Piriformis, junction of the middle and lateral thirds of the piriformis line
- TrP1 (Travell & Simons, vol. 2, ch. 10 — piriforme)
Record status
Documentary views
The muscle and the place
Piriformis, junction of the middle and lateral thirds of the piriformis line
What the finger seeks
The authors place the point, for injection, with the person lying on the sound side, the upper thigh flexed to about ninety degrees; the palpation is flat, through the gluteus maximus, along the piriformis line, just outside the junction of its middle and lateral thirds.
The band is sought by flat palpation, through the thickness of the overlying gluteus maximus, following the piriformis line (the line running from the top of the greater trochanter to the upper border of the greater sciatic foramen, where the free border of the sacrum meets the ilium); the pressure sometimes needs to be fairly vigorous to get through the gluteus maximus.
Sources
- travell-tpm-2 · vol. 2, ch. 10 — p. 206 (X latéral, TrP1), p. 216-217 (jonction des tiers, palpation à travers le grand glutéal), p. 225 (position, cuisse fléchie à 90°), p. 216 (cas de reproduction exacte)
- baldry-tp-acupuncture · p. 301 — sensibilité provoquée par pression profonde sur la partie latérale du muscle à travers les muscles glutéaux sus-jacents
What pressure brings out
A published case reports that a trigger point in the left piriformis reproduced the pain exactly; the source specifies neither the manoeuvre used nor which of the two points was tested.
The pain gathers at the sacroiliac region, over the whole buttock, and over the hip region at the back.
It sometimes reaches the proximal two-thirds of the back of the thigh and continues, according to the authors, down the back of the leg in the territory of the sciatic nerve; the groin, the greater trochanter and the coccyx are also noted here and there in the sources.
Sources
- travell-tpm-2 · p. 204-205 — patron principal, extension proximale de la cuisse, notes sur l’aine, le trochanter et le coccyx
- baldry-tp-acupuncture · p. 299 — fesse, hanche, arrière de la jambe dans la distribution du nerf sciatique
The technique
Invasive technique not publishable: the structured contract is incomplete.
Caution
This lateral spot has no published depth figure: the authors choose the needle length by the patient's build rather than a measurement to a landmark, and they state themselves that this area stays away from any major nerve trunk — so there is no critical structure to set against it here.
Convergence
This section requires a distance explicitly referencing this geometrically placed locus. A distance to its carrying muscle is never assigned to it.
no convergence calculated for this place