Prevalence and Clinical Patterns of Piriformis Syndrome Among Actively Competing and Retired Elite Hockey Players

Piriformis syndrome, a neuromuscular disorder caused by sciatic nerve compression by the piriformis muscle, remains understudied in athletic populations despite anecdotal reports of elevated prevalence in hockey players. This study investigated the prevalence of piriformis syndrome symptoms and potential risk factors in actively competing (current) and retired (former) high-level hockey players. A cross-sectional survey was conducted among 67 actively competing and retired professional, collegiate, and junior hockey players (58 males, 9 females; mean age 25.6 ± 4.0 years; mean playing experience 17.8 ± 3.7 years). Active playing status was defined as currently participating in organized competitive hockey at any level, while retired status was defined as having ceased competitive participation for at least one season. The survey instrument was based on a validated clinical assessment scoring system, consisting of 12 questions assessing piriformis syndrome-related symptoms. Participants were classified as "high score" (≥6 affirmative responses) or "low score" (<6 responses). Multiple linear regression analysis was used to evaluate associations between demographic variables (age, playing status, years played, competitive level) and total symptom scores. Overall, 25.4% (n = 17) of participants met criteria for high symptom burden, with sitting-induced buttock pain being the most prevalent specific symptom (40.3%). Mean total score was 4.8 ± 1.8 (range 2-10). Multiple regression analysis revealed no statistically significant associations between piriformis syndrome scores and any demographic variable (overall model: R2 = 0.065, p = 0.374). Retired players showed a non-significant trend toward higher scores compared to actively competing players (β = -1.388, 95% CI: -2.793 to 0.018, p = 0.053). No correlations were observed with age (r = -0.045, p = 0.719), years played (r = -0.054, p = 0.666), or competitive level (p = 0.666). In conclusion, this study revealed substantial piriformis syndrome symptom burden (25.4%) in high-level hockey players without significant demographic associations.