This pain in the butt...
is called Piriformis Syndrome.

What is Piriformis Syndrome?

Well, the Piriformis is a muscle (a deep lateral rotator of your leg to be specific), located deep under your gluteus maximus muscle, which is why it is often confused with gluteus maximus pain. It runs sideways under your glute and very near your sciatic nerve (a large nerve that runs down your leg). Actually in a percentage of the population of humans, the sciatic nerve actually runs THROUGH the piriformis muscle. This means that if that muscle gets really tight, it will cause that pain in the butt to creep down to a pain in the leg as well. Not fun. Many runners get this from the repetitive nature of the running movement, and some things folks do to shorten this on a regular basis create difficulty while running. Something to be aware of if you are experiencing piriformis syndrome type of pain, is how you are sitting, standing and sleeping.

Typically when piriformis syndrome kicks up, it's because the muscle gets shortened due to leg stay in a position for a long period of time, day-in and day-out, your body starts to hold the pattern. So, if you stand with your foot rotated out to the side, that would be something to work on. Try to be aware of your standing position, and bring your feet to parallel, or a neutral position when you think of it.

The piriformis is located just 'north' of the insertion of the muscles of the hamstrings at the 'sit bones'. *Sometimes*, when the hamstrings are really tight, it can feel like it's in your 'cheek'. When the hamstrings are involved, the stretch to the right can help, and you can see a bit more information about chronic hamstring tension patterns on the tight hamstring page.

If you sleep with your knee of that leg kicked out to the side (we call it the figure four position) then you need to tuck those legs in to keep them closer together to keep that muscle from shortening all night long. The position which can exacerbate the shortening of the piriformis muslce, sometimes causing piriformis syndrome pain is the belly sleeping position with one leg out, or the knee pulled up toward your armpit, so that the inside of the leg is contacting the bed.

Last, but not least, if you have piriformis syndrome, don't sit with your legs crossed, which is soooo hard to do, if it is a regular habit. If you become aware of it, and at least move your legs to neutral every time you realize you are sitting with crossed legs, that will help a lot.

Now for the tool you can use at home. We steal the tennis ball from the pooch and sit on the floor with it under that tight muscle in the's kinda ouchy when siting on it...if it's way too much, try it on the bed. Usually it will help to soften it a little after a couple of minutes.

Massage with the right therapist can help A LOT with the pain associated with piriformis, keep that in mind when you get tired of that pain in the butt.

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