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Piriformis Syndrome and Piriformis Stretches

Piriformis Syndrome and Piriformis Stretches

piriformis syndrome

Discover treatment and prevention ideas for pirifomis syndrome, plus learn a few effective piriformis muscle stretches to help you have success into the future.

What is Piriformis Syndrome?

Piriformis syndrome is a condition where the piriformis muscle tightens up or spasms, and irritates the big sciatic nerve as it travels through the hip. This induces an ache into the buttocks region and may also result in referred pain in the low back or upper leg. People often experience an ache deep within the hip and buttocks, and for this reason, piriformis syndrome has also been referred to as “Deep Buttock” disorder.

If you experience piriformis syndrome or are looking to stop its occurrence, then you will benefit from the information in this article. Furthermore, adding a few easy stretches to your health and fitness program will certainly help you have success in the future.

Makeup of the Piriformis Muscle

Piriformis Syndrome

The piriformis is a small muscular tissue deep within the hip and buttocks region. It originates at the sacrum (wedge shape muscle at the base of the spine) and attaches to the top of the femur (thigh bone), helping you rotate your hip externally (away from the body).

Piriformis Muscle picture taken from Principles of Anatomy and Physiology 12th edition.

As you can see from the diagram above, there are several muscles and ligaments that comprise the hip and butts region. The diagram provides the posterior (rear) view of the buttock. The piriformis is the horizontal muscle in the center of the picture running over the top part of the sciatic nerve shown in yellown.

What Causes Piriformis Syndrome?

Piriformis syndrome occurs when the piriformis muscle spasms or tightens and puts pressure onto the sciatic nerve. The 2 main causes of muscle spasms in the piriformis are 1. 0veruse trauma, and 2. Repetitive stress from improper biomechanics. (ie: if your car alignment is off, you are bound to wear down the tires).

Piriformis syndrome as a result of overuse trauma is commonly associated with sports that require a lot of running, change of direction or jumping activities. However, piriformis syndrome is not just isolated to athletes. In reality, a huge proportion of reported piriformis syndrome happens in people who lead a sedentary lifestyle. The source of trauma or overload for these individuals may include:

  • Working out on tough surfaces, like concrete
  • Exercising/working on uneven ground
  • Starting a workout program after a period of inactivity
  • Increasing the duration or demand of a workout before the body is ready
  • Sitting for lengthy periods at work (truck driver, secretary)

Piriformis syndrome as a result of Repetive Stress from biomechanical inefficiencies: The major biomechanical ineffeciency contributing to piriformis syndrome are damaged foot and body mechanics, gait disruptions and inadequate posture or sitting habits. Various other sources can include spinal troubles like herniated discs and spinal stenosis. Various other biomechanical sources may include:

  • Poor working and walking mechanics
  • Tight, stiff muscles in the lower back, hips and butts
  • Running or walking with your consistently rotated outward

Signs of Piriformis Syndrome

A deep ache is the most common symptom related to piriformis syndrome. This deep ache usually occurs into the hip and buttocks area, but can also be experienced anywhere from the low back all the way to the lower leg.

Muscle weakness, muscle spasm, and general restriction of motion are other common symptoms that are associated with piriformis syndrome. In some cases, even tingling and numbness into the legs can be experienced as the muscle puts pressure onto the nerve for a prolonged period of time.

Piriformis Syndrome Treatment

Piriformis sydrome is a soft tissue trauma of the piriformis muscle and therefore ought to be addressed like any other muscular trauma. At the onset of symptoms, the principles captured in the acronym R.I.C.E.R. should be followed by the patient. R.I.C.E.R. stands for Rest, Ice, Compression, Elevation, and Referral to an appropriate expert for an precise diagnosis.

Typically R.I.C.E. should be followed for at least the first 48 to 72 hours. Doing this will help to control swelling and pain and give you greater potential for a quick and full recovery. If following the the first 48 to 72 hours your symptoms aren’t changing, or if your symptoms increase over that initial period of time you should seek medical advise.

The next phase of procedure (after the first 48 to 72 hrs) involves a lot of physical therapy strategies. The application of warmth and massage therapy is among the most efficient treatments for getting rid of damaged or injured cells in the area and speeding up the recuperation process of the muscles and tendons.

As soon as most of the pain has subsided, it is time to move into the rehabilitation stage of your treatment. The main purpose of this stage is to restore the strength, power, endurance and flexibility of the muscles and ligaments that have actually been effected by the injury. Returning gradually to normal activities and then progressing to more recreational activities as your symptoms allow.

Piriformis Syndrome Prevention

Prevention is the key when it comes to piriformis syndrome. It is always better to avoid symptoms before they occur. There are several prevention techniques that will help you avoid future injury. However, there are 4 preventative actions that I feel are worth your time an effort.

