Piriformis syndrome is an all too common but often overlooked source of discomfort and pain in the lower back and buttocks.
It can arise from direct injury to the affected area or, similar to many running-related injuries, when your training volume surpasses your body’s capacity, resulting in overuse.
If ignored, it can lead to symptoms like pain, tingling, or numbness in the buttocks and down the leg.
Fortunately, a combination of strength exercises and stretches can help alleviate the discomfort associated with piriformis syndrome.
In this article, we will look at the following:
- Why Piriformis Syndrome Exercises Play A Role In Recovery
- 5 Stretches For Piriformis Syndrome
- 5 Strength Exercises For Piriformis Syndrome
Let’s get to it!
Why Piriformis Syndrome Exercises Play A role in the recovery
Understanding the root causes of Piriformis Syndrome is important for appreciating the essential role that exercises play in the road to recovery.
Although there’s no universally accepted definition for this condition, it is generally understood that Piriformis Syndrome primarily stems from the sustained pressure exerted on the sciatic nerve by the piriformis muscle in the hip.
Here are the three most common causes of piriformis syndrome:
#1: Muscle Trauma
In more than 50% of Piriformis Syndrome cases, the trigger is muscle trauma, often resulting from direct impact to the piriformis area.This can occur during various activities, such as a seemingly innocuous fall while running on a trail. Even minor incidents can lead to inflammation of soft tissues, muscle spasms, or a combination of both, ultimately causing nerve compression.
One of the most prevalent risk factors, especially among runners, is overuse. This often occurs when individuals rapidly increase their training volume without allowing their bodies sufficient time to recover and repair.
Overuse will end up placing excessive stress on the piriformis muscle, gradually increasing tension and inflammation within it and potentially resulting in nerve compression.
Whether you’re new to running or an experienced athlete, it’s crucial to monitor your training load for sudden inconsistencies or spikes.
Another form of overuse can be attributed to prolonged sitting. Spending prolonged hours sitting on a firm surface can aggravate the sciatic nerve, compounding the risk of Piriformis Syndrome.
#3: Muscle Weakness
Closely intertwined with overuse is the issue of muscle weakness. When the piriformis and glute muscles are inherently weak, sudden increases in training volume or intensity can exacerbate the problem.
Core and glute muscles play a pivotal role in stabilizing the hips, pelvis, and lumbar spine. If these muscles lack strength, the piriformis muscle must compensate, potentially leading to strain and nerve compression.
In summary, understanding the three primary causes of Piriformis Syndrome—muscle trauma, overuse, and muscle weakness—can guide preventive measures and tailored rehabilitation strategies for those grappling with this condition.
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5 Stretches For Piriformis Syndrome
By incorporating stretches into your routine, you can target the various causes of piriformis syndrome that we spoke about above, including muscle weakness, overuse, and trauma.
Remember to consult with a healthcare professional or fitness expert before starting any new exercise regimen, especially if you have a preexisting condition.
They can provide personalized guidance to ensure that your exercises are safe and effective for your specific needs.
Here, we’ll provide you with five effective stretches along with instructions on how to perform them:
#1: Piriformis Stretch:
- Begin by sitting on the floor with one leg extended straight and the affected leg bent, crossing it over the opposite side of the straight leg.
- Gently guide your bent knee toward your chest using your hands or a strap until you feel a gentle, but not painful, stretch in your buttocks.
- Keep your back straight and chest lifted during the stretch.
- Hold this position for 20-30 seconds, taking slow, deep breaths, and then repeat the stretch on the other side.
If you want to deepen the stretch, gently press your bent knee outwards with your elbow while keeping your chest lifted.
#2: Seated Forward Bend:
- Sit with your legs extended in front of you.
- As you hinge at your hips, reach forward toward your toes while keeping your back straight. Only go as far as it feels comfortable to do so.
- Aim to feel the stretch primarily in your hamstrings and lower back.
- Hold this position for 20-30 seconds, ensuring your neck and shoulders remain relaxed.
Focus on maintaining a straight back and hinging at your hips; visualize reaching your chest forward towards your toes.
If you want to make it harder, place a yoga block or a rolled-up towel under your feet to elevate them slightly, intensifying the hamstring and lower back stretch.
#3: Child’s Pose:
- Start on your hands and knees, then gradually shift your weight back onto your heels.
- Extend your arms forward and lower your chest towards the floor while keeping your buttocks close to your heels.
- Feel the gentle stretch in your lower back, buttocks, and hips.
- Hold this soothing position for 20-30 seconds, focusing on deep, calming breaths.
