Runner’s Bum (Piriformis Syndrome)

Like me this condition is painful in the same area! The piriformis is a small rectangular shaped muscle that lies deep in the buttocks. Small it may be, but when not happy you certainly know it’s there.

Unfortunately it lies very close to the sciatic nerve, the largest nerve in the body. This nerve usually lies behind the piriformis muscle, however in up to 30% of cases it can go straight through the centre of the muscle

And that of course is OK, until the piriformis decides to tighten and contract, and we all know what the pain of a compressed nerve can do to our lives…no once again, I’m not referring to myself!

The piriformis has the role of externally rotating the hip, meaning it helps to turn the leg and foot outwards.

The pain from Runners Bum can be deep in the buttock, or if the sciatica nerve is involved it can send pain down the leg, and in some cases all the way to the foot. This pain is often called sciatica. But be aware sciatica is not always caused by a tight piriformis.  The most common cause of sciatic pain comes from the lumbar region of the spine, and irritation of the spinal nerves. This condition can be far more debilitating and can require surgery. Piriformis pain, being muscular will respond to common soft tissue remedies, and very rarely requires surgical procedures.

The reasons for Piriformis Syndrome can be from sitting for long periods, and running for long periods…, so does that mean we just lie down for long periods?

Weak glutes can bring it on, as can an awkward running gait, either sway back, knock knees or one foot turning out...that all sounds like a good running look doesn't it? 
Cross country runners seem to suffer more than road runners, and hill running can contribute as well. But often with all muscle strain or tightness it can be just an overuse problem, running too much, too far, not giving the body time to repair, or not stretching the area sufficiently after your running.

After years of locating and working on this muscle in footy clubs and on many of my massage clients, I gave it the name Runner’s Bum. However, Piriformis Syndrome is common to other sports as well, like skiing, golf and cycling.

Treatment of course is always rest, take some time off. Ice or heat, or both.

Massage is good and often self massage works. It is an easy one to locate, right in the lower buttock, if you press in firm enough it will soon yell back at you.

Try sitting on a squash ball or tennis ball and rolling your bum around on it, make sure you inform the rest of the family on what you are trying to achieve, as I’m sure gyrating on your couch may get some strange looks, and the dog will probably get very excited and want to join in on the fun.  

Anti inflammatories at the onset can settle it down, and of course find some good stretches to do.

I read recently that Botox can be used as a treatment, I say if you are going to pay hundreds for Botox put it in the face, who is going to care about the no expression lines on your butt for goodness sake!

A pain in the bum can sound funny however, piriformis syndrome can be quite debilitating and take months to recover from. The best cure of course is early detection and prevention. You have often hear me say a niggle is a sign of more to come, and it often will not go away on its own.

So if you are feeling tight and sore in the buttocks, if sitting for long periods makes you squirm and feel uncomfortable. If you have pain that radiates down your legs, it may be coming form your tight piriformis muscle. So start treatment straight away.

As for the other Pain in the Butt associated with running, I’m afraid there is not much you can do about her….