Piriformis involvement in dancers with low back pain — a conservative approach

Issue title: Current Concepts in Dance Medicine

Guest editors: Marika MolnarGuest Editor

Article type: Research Article

Authors: DeMann Jr., Lawrence E.

Affiliations: Manhattan Chiropractic Center, 300 East 56th Street, New York, NY 10022, USA

Abstract: Low back pain is a rather common problem for the dancer, it can account for as much as 25% of all dance injuries. Within dance, injury to the piriformis muscle can be either due to a single traumatic incident or more commonly from overuse factors involved from repetitive micro trauma. The piriformis is of clinical importance in classical dance as regards to both low back and leg pain because of its close relationship anatomically to the sciatic nerve and biomechanically because it is the primary muscle responsible for external rotation of the leg, the turnout in dance. Symptoms arising from an involvement of the piriformis muscle syndrome are often muddled and often mimic other causes of mechanical low back pain. The dancer can either be affected acutely or chronically. It can present itself as either low back pain, buttock pain or leg pain, or any combination of these. Specific considerations may contribute to this syndrome (a) myofascial pain referred from trigger points in the piriformis muscle; (b) nerve and vascular entrapment by the piriformis muscle at the greater sciatic foramen; and (c) dysfunction of the SI joint. Diagnosis is based on evaluating both the static and kinetic functions of the low back and pelvis as well as the biomechanics specific to dance. The therapeutic aim of conservative treatment of the piriformis syndrome in dancers is aimed at relieving pain, reducing the hypertonicity of the piriformis muscle, restoring the biomechanics of the SI joint and lumbar spine, and having the dancer return to dance with little or no down time. A comprehensive protocol for the conservative treatment of the piriformis syndrome is outlined and presented.

Keywords: Piriformis and lowback pain, Piriformis syndrome, Dancing, Treatment piriformis

DOI: 10.3233/BMR-1995-5309

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 5, no. 3, pp. 247-257, 1995