During a single mile of endurance running, your feet hit the ground about 1,000 times, at a force of three to six times your body weight. Each time your foot hits the ground, there is a complex motion involving the entire leg; this requires good range of motion --- mobility --- and the ability to control that motion --- stability. When your body can't provide that mobility and stability, the piriformis --- a muscle of the hip --- comes under excess strain, which can be a factor in a running-related injury. The proper exercises can improve the function of the piriformis and make it less prone to injury.
Basics of the Piriformis
The piriformis muscle connects to the top of the thigh bone --- the femur --- and to the front surface of the sacrum --- the lowest part of the spine. The piriformis has an intimate relationship with a number of nerves, including the sciatic nerve, which feeds many of the muscles of the lower extremity. In running, the piriformis serves to control the rotation of the femur and pelvis that occurs each time your foot hits the ground. Excessive pronation strains the piriformis continuously; the piriformis may become very stiff and short, and impinge upon the nerves causing sciatica-type symptoms and even lower-back pain, explains Dr. Karim Khan, author of "Clinical Sports Medicine."
Improve Tissue Quality
Improving tissue quality of an overused piriformis muscle is the first step in improving function, Khan writes. In lieu of work with a qualified therapist, you can work on the muscle yourself with a small, firm ball, like a tennis or lacrosse ball. Sit on the floor, lean to one direction, place the ball at the level of your back pocket, then sit on it. Cross the same-side leg over your opposite knee and make small, 1-inch-diameter circles around the area of your back pocket. You may find areas that are very tender. In this case, you can stop and rest on the sore spots for up to 20 seconds at a time, provided the pain does not exceed 7 on a scale of 1 to 10.
Improve Joint Mobility
Improving the mobility of all lower-extremity joints --- including the big toe, ankle and hip --- is key to taking a load off the piriformis during running. Many who pronate excessively have flat feet and poor ankle mobility, which makes the pattern worse. Tackle this issue using the wall ankle mobilization. Stand facing a wall, with one foot 2 inches from the wall and the other resting behind it. Keep your heel down and rock your knee outside of your little toe toward the wall, hold for one second and repeat up to 15 times. Repeat on the other leg. Perform up to three sets before running.
Improve Foot Stability
Improving the function of the little muscles of the feet can reduce pronation and may reduce strain on the piriformis during running, physical therapist and biomechanist Bahram Jam explains. Try the single-arm cable row in short-foot posture. Stand facing a cable column holding a handle in one hand. Lift your toes to your shins and create an arch in both of your feet. Maintain the arch, and place your toes back on the floor. Perform a set of 10 rows and repeat on the other side. Do up to four sets.
Warning
As with all injuries, consult your doctor or a qualified manual therapist before beginning any form of injury-rehabilitation program.
References
- "Clinical Sports Medicine"; Peter Brukner, M.D., and Karim Khan, M.D.; 2005
- "Clinical Application of Neuromuscular Techniques: Vol 1"; Leon Chaitow, D.O., N.D., and Judith DeLany, L.M.T.; 2000
- "Evaluation and Retraining of the Intrinsic Foot Muscles for Pain Syndromes Related to Abnormal Control of Pronation"; Bahram Jam; 2008
