Recently, one of my students asked me to write about working with the piriformis. She had several clients experiencing piriformis syndrome and was getting frustrated with inconsistent results.

Piriformis syndrome—sometimes called piriformis dysfunction—goes by many names and is often misunderstood. I want to bring more clarity to this topic and share a broader, more effective way of looking at it.

If you’ve ever experienced it yourself, or if you treat clients with piriformis syndrome or sciatica, you know how intense it can be. It’s deeply painful and often creates wide-ranging referred pain. That’s why understanding this muscle in isolation isn’t enough—we need to see the full ecosystem.

Let’s start with the role of the piriformis then we’ll go around the corner to the psoas:

Piriformis acts as an external rotator of the hip and, in certain positions, becomes an internal rotator. It is extremely sensitive to anything happening around the sacroiliac (SI) joint because it attaches ...