The piriformis short, flat muscle in the posterior hip. It is located deep to the gluteus maximus, and works in tandem with five other muscles to laterally rotate the hip joint.


Identifying the Piriformis (Biel, 2005)


Image by East West Massage

  • Origin: The piriformis attaches at the anterior surface of the sacrum.
  • Insertion: The other end of the muscle attaches to the greater trochanter of the femur.
  • Action: The piriformis is a lateral rotator of the coxal joint, or your hip. It also abducts the hip when the hip is flexed.
  • Innervation: This muscle is innervated by a branch of the sacral plexus, which is a branching network of nerves that provide motor and sensory signals to parts of the pelvis, the posterior thigh, and most of the leg and foot.

Causes of Injury or Tightness in the Piriformis (Metzl, 2016)

  • Too much sitting
  • Overuse
  • Spasm


Symptoms of Injury or Tightness in the Piriformis (Metzl, 2016)

  • Pain in lower back or buttock
  • Pain or tingling radiating down posterior leg
  • Pain or discomfort while sitting, or while walking up stairs
  • Reduced range of motion in hip
  • Direct blow to muscle
  • Foot pronation
  • Natural disfigurement, such as one shorter leg


Trigger Point Referral Pattern in the Piriformis (Perry, 2013)


Image by Complete Pain Care

  • Medial trigger points refer pain to the sacroiliac joint
  • Lateral trigger points refer pain to posterior hip and buttock


Relieving Pain and Tightness in the Piriformis (Metzl, 2016)

  • Rest: Discontinuing the offending activity will allow the muscle to relax.
  • NSAIDs: Nonsteroidal anti-inflammatory drugs reduce swelling and ease pain.
  • Stretching and strengthening exercises: Stretching the muscles will allow greater flexibility, while strengthening will decrease susceptibility to further injury.
  • Massage: Massage therapy is a great way to loosen up tight muscles and increase range of motion.



Anterior – Front side of something.

Insertion – The insertion of a muscle is the point at which the muscle attaches to a bone that is moved by that muscle. This point will be more distal (away from the core of the body) than the origin.

Lateral – Toward the side.

Medial – Toward the center.

Origin – A muscle’s origin is the point at which the muscle attaches to a fixed, proximal (close to the core of the body) bone.

Posterior – Back side of something

Trigger Point – An area of hyperactive tissue that sends excessive pain signals to the spine, which generally “confuses” the brain as to where the pain is coming from.


Biel, A., 2005. Trail Guide to the Body, Third Edition. Book of Discovery, Boulder, CO. Pp.322

Metzl, J. Piriformis Syndrome Treatment, Prevention And Exercises. [Internet]. [Updated 2016 Dec 19]. Triathlon Magazine. [Accessed 2017 Mar 12]. Available from: http://www.triathlete.com/2015/03/training/piriformis-syndrome-treatment-prevention-and-exercises_77623

Perry, L. Piriformis Trigger Points: Double Trouble. [Internet]. [Updated 2013 Jan 12]. Institute of Trigger Point Therapy, Houston, TX. [Accessed 2017 Mar 12]. Available from: http://www.triggerpointtherapist.com/blog/piriformis-pain/piriformis-trigger-points-double-trouble/

Cover image by Yoganatomy


About Tonya Sapiel, LMT

My goal with The Wellness Seeker blog is to educate the general public on the benefits of massage therapy, why it is an important addition to their health care routine, and what they can do to help themselves in between their massage therapy sessions. I welcome feedback and questions. I also accept requests for post topics. For more information about me or my practice, please visit www.tonyasapiel.massagetherapy.com

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