Piriformis Pain with Cycling - what it is, why it happens, and what to do about it.
Do you get piriformis pain during or after cycling? There are several reasons why that may be happening. In this blog we’re going to cover:
· Exactly what the piriformis is
· Reasons why it may cause pain on the bike
· What you can do to fix it
What is the piriformis?
The piriformis is a muscle that connects from the sacrum to the greater trochanter on the femur. It externally rotates, abducts, and helps extend the hip. It also stabilizes the hip joint. (We’ll come back to why this is specifically important in a bit). Because of its insertion sites, it impacts pelvic floor muscles as well.
Why can it cause pain on the bike?
There are several reasons why you may experience piriformis pain with cycling. Let’s go through the main ones now:
1. One really important structure that runs directly under the piriformis in about 70% of people is the sciatic nerve. The sciatic nerve is a large nerve that innervates muscles and supplies sensation to different parts of the leg. Issues with it is often what causes pain that may be described as “sciatica”. If the piriformis muscle is tight, it can press on the sciatic nerve. Nerves do NOT like extra pressure on the, so this pressure from the piriformis can cause pain with cycling.
The piriformis muscle (faded orange) and how it crosses over the sciatic nerve (in yellow)
(Psst – I’ve written a couple blogs about sciatica and cycling. You can check them out here:)
2. The piriformis muscle is a hip rotator. However, cycling is a non-rotational sport. (we just pedal forward). Additionally, as we age, we rotate less. (We’re not playing on the playground or participating in sports like soccer or football). The body is a big “use it or lose it” enthusiast. If we don’t train those rotators, they get weaker. When the piriformis gets weaker, it has a hard time doing its jobs, one of which is stabilizing the hip. When a muscle can’t do its job appropriately, that often results in pain in the area of that muscle.
3. When a muscle isn’t being used all that often or is weak, it will often tighten up and stay tight. This can cause the above issue with sciatica. It can also pull on the pelvis, causing pain that radiates from the insertion of the piriformis on the sacrum.
What you can do to fix piriformis pain with cycling
1. First, you need to train the piriformis.
A great way to do that is with min-clamshells. If you’re familiar with clamshells, the way you’ve been doing them has most likely worked mostly the glutes. Check out the video below to find out how to specifically target the muscles underneath the glutes, like the piriformis, that stabilize the hip.
2. Coordinate those muscles.
No muscle in the body works in isolation. Therefore, once you’ve strengthen the hip stabilizers, you need to teach them how to work with the other muscles in the body. There are several ways to do that, but check out one of my favorites below;
3. Get a bike fit.
If your saddle is too high, your reach is too long, or your saddle is tipped too far up or down, it may result in piriformis pain with cycling. Make sure your bike fits your body as best it can so that it supports the right muscles to do the right jobs when you’re on the bike.
In the clinic, I see lots of cyclists with piriformis pain. I utilize the above strategies to help them get back to riding pain-free.
Several of the strategies and resources I use to help them are available to you, too. The first one is for my clients I actually don’t physically see in person.
That is:
The Virtual Bike Fit Rx, a virtual bike fit program that allows me to perform a comprehensive bike fit to any cyclist, anywhere.
The second is:
The Strength Revolution – a 12 week strength training program that helps cyclists coordinate and strengthen all of the muscles that need to be strong for them to perform and feel their best on the bike.
Additionally, I blog a LOT about issues my cyclists experience and how to address them. Check out some of my recommended reading below, and fix your pain while cycling now. Because life’s too short to be uncomfortable on the bike.
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