
What is Piriformis Syndrome?
Have you ever had pain starting deep in your butt and/or hip that travels down the back of your leg?
This can be due to the piriformis muscle compressing the sciatic nerve, referred to as piriformis syndrome. [1]
Piriformis syndrome may constitute up to 5% of cases of low back, buttock, and leg pain. [1]
The piriformis muscle is one of the deep hip muscle. It’s located deep in the buttocks area. It is responsible for external rotation, abduction, and extension of the hip joint, but it acts primarily as a hip joint stabilizer. [2]
The sciatic nerve runs right under the piriformis muscle in most individuals, See image below:
Now that you understand how close these two structures are to one another, it’s easy to see why an overly tight or swollen piriformis muscle can press (impinge) on the sciatic nerve and cause pain. [2]
Symptoms of Piriformis Syndrome
Piriformis syndrome has typically been characterized by the following symptoms: [2][3]
• Sciatica – Irritation/Impingement of the sciatic nerve
• Pain tingling, or numbness into the buttocks.
• Pain that travels down the leg, usually the back of the leg
• Pain that worsens after sitting for a long time
• Pain after climbing stairs, walking, squatting, or running.
Main Causes of Piriformis Syndrome
• Overuse of piriformis muscle which causes it to tighten, spasm.[7]
• Weakness of Piriformis muscle and other butt muscles. [3][6]
How About Piriformis Syndrome Treatment?
The methodology outlined below will first focus on relieving some of the immediate piriformis muscle tension with Self-Massage and Stretching. Then, we also included 2 Strengthening exercises (last 2) to help you stabilize your hip and butt area. [1][5]
* Note: If any of the following techniques increase symptoms down your leg, stop, and get a proper evaluation by a trained professional to rule out underlying issues.
First, Start With Self Massage (SMR):
Before doing any stretches you should try to release this muscle with massage. We’ll use a foam roller and massage ball for this.
1. Foam Roll The Muscle
This helps release the piriformis muscle and take pressure off of the nerve.
How to do it:
– Start by sitting on a foam roll.
– Cross your affected leg on top of your other knee as shown.
– Lean slightly towards your affected side and find a tight spot.
– Hold 30-30 seconds on the tight spot.
– Find another tight spot in the same are and repeat.
2. Self Massage It Using Massage Ball
Using a massage Ball you can trigger the muscle even more precisely. Be careful when applying pressure to not overdo it.
How to do it:
– Begin in a seated position on the ground with your knees bent.
– Position a massage ball under your right buttock (affected area) and rest your hands on the ground behind your back.
– Cross the other leg (left) on top of the right leg.
– Find a tight spot and hold it for 30-60 seconds.
– Move on to the next tight spot.
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Next, Piriformis Muscle Stretches:
1. Standing Piriformis Stretch
This helps by putting the piriformis in a nice stretched position. This stretch not only relieves piriformis muscle tension, but also may take stress of the sciatic nerve as well.
How to do it:
• Place your leg on top of a table top as shown.
• If a stretch in your buttock is not felt you can lean forward to increase the stretch.
• Hold 30-60 seconds and do about 2 sets on the affected leg/s.
3. Supine Hip/Piriformis Stretch
It stretches the piriformis muscle as well as other muscles in the region which helps take tension off of the sciatic nerve.
How to do it:
• Lie on your back as shown.
• Cross one foot over the opposite knee and keep your foot on the floor/mat.
• Pull the knee with the opposite hand toward the opposite shoulder.
• Hold 20-30 seconds. Repeat 2-3 times per side.
3. Pigeon Pose
Another way to stretch your hips and this buttocks.
How to do it:
• Position one leg in front of the other (Affected leg in front).
• Bring the outer thigh of front leg down to the floor (as much as you can).
• If you need to make this stretch deeper, simply lean forward a little.
• Hold 20-30 seconds. Repeat 2-3 times per affected side.
4. Glute bridge
This exercise helps to strengthen both your core, gluteal and back muscles.
How to do it:
Begin lying on your back on the floor with your knees bent and feet positioned flat on the floor with your arms positioned beside your torso.
– Brace your core and squeeze your butt before any movement.
– While bracing, lift your butt off the floor, and continue squeezing your butt.
– Hold this position for 5 seconds and return slowly to the starting position.
– Aim for 10 repetitions.
**Don’t hyperextend during this movement, you should feel your glutes firing.
5. Side Leg Raises (Abduction)
This will help to strengthen the Gluteus Medius muscle which is an important hip stabilizer.
By strengthening the muscles of the hip and butt – we are able to stabilize the body better and reduce our risk of developing injuries and allow our bodies to move the active way they were intended to without pain.
How to do it:
• While lying on your side, slowly raise up your top leg to the side.
• Keep the knee straight (leg going up) and maintain your toes pointed forward the entire time.
• Keep your leg in-line with your body.
• Aim for 10 repetitions.
* The bottom leg can be bent to stabilize your body.
Check out this video to learn more about the Piriformis Syndrome & Releases For it:
Learn More
Related:
Sciatica Exercises
Si Joint Exercises
Pulled Muscle in low back treatment
How To Do Self Massage
Written by Leon Turetsky, Dr. Brandon Smith, Dr. Amanda Anderson
Sources:[1] Frank RM, Slabaugh MA, Grumet RC, Virkus WW, Bush-Joseph CA, Nho SJ. Posterior Hip Pain in an Athletic Population: Differential Diagnosis and Treatment Options. Sports Health. 2010;2(3):237-246.
[2] Hopayian K, Song F, Riera R, Sambandan S. The clinical features of the piriformis syndrome: a systematic review. European Spine Journal. 2010;19(12):2095-2109.
[3] Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an Individual With Piriformis Syndrome Focusing on Hip Muscle Strengthening and Movement Reeducation: A Case Report. JOSPT Feb 2010;40(2):103-111.
Corrective Exercise Specialist (NASM-CES), Certified Personal Trainer (NASM-CPT), Professional Dancer
As a long time back sufferer Leon found unique methods to alleviate his pain using natural methods including self massage, exercise/stretching and postural habits. He founded Backintelligence.com to empower others to fix their postures and ease their back pain from home.