All about the pyramidal syndrome

It is a fairly common injury in runners and triathletes that affects the gluteal area

Surely more than once we will have heard within the sports world, that an athlete can have strong discomfort or overload in the gluteal area.

We may not know that this symptom can lead to greater consequences causing what is known as pyramidal syndrome.

But do we really know what the injury is caused by and the causes of it?.

In this article our coloborador Healthing will try to clarify the main concepts in a brief and concise way.

What is it?

We thus refer to the symptomatic picture triggered by the contracture of the pyramidal muscle (also known as piriform) and the compression or irritation of the sciatic nerve that can lead.

Since the sciatic nerve passes through or under this muscle, the pyramidal spasm can compromise the nerve space and irritate it (Image 1).

The athlete may suffer pain in the middle area of ​​one of the buttocks It can extend along the leg even be accompanied by weakness, numbness or tingling, if you continue with your sports practice routinely.

this pathology It is also known as pseudocytic or false sciatica, so that it is important to make a good diagnosis differential.

In addition, in those athletes with a high physical requirement it can be related to a simple muscular overload, not knowing the nervous consequences that can bring and consequently the suspension of their sport practice.

Sciatic nerve entrapment caused by the left pyramidal muscle

1 image: Sciatic nerve entrapment caused by the left pyramidal muscle.

Anatomy - Pyramidal muscle

The pyramidal runs from the antero-lateral aspect of the sacrum, inserting into the greater trochanter of the femur.

This muscle is characterized by its triangular and flattened shape and has a very close relationship with the sciatic nerve as we have commented previously.

Its main function is: perform extension movements, external rotation and hip abduction.

What is the origin of pyramidal syndrome?

Multifactorial: overtraining, muscle shortening (especially the pyramidal and adjacent muscles) as well as spinal problems, especially in the lumbosacral area, are the main causes of this pathology since they lead to altered biomechanics and poor tissue quality.

In addition some visceral alterations can also trigger this syndrome.

How do we treat it?

In the early stages, we use conservative techniques such as manual therapy and osteopathic techniques.

If the lesion is very acute and disabling we can use the latest technologies we have, especially highlighting the superpulsed high energy laser, application of diathermy and invasive techniques such as neuromodulation, PID or dry puncture in the musculature to be treated.

Application of diathermy in the lumbo-sacral area

 2 image: Application of diathermy in lumbo-sacral area

More information


Healthing, Calle Serrano, 61. 4th floor - 28006 (Madrid)

Telephone: + 34 91 426 29 24

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