Piriformis Syndrome
Are you experiencing pain that feels like it is coming from deep in your gluteal region? Does it go down to your legs? Does it feel like an electric shock, pulling or nerve pain? Has it been so bad that even changing your position does not help relieve it? Do you sit behind your desk or stand all day? If yes, then you might be having piriformis syndrome.
The piriformis is a muscle that originates from the front of the sacrum and inserts on the side of the femur. It helps to rotate the hip externally and hip abduction. The sciatic nerve runs under the piriformis muscle on its was out of the pelvis.
What causes piriformis syndrome?
- Poor posture – after sitting or standing for a long period of time(e.g. Office workers, students, and drivers)
- Muscle overuse – running or jumping for long periods, the muscle is forced to contract beyond its limit
- Direct trauma – accidental falls, car accidents or sports injuries leading to muscle damage. Lifting heavy objects or sudden twist of the hip
The factors that have mentioned above, will lead to inflammation of the piriformis muscle, resulting in the irritation of sciatica nerve that runs under it. Some common signs of piriformis syndrome include :
- Pain starts from buttocks and runs down the leg, like an electric shock
- Tenderness when pressure applied directly to the piriformis muscle
- Pain in buttocks when changing positions (e.g. From squatting to standing, sitting to standing or turning over the body)
- Pain in buttocks after long sitting or standing or even running
How can physiotherapy help you?
- Deep tissue massage or electrotherapy
- To relieve pain and muscle spasm, increase blood circulation of the affected side
- Stretching
- In sitting position, cross your affected leg over your opposite thigh, slowly lean your body forward until you feel a stretch in the hip, hold for 30s, 35 reps, 3 sets/day.
- Lying on your back, cross your affected leg over your opposite thigh, pull your opposite thigh to your chest until a stretch is felt deep in your hip, hold for 30s, 35 reps, 3 sets/day.
- Strengthening (gluteal muscles)
- Lying on your back, knee bent, hold for 30s, repeat 5-10 times, 3 sets/ day.
To prevent piriformis syndrome, you should do the following:
- Avoid long sitting, move every 30 mins at least for 3 mins.
- Maintain good posture while sitting, standing or running
- Stretch regularly, to maintain or increase the flexibility
References: https://journals.lww.com/acsm-Healthfitness/fulltext/2014/07000/Piriformis_Syndrome.3.aspx
It is becoming more common for us to see patients with this condition. Our physiotherapists team often treat and help patients recover from piriformis syndrome. If you think you may have this condition, we encourage you to seek for proper assessment to be diagnosed and treated by a professional. To make an appointment, call 03-6211 7533.
日常生活中您有沒有经历过臀部深处感到疼痛，甚至一站起来就就好像有麻或是电到的感觉，由臀部延伸到大腿或者小腿，让您感到坐立不安，找不到任何姿势去缓解的这种不适？那您又是不是需要又或者是习惯经常久坐的一群呢？如果是的话，那您有可能是梨狀肌症候群哦！
首先，先来了解一下梨狀肌的解剖位置。梨状肌是一条位于臀部深处的小肌肉，起自於荐椎前方，经坐骨大孔，附着在股骨大转子上粗隆的上方，主要负责髋关节的外转，以及协助屈曲的髋关节做外展的动作。从梨状肌下方穿过的神经，正是我们熟知的坐骨神经。
那么造成梨状肌症候群的原因是什么呢？
- 姿势不良 – 长时间的久坐不动 （例如上班族、司机、学生）
- 过度運動 – 长时间的跑跳（例如跑步），导致梨状肌超出它所能负荷的运动量。需要快速转变方向的运动，例如足球，篮球等
- 外傷 – 跌倒、车祸或运动时导致梨状肌受到外力的撞击
- 搬重物，扭转身体的动作
上述所提到的这些因素，会造成梨状肌受损发炎（红、肿、热、痛），而发炎反应的肿胀会进而压迫或刺激到底下的坐骨神经，导致这些不适的症状出现：
- 臀部深处感到疼痛，从臀部延伸到大腿或小腿的电击感
- 患处会有压痛感
- 转换姿势像是蹲到站、坐到站、翻身的时候
- 长时间走路或跑步
物理治療如何帮助您？
- 徒手深层按摩或电疗
- 降低肌肉的疼痛和痉挛，同时促进患侧血液循环
- 伸展运动
- 在坐姿下，把患侧脚放在另一只脚膝盖上，做跷二郎腿的动作，收腹，身体向前倾，维持30秒，做3-5次，每天3组。
- 在躺姿，患侧脚做跷二郎腿的动作，双手抱着另一只脚的大腿拉近胸口至感觉臀部后侧，维持30秒，做3-5次，每天3组。
- 肌力训练（強化臀部肌力）
- 在平躺姿势下，膝盖弯曲抬臀，维持10秒，重复5-10次，每天3组
如何预防梨状肌症候群？
- 避免久坐，每半个小时站起来活动一下
- 保持良好的坐姿（避免跷二郎腿、站姿、以及跑步、运动时的姿势
- 适当的做伸展运动，维持良好的柔软度
由于工作需求、不良的姿势，梨状肌症候群已经越来越常见。如果您有上述的症状困扰着您，建议您可以来我们的中心接受评估，我們的物理治疗团队会提供您建议和相对的治疗方案。
预约评估电话， 请拨03-6211 7533。