  1. Before any kind of activity make sure you completely heat up all the muscular tissues and tendons that will be utilized during your sport or task. Warming up will prepare your muscles and tendons for more aggressive activities. Without a proper warm up the muscular tissues and tendons can be tight. When tissues are tight it creates pressure on the vasculature and restricts blood circulation to the surrounding muscles, which leads to a decrease in oxygen and nutrients. The lack of proper oxygen and nutrients to the tissues can lead to muscle or ligament injury.
  2. Rest and recovery following activity is essential to keeping tissues healthy, specifically for athletes or people whose normal activities include strenuous physical activity. Be sure to let your muscles recover after heavy physical activity.
  3. Strengthening and conditioning the muscular tissues of the hips, buttocks and low back will certainly assist you in avoiding piriformis syndrome.
  4. Finally, (and most significantly) flexible muscles and ligaments are remarkably vital in preventing piriformis syndrome. When muscles and tendons are pliable and supple, they have the ability to move and complete specific tasks without being over stretched. However, if your muscles and tendons are tight and stiff, it is rather easy for those muscles and tendons to be pushed past their capacity and create stressed, strained, and pulled muscles.

To keep your piriformis and other hip musculature flexible and supple it is important to get into a consistent stretching routine. I’ve included 2 piriformis stretches to help you loosen up your hips and prevent injury:

Supine Piriformis Stretch

Supine Piriformis StretchSupine Piriformis Strethc

– Lie on your back with both knees bent to 90 degrees, feet flat on the floor. – Place one bent leg over the opposite leg with ankle placed on the mid thigh. – Using both hands, grab the ankle and the back of the knee of the crossed leg. – Gently pull the knee towards the opposite shoulder until you feel a stretch in the buttock of the elevated leg. – Hold for 30 seconds 2 times on both legs. – Relax and repeat.

Seated Foam Rolling of Hamstring and Piriformis Muscles

Hamstring Foam Rolling Hamstring Foam Rolling

– Place your foam roller on the floor and sit on the foam roller so that it spans across your hips with your hands behind you, holding you in the seated position. – With the back of one thigh over the foam roller and the other leg on the floor for support, roll along the back of your thigh, from your buttocks to the back of the knee. – Keep your abs tight and try and maintain good low back posture during the exercise. – Repeat for 3 mins on both legs holding it on spots that are more painful to get the best results.

To YOUR Success!

Piriformis Syndrome

P.S. Please share this post on Piriformis Syndrome and Piriformis Stretches with friends and family who may benefit from the information and please leave comments below if you benefit from these tips!

Recommendation for athletes and for people looking to take control of their health:

While the recommendations on this page are a good starting point, you’ll get a lot more benefit when you include a wider variety of exercises. So to improve your athletic ability, reduce injuries and really take advantage of all the stretching exercises on offer, grab a copy of the Ultimate Guide to Stretching & Flexibility (Handbook, DVD & CD-ROM).

In total, they include 135 clear photographs and 44 video demonstrations of unique stretching exercises for every major muscle group in your body. Plus, over 80 printable stretching routines for 22 sports and 19 different muscle groups.

The DVD also includes 3 customized stretching routines (8 minutes each) for the Upper Body; the Lower Body; and the Neck, Back & Core, plus a bonus CD-ROM that allows you to print out over 80 stretching routines that you can take with you where ever you go.

The Handbook and DVD will show you, step-by-step, how to perform each stretch correctly. Plus, you’ll also learn the 7 critical rules for safe stretching; the benefits of flexibility; and how to stretch properly. Check out the Ultimate Guide to Stretching & Flexibility for yourself for more snow skiing stretches along with stretches to help prevent other sports related injuries!

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4 Responses to Piriformis Syndrome and Piriformis Stretches

  1. Time for me to go stretch. Thanks for the info!

    • David Hawkins PT, CSCS at #

      Make sure you take in a few deep breaths as well!

  2. David,

    Thanks for this info. I frequently have a very sore lower right portion of my back. I typically feel it most in my hip. I am unsure EXACTLY the source of the pain, but it feels like it is my hip specifically in the area you are mentioning here (that I had never heard of by the way!). After visits with a chiropractor, I do also know that my hip likes to slide out of alignment, making one leg slightly shorter than the other, which is likely another reason I feel pain. I think mine stems from sitting all day and strenuous exercise. It always hurts worse after exercise and in the mornings when I wake up. I will be trying these stretches!

    • David Hawkins PT, CSCS at #

      Whitney – you may also try using a foam roller to work out some of the tightness and soreness. Good Luck!

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