If you’re sitting there, feeling the ache in your lower back or pelvis, wondering if your tight piriformis is the cause of your sacroiliac (SI) joint pain, you’re not alone.
This is a question many ask, especially those who move too much or sit too long.
Let’s break it down, simply and clearly, so you can understand the connection and what to do about it.
The Piriformis and the SI Joint: A Simple Explanation
The piriformis muscle is small but strong, deep in your buttock. It connects your sacrum to your thigh bone, helping you rotate your leg and keep your hip steady.
The SI joint is where your sacrum meets your pelvis. It’s built to take the weight of your body and transfer it to your legs.
These 2 are close, both in place and purpose. When the piriformis gets tight or knotted, it can pull on the sacrum, messing up the SI joint and causing pain.
How a Tight Piriformis Hurts the SI Joint
Here’s the straightforward truth:
Pulling and Tugging: A tight piriformis yanks the sacrum out of place, putting pressure on the SI joint.
Compensating: Other muscles and joints try to make up for the tightness, taking on up to 40% more workload. This leads to overuse and more pain.
Nerve Trouble: The piriformis sits near the sciatic nerve. If it’s tight, it can irritate the nerve, causing pain that spreads to your lower back, buttock, and leg—pain that feels like SI joint trouble.
Pelvic Tilt: A tight piriformis can tilt your pelvis, making one leg seem shorter than the other and stressing the SI joint even more.
The Body’s Compensation: No Injury Happens Alone
No injury is isolated. When your piriformis is tight, your body adapts to keep functioning, but these compensations can lead to other issues:
Reduced Mobility: The upper thoracic spine (T4) and the cervical spine (C2, occiput, and atlas) may lose their normal range of motion.
Pain Patterns: You might feel pain in your lower back and sacrum, or even develop headaches.
Systemic Effects: Gastrointestinal issues can arise as the body’s alignment and nerve function are disrupted.
These compensations are your body’s way of coping, but they can create a cascade of problems if not addressed.
Signs Your Piriformis Is the Issue
If you’re feeling these things, your piriformis might be to blame:
Pain in your buttock that gets worse when you sit or stand too long.
Trouble crossing your legs or turning your hip inward.
Pain that starts in your lower back and shoots down to your thigh or knee.
Stiffness or tightness in your buttock.
Pain that eases when you walk but comes back when you’re still.
A tight piriformis muscle can cause sacroiliac joint pain, but you can alleviate the discomfort by releasing myofascial trigger points in the piriformis.
Where are the piriformis trigger points located?
Follow the method shown in the video to locate the trigger points. Typically, massage therapists use their elbow to apply pressure while swinging your leg.
If I can’t find the trigger point, can I massage the entire piriformis muscle?
No, you cannot massage the entire piriformis muscle. You should only apply pressure to the two ends or adjacent areas of the piriformis. Do not apply pressure to the entire muscle at once.
You can use tools to help locate the piriformis trigger points.
Place The Hoop (M-mode) on the ground and sit on either side.
Align the device’s midline with your body’s midline, then lean back slightly.
The 2 modules will press on the piriformis trigger points in your buttocks. By shifting your weight side to side (changing your center of gravity), you can increase the pressure intensity.
Additionally, SI joint pain can be prevented through exercise. That method help release seven key muscles that may contribute to sacroiliac (SI) joint dysfunction.
Understand the connection, take care of your body, and you’ll feel better. If you’re still unsure, consult a professional. They’ll help you resolve the issue and get you back on your feet.
References:
Sacroiliac Joint Dysfunction and Piriformis Syndrome: The Complete Guide for Physical Therapists, by Paula Clayton
Sacroiliac Joint Dysfunction and Piriformis Syndrome, by Erika T. Yih, Danielle L. Sarno
