Have you had a dull ache in your butt for some time? There could be a reason. You may have piriformis syndrome. The piriformis muscle lies deep in the gluteus maximus. It is often a neglected stretching area in your body. Piriformis syndrome is a condition in which this tight muscle irritates the sciatic nerve causing pain (or a dull ache) in the buttocks and referring pain along the sciatic nerve.
This pain goes down the back of the thigh and/or into the lower back. Deep pain is often made worse by sitting, climbing or squatting.
Piriformis syndrome is often found in runners or athletes in sports that require running, change of direction and weight-bearing activities. Exercising on hard or uneven surfaces also cause problems.
Biomechanical problems such as poor running mechanics, tight muscles in the lower back, hips and buttocks and running with the toes pointed out also cause piriformis problems.
The glutes don't fire properly when the hip flexors (psoas, iliacus, tensor fascia latae, etc.) are overactive or tight. This can happen due to poor flexibility or prolonged sitting. When the hip flexors don't work properly, its antagonist (mainly the gluteus maximus) becomes weak.
This is known as reciprocal inhibition (when muscles on one side of a joint become tight or overactive, it shuts down the muscles on the other side of the joint). When a prime mover (such as the gluteus maximus) becomes weak, other muscles (synergists) take over the function that the prime mover should be doing.
In this case, the synergists would be the hamstrings. Some injuries that occur because of inactive glutes are piriformis syndrome, knee ACL tears and low back injuries.
Treatment of piriformis syndrome is treated like any other soft tissue injury:
1. begin with the R.I.C.E.R. principle the first 24-72 hours (Rest, Ice, Compression, Elevation, Referral to Doctor)
2. rest and recovery
3. strengthen and condition the muscles of the hips, buttocks and lower back
And, of course, a proper warm-up and stretching routine is always critical.
Stretch the piriformis muscle this way:
1. Lie back and cross legs with the involved leg on top