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Massage Aha!

Professional therapeutic massage therapy in Kansas City, MO by Aaron Harris, BCTMB

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The Piriformis Muscle

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Responsible for laterally rotating the femur, the Piriformis muscle lies deep on the posterior pelvis, under Gluteus Maximus.

The Piriformis Muscle
The Piriformis muscle attaches the anterior sacrum to the greater trochanter of the femur.

What Does Piriformis Do?

In addition to lateral rotation of the leg (turning your foot to the outside), the Piriformis muscle also assists with abduction (bringing the thigh back to midline) when your hip is flexed.

This muscle is vital to lower body movement. It enables us to walk, shift our weight from one foot to another, and maintain balance. Piriformis is also used in sports that involve lifting and rotating the thighs. Almost every action you take with your leg involves this short but very strong muscle.

How Do You Find the Piriformis Muscle?

Locate the coccyx (tailbone), the greater trochanter of the femur (a large knob on the outside of the top of your leg), and the Posterior Superior Iliac Spine (PSIS), which is where the large round bone of your hip meets your sacrum. If you picture those three points forming the letter “T,” Pirformis runs along the base.

Trigger Points in Piriformis

The common trigger points in this muscle refer pain into the sacro-iliac region, across the posterior hip, and down the thigh.

Piriformis Trigger Points
Trigger points in the Piriformis muscle (marked by X) refer pain into the sacro-iliac region, across the posterior hip, and down the thigh (marked in blue).

Piriformis Syndrome

Sometimes, the Piriformis becomes inflamed or spasms and compresses the sciatic nerve, mimicking the symptoms of sciatica.

Pain that radiates from the sacrum down the back of one or both of your thighs should be evaluated by your physician. They are able to determine if the cause is a herniated disc or other condition.

Massage of the Piriformis Muscle

My typical approach to working on this muscle is to place the client in a face down position. Then I will flex the hip and knee into a “figure 4” position. This position contracts the Piriformis, making it easier to identify. After feeling the muscle belly for any trigger points or knots, I will frequently sink deep into the muscle using my elbow. This is a definite “moan maker” point.

I incorporate manipulation of the Piriformis into most of my modalities, including Swedish, Shiatsu, Thai, and Deep Tissue. It’s one of my favorite muscles because most clients experience pain here. Also it typically releases quickly which means clients notice an immediate difference after a session.

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