Issue link: https://www.massageandbodyworkdigital.com/i/1476304
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 57 Piriformis: Stabilizer of the sacroiliac joint and possible cause of sciatica. Posterior views. a b 1 1. PIRIFORMIS Let's start with one of the perennial favorites, the piriformis. What makes the piriformis cool? To begin, the piriformis is the only member of the deep lateral rotator muscle group (along with the superior and inferior gemellus, the obturator internus and externus, and the quadratus femoris) that also crosses the sacroiliac joint (SIJ), and therefore plays a role in SIJ function and dysfunction. In fact, it is often stated that the piriformis is the only muscle that directly crosses the SIJ. This is technically not true because the coccygeus and the superior deeper fi bers of the gluteus maximus also cross the SIJ. But the piriformis is likely the most important of these muscles, and it is incredibly important for stabilization of the SIJ. As a result, the piriformis is often overused and tight when there is SIJ dysfunction; and similarly, when the piriformis becomes tight, it can then lead to hypomobility dysfunction of the SIJ. The piriformis has another feature that makes it stand out. The sciatic nerve emerges from the internal pelvis through the greater sciatic foramen between the piriformis and superior gemellus into the gluteal region. However, there is a common anomaly in which all, or part, of the sciatic nerve (usually the common fi bular nerve portion) emerges either through the belly of the piriformis or superior to the piriformis. The common narrative is that this anomaly can lead to compression of the sciatic nerve, causing sciatica, mimicking sciatic nerve compression by a pathologic disc. However, it would seem likely that a tight piriformis could cause sciatic nerve compression, regardless of whether there is a normal presentation of the nerve or the anomalous presentation. Gluteus maximus Piriformis Superior gemellus Quadratus femoris Sciatic nerve Piriformis Superior gemellus Gluteus medius