gluteal muscles may cause the syndrome to develop. A major cause
for inaction gluteals is overactive hip flexors. [Psoas Major,
Iliacus, and Rectus Femorus]
This imbalance occurs when the hip
flexors are trained and become too short and tight; as in when
someone sits with hips flexed all day at work. This deprives
the gluteals of activation and the hamstrings, adductors, and
piriformis muscles have to perform extra roles they were not
designed to do. The result is swelling of the piriformis that
produces sciatica symptoms.
Runners, cyclists, and athletes engaging in
forward-moving activity are susceptible to piriformis syndrome
if they do not engage in lateral stretching and strengthening
Weak outer thighs and hip muscles combined with tight inner
thigh muscles can cause the piriformis muscle to shorten and
Another cause for piriformis syndrome may be stiffness of
the sacroiliac joint. This changes the walking gait and can
result in sheering the origin of the piriformis causing malfunction
and low back pain.
Over pronation of the foot causes the knee to
turn medially causing the piriformis to activate the stop the
knee from over rotating, resulting in overuse of the piriformis
muscle, thus leading to piriformis syndrome.
Lastly, the most frequently associated cause is a falling