Piriformis syndrome relief with 6 physical therapy exercises

Piriformis syndrome causes

Your piriformis muscle runs from your sacrum to your hip. It’s a deep gluteal muscle. Your piriform muscle externally rotates your hip. It often runs over your sciatic nerve. With some people, however, your sciatic nerve runs through your piriformis muscle.

Overuse of your piriformis muscle causes piriformis syndrome. Overuse of your piriformis can come through climbing a lot of stairs or constant heavy lifting. Also, sitting on your wallet for a long time is a known cause of piriformis syndrome. It causes compression on the muscle causing tension in the muscle.

Another cause for piriformis syndrome is a tight or weak lower back op hip. Due to tightness or weakness, your piriformis muscle has to work harder when walking or lifting. That causes it to tighten, resulting in pain.

The last possible piriformis cause is pregnancy. When you’re pregnant, you produce hormones that loosen the ligaments in your body to prepare for birth. It changes the forces that work on your hip area, which can cause overuse of the piriformis if it’s not strong enough.

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Two main symptoms can point you towards piriformis syndrome. I’ll discuss both of them and explain why they appear.

The first and most pronounced symptom is pain in the buttocks. Excessive use of your piriformis muscle causes pain. Overuse of the muscle damages the tissue, making it stiffer.

When your piriformis muscle becomes stiffer, it pressurizes your sciatic nerve. This nerve passes under the piriformis muscle. The pressure irritates the sciatic nerve. This irritation causes radiating pain at the back of your leg. The pain can go through your leg to your calf muscle. It is the second sign through which you can recognize piriformis syndrome. Therefore it’s one of the causes of sciatica pain.

Also, piriformis syndrome reduces your ability to walk, sit for an extended period, and bend forward to pick something up.

You can do the following two tests to see if you have piriformis syndrome.

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When you stretch your piriformis muscle, you can also feel the tightness. In this example, I’m treating my left piriformis muscle:

• Grab your left knee with your left hand.
• Grab your left ankle with your right hand.
• Pull your left knee toward your right shoulder.
• Pull your left ankle also towards your right shoulder.

When you feel a difference in stiffness and pain between your left and right side, you have piriformis syndrome.

When they both feel the same, you don’t have piriformis syndrome. They are never both tight at the same time.

When the test is positive, you can do the second piriformis syndrome test to see if your sciatic nerve is also irritated.

There is a simple way to test this:

• Lay down flat on your back.
• Lift the leg on the painful side extended with your toes pointing towards you.

Here you should also feel a big difference between left and right. When you can lift your painful leg less high and when it causes a tingling sensation sooner then your healthy side the test is also positive.

It shows that not only your piriformis muscle is tight and irritated but that also the nerve is irritated.

To relieve your piriformis syndrome quickly, you’ll have to help your body repair the damage to your piriformis muscle.

First, you’ll need this piriformis cushion to reduce the pressure on your piriformis muscle when you’re sitting. That way, the muscle can repair itself without getting overused and injured again. The pressure reduction also results in immediate pain relief.

The second thing that will help you is to apply this anti-inflammatory cream. That also reduces pain and swelling and aids the repair process.

You’ll also have to stretch your piriformis muscle and sciatic nerve to reduce the pressure on the nerve and give it a chance to recover.

To make sure the overuse of the muscle doesn’t happen again, we’re also going to stretch and train your lower back and hip.

The first and most important exercise is the piriformis stretch. By stretching your piriformis muscles, it relaxes what improves blood flow. Blood is needed to repair the tissue.

Perform the exercise like this for your left side:

• Grab your left knee with your left hand.
• Grab your left ankle with your right hand.
• Pull your left knee toward your right shoulder.
• Pull your left ankle also towards your right shoulder.
• Hold this for 20 seconds and repeat it three times.

You can also watch this YouTube video to see how to perform the exercise correctly. Perform this exercise as often as you can during the day.

The other thing you can do to reduce the tension on your piriformis muscle is massaging the painful spot. When you do this, I would recommend this massage oil. It makes the tissue nice and warm, which will relieve your pain fast. It is also great for relieving other painful muscles. It’s the same oil I use.

The second exercise you’ll have to do is piriformis training. With this exercise, you’ll train all the muscles in your buttocks area.

Training your piriformis muscle is necessary because it’s often an overuse injury. You’re asking more from your piriformis muscle than it can deliver. When you don’t increase its performance level, the imbalance between what you ask and what your piriformis can provide remains. That’s why the pain will remain as well.

Perform the exercise like this:

• Lay down on your healthy side
• Extend your leg
• Pull your toes towards you
• Lift your leg
• Repeat this ten times
• Do this three times

You can also watch this Youtube video to see how to perform the exercise correctly. Training the muscle will restore the balance, which will lead to your recovery in the end.

When the exercise becomes too easy this way, you can also add some weight through these ankle weights.

By adding these weights, you can increase the strength of your piriformis muscle even further, thus achieving even better results.

You can choose between different weights based on your strength.

You can also use these weights for various other exercises.

The third piriformis syndrome exercise is the sciatic nerve stretch.

A protective layer covers your sciatic nerve. The nerve slides through this layer when you move your leg. It looks a little bit like an electrical wire.

When you have piriformis syndrome for a long time, the nerve gets stuck in the protective layer. Therefore it can no longer move properly. It results in a tingling sensation in your leg.

To resolve this feeling, you’ll have to stretch your sciatic nerve. The stretching releases the nerve from its protective layer, giving it more mobility.

The exercise also works well against sciatica pain.

Perform the exercise like this:

• Place your heel on a chair
• Extend your knee and pull your toes towards you
• Try to reach for your toes with your hand
• Hold this for 20 seconds
• Repeat this three times

You can also watch this Youtube video to see how to perform the exercise correctly.

Perform the exercise several times a day.

The purpose of the fourth exercise is to improve the mobility of your lower back. By making your back more flexible, the load on your gluteal muscles reduces, resulting in less overuse of the muscles.

This exercise is also good against lower back pain.

The exercise goes like this:

• Lie on your back
• Bend your knees and put your feet on the floor
• Put your arms sideways on the floor
• Rotate your knees to the side as far as possible and keep your shoulders on the floor
• Hold for 10 seconds and then turn the other way

You can also find the execution of the exercise in this video.

Repeat the exercise 10 times on each side and do this 3 times a day. You will notice that this makes your back more flexible.

The fifth exercise improves the stability of your lower back. The exercise trains the small back muscles to work better together and react faster.

Reduced lower back stability increases the load on your hips and gluteal muscles, including your piriformis. It can cause an overload of your piriformis muscle.

The exercise goes like this:

• Lie on your back with your legs bent
• Cross your arms on your chest
• Now lift your pelvis off the ground
• Hold this for 10 seconds
• Repeat 3 times

The exercise can also be seen in this video.

Perform the exercise twice a day. When the basic execution becomes too easy, you can perform the exercise with one leg extended. Also, hold this for 10 seconds on each side and repeat 3 times. You can then build up the exercise to 15 seconds.

The final piriformis syndrome exercise focuses on improving the strength of your lower back. In addition to muscles that stabilize your back, you also have muscles that make your back stronger and help with bending and lifting. A strong lower back reduces the load on your piriformis muscle.

The exercise goes like this:

• Lie on your stomach
• Put your arms bent in front of your head
• Now lift your upper body and your arms
• Repeat 10 times
• Do this 3 times in a row

If it gets easier, you can also try 15 or 20 reps.