in the area.
Motion: First, allow your body to sink into the tool. Breathe deeply and slowly, signally to the body that it is safe to relax. A colleague describes the feeling as "melting" around the tool and I find that accurate. Second, start working in light motion. Find your groove here - you can tilt into and away from the Claw, you can rock north-south, or you can full on lean into it if your body can take it.
Sets/Reps: Spend 2-3 minutes massaging each side twice per day. After 3 days or so, you should notice an incredible difference! If you do not notice a difference, there is either 1) a different muscle or issue at play, or 2) you may need another set of eyes to make sure you hit the right spot. Either way - don't give up, you got this!
Piriformis Release Using the QL Claw Device
Piriformis Release Tutorial Using QL Claw
5. Piriformis Trigger Point Prevention
After the trigger points and knots are successfully massaged out of the Piriformis, stretching and strengthening can be very beneficial to prevent relapse and future pain. It is important to perform the massage step first because trigger points most often will not stretch, and strengthening does not relieve the constant tension of trigger points.
Piriformis Stretch: Stretching the Piriformis lengthens the muscle to decrease pressure and tension on your joints. If Piriformis syndrome is present, stretching is crucial so the muscle gets off the sciatic nerve as much as possible. Here is an example of a Piriformis stretch you can do right at home:
Piriformis Stretch [2]
Piriformis Strengthening: Strengthening the Piriformis (strengthening the entire glutes for that matter) can help build resilience and stamina so that trigger points are less likely to come back in the future. If you like to play sports or live an active lifestyle this is a must! Here are a few glute strengthening exercises you can do to prevent Piriformis trigger points:
- Fire Hydrants
- Single Leg Deadlift
- Kas Glute Bridge
- Hip Thrust
Thank you for reading Piriformis Trigger Points! Leave a comment or read one of the following next to master the Piriformis:
Source:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.