It is pretty amazing how much trouble inflammation, tightness or weakness of a small triangular muscle buried deep in your rear-end can cause. But, I guess that’s why we call the things that aggravate us the most a “pain in the butt!”
When your piriformis muscle is cranky, your whole body can suffer. The piriformis attaches your sacrum in the lower back to the femurs at the top of your thighs. What this means is that when this little gem of a muscle is aggravated all associated muscles and nerves can feel completely agitated and uncooperative.
The piriformis itself might hurt when it is inflamed and unable to carry out its job. But, what really seems to bring people down is the associated sciatic nerve pain that occurs when the nerve becomes compressed by the piriformis’ ire. Piriformis Syndrome can bring both distance runners and those who just run errands down! If you are human, your periformis needs care.
The sciatic pain associated with piriformis syndrome can shoot all the way down the lower chain- from lower back through the hip and leg. The good news is that the nerve isn’t necessarily permanently damaged. Addressing the muscular pain and problem does wonders if the sciatic pain you struggle with is caused by a misbehaved piriformis.
There are many things that can trigger piriformis dysfunction. It can be as simple as sitting for too long with a wallet in your back pocket. Or, in women it is sometimes tied to pelvic changes associated with pregnancy, other hormone changes or the structural angle of the quadriceps muscles. While it is important to figure out what might be causing the piriformis to complain and spread its fury so that you can correct any offending behavior or movement patterns (if possible). Note that there are stretches and strength movements you can incorporate into your day to help the piriformis calm down.
If you are currently in pain, approach all new movements with caution. That might go without saying, since if you do have shooting sciatic nerve pain and piriformis muscle issues, the acute discomfort likely screams at you to back off! Talk to a physician to clarify that the approach you intend to take is suitable for your particular condition.
If you get the go ahead, try these 10 movements that target the piriformis and see what works for you. Remember, that one bout of stretching, self-massage or strengthening is unlikely to fix your piriformis problems forever. Healing takes time. Keeping the piriformis happy once it calms down will involve continuing to respect the muscle with maintenance movements and making sure all associated muscles in your hips, legs and back (quads, hamstrings, erector spinae, adductors, abductors, etc.) remain strong, flexible and functional.
Piriformis stretches are listed here in order of complexity. Start at the top and see what feels good. If it makes your pain worse, back-off or stop. Don’t force any stretch. If you choose to get on the ground, make sure you have the ability to get back up! If your sciatic nerve is raging, getting up and down off the floor might not be as easy as you wish it. If that is the case, try the chair/ball stretches. If you find a position that feels good, stay there for about 30 seconds and repeat the stretch a few times.Do the stretch on both sides. Body balance is a key to correcting current imbalances and preventing future ones.
On the Ground. Check out this video for tips!
- Back Lying Simple Release
Ease yourself to the ground to a back lying position. Bend both legs with your feet on the ground. Place your one ankle on top of the opposite thigh, right above your knee. This alone, might provide enough stretch for some individuals.
- Back Lying Release with Lift
If you feel good in the simple release, thread your hands through the triangle you created with your legs to grab the back of your thigh on the grounded leg. Gently pull your legs toward you, lifting the grounded foot off of the floor.
- Back Lying Release with Twist
Return to the position with both feet on the ground. Slowly straighten one leg while leaving the other one bent. Try hugging your bent knee toward your chest. If that feels good, consider using your hands to gently guide your knee over the mid-line of your body until you feel a stretch.
- Seated Stretch with Gentle Twist
Sit on the ground with your legs extended in front of you. This can feel challenging if your hamstrings are tight. Don’t fret. Soften your knees as much as you need to remain comfortable. Lift one of your legs, bend your knee and cross it over the other leg. Very slowly, turn your upper body so you are looking at the wall on the same side as the bent knee. Use the hand opposite the bent knee to hold the outside of that leg. Gently pull the bent knee across the mid-line of your body.
With a Toy!
- Chair/Ball Stretch
If getting up and down off of the ground isn’t an accessible option for you right now, grab a chair or a stability ball. Sit on the chair or ball with your knees at a 90-degree angle. Place one ankle on top of the opposite thigh so your lifted leg forms a triangle. That alone might provide a nice, safe stretch. If you want more, hinge at your hips and lean forward until you feel a deeper stretch.
- Self-massage Sit
Another option is to try a simple trigger point release position for the piriformis. You will need to have some wrist strength to do this movement. Grab a baseball, tennis ball, lacrosse ball or other small ball. Sit on the ground with legs straight in front of you. You’re your knees, with your knees about shoulder width apart. Place one ankle on the opposite thigh to create a triangle. Place the ball under the glute of the lifted leg. With your hands by your side, lift yourself off of the ground and bear into the ball, using your body weight to dig into the spot. You don’t need to “roll.” Just sit there for a handful of breaths.
Basic Yoga to Target a Pained Piriformis
- Half Lord of the Fishes Pose
This yoga pose takes the Seated Stretch with Gentle Twist (#4) a step further. Sit on the ground with your legs outstretched in front of you. Bend one leg and cross it over the opposite leg. Then, bend the outstretched leg by sweeping it on the ground in front of the mid-line of your body to draw your foot toward the opposite glute. Twist your upper body gently and hug the “top” knee close to your chest. Or, get deeper into the stretch by adding counter tension by twisting even more. Confused? Check out this image.
- Pigeon Pose
This yoga pose can provide a very deep release. But, move into it slowly if you have never tried it before. Start on your hands and knees.Bring one foot forward toward the opposite hand. The outside of your ankle will be on the ground near your opposite wrist. Slide your other leg behind you to a straight-ish position. Try to keep your hips square. You can walk your hands in front of you and rest your head on the ground if that feels good. Or you can use your hands to support yourself upright. Hold for a few breaths. Check out this page for beginner tips for pigeon pose and a helpful image.
Other Yoga Poses to Consider
There are a plethora of other yoga poses that stretch the pirifomis and relieve the pressure piriformis problems put on associated muscles (and nerves). Hero Pose, Eagle, Cow Face Pose and One-Legged King Pigeon, for example, are just a few of the many poses/stretches that can enhance function and comfort throughout your lower body chain. All involve a bit more flexion through the knees and torso than the ones detailed above in this article, though. So start with the basics before twisting yourself into a pretzel. If you master the first steps presented above, keep exploring! Pay attention to that screaming little muscle and you might find that a life that’s free of piriformis pain and sciatica is out there waiting for you.