So your butt hurts and maybe it is even aching down your leg. It probably hurts to stand and lie down but most likely the worst position is sitting. You may be wondering if it is your butt causing your back to hurt or your back causing your butt to hurt. Honestly, it turns into a vicious cycle. It is hard to tell which one came first the chicken or the egg. I am going to do my best to make some sense of all this pain for you.
It is likely you heard of “Piriformis Syndrome” because if you went to your doctor and told him/her you have pain in your butt then you were probably informed that you have “Piriformis Syndrome”. You may be wondering exactly what that means. There is a very small muscle in your buttocks called the piriformis muscle.
If you look at the picture you can see that the Piriformis muscle is clearly labeled (it is the third name down on the right hand side). The piriformis muscle is the second layer of muscle and the Gluteus Maximus is the first layer of muscle. The second layer contains many small muscles as you can see in the picture and they are all primarily responsible for rotation of the hip joint.
In the case of “Piriformis Syndrome” the piriformis muscle is overly tight or in spasm. Typically this muscle is not going to spasm for no reason and there are a few reasons this could be happening. One obvious reason is maybe you had a fall and landed on your butt and traumatized the piriformis. In this case it is possible that there is scar tissue in the muscle from the trauma which causes it to spasm.
Another reason for the piriformis to spasm could be degeneration in the hip or damage to the hip joint itself. The damage in the joint causes the muscles attaching it to tighten up in attempts to protect the joint. It is unlikely in this case that ONLY the piriformis muscle would react; however, it is possible. I have worked with enough patients that very little surprises me these days.
The most likely reason for the piriformis to be in spasm is because of issues at the sacroiliac joint. If you look closely at the picture you will see that piriformis attaches right at the joint line between the sacrum (the triangle bone) and the ilium (the wing bone).
There is very subtle movement at the sacroiliac joint and I address that in chapter 2 of my book Free My Back. If the motion of the joint is off kilter then it can cause problems including spasms of the piriformis muscle. There is a technique that can be used to get the joint to move correctly again and step by step instructions are in chapter 4 of the same book Free My Back.
If you already have the book Free My Back then take a look at those two chapters and see what you can do for your butt pain. If you do not have the book then you can get free access to the E-Book version by clicking here.
There is ONE more reason that your piriformis muscle could be acting up on you and I have NOT covered this in the book. You may find this offensive when I tell you; I know I did when it was explained to me. Despite the fact that you may be very physically active and strong from exercise and working out; you may have a muscle that is not working properly. That muscle is the hip flexor muscle.
As you can see this muscle attaches to several segments of the spine and can easily be linked to back pain problems. This muscle flexes your hip and brings your knee towards your chest and it also stabilizes your posture and assists with walking. For some reason (I still do not fully understand why) this muscle can get deactivated and not contract properly.
This problem with the hip flexor muscle happened to me, even when I was working out at the gym and able to lift over 200 lbs. I did not have any pain or problem with my hip flexor; however, my piriformis went haywire and hurt like crazy. It turns out, when the hip flexor is deactivated, the piriformis muscle tries to pick up the slack and do a job it was not designed for. Though that is very helpful of the piriformis to try and kick in and help out, it only ends up getting overworked and tightens itself up into a spasm.
Now there is a fairly simple exercise you can do to get the hip flexor muscle to activate. This is similar to the warrior pose in Yoga; however, to explain it would take too many words and likely it would not be understood. In this case, a video is worth a thousand words and I will be honest and say I have not created that video yet. I promise you, it is on my “TO DO” list. I cannot tell you when I will get to creating that video (yes… I tend to procrastinate on videos because well… I just do). However, what I can do right now for you is a 30 minute one on one consult to explain this exercise OR we can do a video chat session, your choice. Register for a time to chat with me by clicking here.
I look forward to being a part of your success story in resolving your chronic pain.