Piriformis Test: How to Check for Piriformis Syndrome

The Piriformis Test is a special test for the hip used by physiotherapists to assess for tightness in the piriformis muscle. A tight piriformis can compress the sciatic nerve and cause Piriformis Syndrome.

1. Purpose

The primary purpose is to **test for** tightness of the Piriformis muscle. A tight piriformis can be a source of posterior hip pain or, more notably, can compress the sciatic nerve, leading to "Piriformis Syndrome" (a form of sciatica).

2. How to Perform

1. The patient is positioned in sidelying, with the test leg on top and the bottom leg straight or slightly flexed for stability.
2. The examiner instructs the patient to flex the top hip to approximately 60 degrees and the knee to 90 degrees, then rest their foot on the table in front of their bottom leg.
3. The examiner stabilizes the pelvis with one hand.
4. With the other hand, the examiner applies a gentle, steady downward (adduction) force to the top of the patient's knee, pushing it toward the table.
5. (An alternative method in supine is the FABER test, which also stresses the piriformis).

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating tightness or nerve irritation) is one or both of the following:

• Reproduction of the patient's familiar, deep pain in the buttock, which may or may not radiate down the back of the leg (sciatica).
• The knee feels very tight and restricted compared to the uninjured side.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of pain and a comparable range of adduction to the uninjured side.