There is an option to add a gentle side stretch by walking your hands to one side while keeping your hips in place. Hold for 15-20 seconds, then switch to the other side.
#4: Hip Flexor Stretch:
- Begin by kneeling on one knee with the other foot in front, forming a 90-degree angle.
- Tilt your pelvis backward slightly and gently push your hips forward until you feel a stretch in the front of your hip.
- Maintain an upright posture and engage your core.
- Hold this stretch for 20-30 seconds, ensuring you feel a comfortable pull, and then switch to the other side.
For a slightly deeper stretch, incorporate a gentle torso twist away from the front leg.
#5: Pigeon Pose:
- Begin in a tabletop position, with your hands under your shoulders and knees under your hips.
- Lift your right leg and slide your right knee forward, placing it behind your right wrist. Your right ankle should be behind your left wrist.
- Extend your left leg straight back behind you, keeping your toes pointed.
- Flex your right foot to protect your knee.
- You can adjust the angle of your right shin and the distance between your right foot and left hip to find a comfortable stretch.
- Stay relaxed in your upper body, and place your hands on the floor in front of you.
- Hold this position for 20-30 seconds while taking slow, deep breaths.
Focus on feeling the stretch in your right buttock and hip. This pose helps to open up the hips and relieve tension in the piriformis muscle.
5 Strength Exercises For Piriformis Syndrome
By incorporating strength exercises into your recovery, you can target the various causes of piriformis syndrome that we spoke about above, including muscle weakness, overuse, and trauma.
Building your strength is key to improving your resilience and reducing the chances of recurring injuries.
This is a gradual journey. Each week, you’ll progressively increase the level of load to the injured area. Take your time; what might be manageable in week four would probably be overwhelming in week one.
If any of the exercises cause intense pain, stop, try to make the exercise easier, and try again.
Are there any piriformis syndrome exercises to avoid? The answer to this question isn’t straightforward. If an exercise causes you excessive pain, stop. That would be one of the piriformis syndrome exercises to avoid.
Rehab isn’t the same for everyone; individuals with Piriformis Syndrome can have varying levels of tolerance, so it’s essential to listen to your body.
Here, we’ll provide you with five effective strengthening exercises along with instructions on how to perform them:
- Lie on your back with your knees bent and feet flat on the floor.
- Lift your hips off the ground while squeezing your glutes, focusing on lifting your pelvis as high as comfortably possible.
- Hold the lifted position for a few seconds, ensuring you maintain a straight line from your shoulders to your knees.
- Lower your hips back down gradually.
- Complete 3 sets of 10-20 repetitions to build hip strength and stability.
If you want to make it harder, try performing single-leg bridges by extending one leg straight in the air while keeping the other foot on the ground.
- Lie on your side with your knees bent at a 90-degree angle and your feet together.
- Keeping your feet touching, open your top knee as far as you comfortably can without moving your pelvis.
- Return your top knee to the starting position.
- Perform 3 sets of 10-15 repetitions on each side to strengthen your hip abductors.
If you want to make it harder, place a resistance band around your knees to add resistance and intensify the activation of your hip abductors.
- Begin on your hands and knees in a tabletop position, ensuring your wrists are aligned under your shoulders and your knees under your hips.
- Extend your right arm forward and your left leg backward while maintaining a flat back.
- Hold this position for a few seconds, focusing on balance and stability.
- Slowly return to the starting position by bringing your arm and leg back down.
- Perform 3 sets of 10-12 repetitions on each side to enhance core and hip stability.
- Stand with your feet shoulder-width apart and your toes pointing slightly outward.
- Initiate the squat by bending your knees and hips simultaneously, pushing your hips back, and keeping your back straight.
- Lower your body until your thighs are parallel to the ground or as far as your comfort allows.
- Push through your heels to return to the initial standing position.
- Perform 3 sets of 10-15 repetitions to improve lower body strength and hip stability.
If you want to make it harder, try holding a dumbbell or kettlebell close to your chest while performing the squat.
- Begin by positioning your body on the floor by placing your elbows directly under your shoulders.
- Rest your forearms flat on the ground.
- Support your body with your toes, ensuring a straight line from head to heels.
- Squeeze your glutes as firmly as possible.
- Keep your hips aligned with the rest of your body.
- Maintain a neutral spine by looking down.
- Start with a 30-second hold and gradually work your way up to 60 seconds as your strength improves.
Piriformis Syndrome is often caused by muscle trauma, overuse, or weakness, leading to discomfort and pain.
Combining stretches and strength exercises is a crucial step to alleviate symptoms and prevent recurrence. Progress will be gradual, and personalized guidance is recommended for safe and effective recovery.
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