The Core Mechanism
Tightness or overuse of the piriformis compressing the sciatic nerve, often from weak glutes, long sitting periods, and asymmetric loading.
The Real-World Triggers
Piriformis rarely has a single cause. In runners, these are the consistent contributors:
- Chronic sitting and weak glute med/max
- Sudden mileage or hill increase
- Running on cambered surfaces
- Asymmetric stride mechanics
- Tight hip rotators and weak abductors
Why Runners in Particular
Running concentrates repeated impact and load through the same tissues thousands of times per session. Piriformis develops when that load exceeds the tissue's adaptation rate — usually because training spiked, recovery dropped, or strength didn't keep up.
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