Top 5 Exercises for Piriformis Syndrome

If I could count every time someone came to our physiotherapy clinic and said “I’ve got sciatic pain in my leg and I think I’ve looked it up on the internet, and I think I have piriformis syndrome”, then I’d have lost count by now.

The truth is, piriformis syndrome is very rare (if it even exists), and I am not convinced how likely piriformis syndrome is to exist. Having said that, it is a well-known diagnosis and commonly advised to patients with sciatica.

The piriformis is a “pear-shaped” muscle sitting in the buttock. The theory is that a small percentage of the population have the sciatic nerve going through the piriformis muscles. The theory goes on to state that if the piriformis gets “tight” or “contracted” then the sciatica nerve can be pinched or squeezed.

There is however one major flaw with this diagnosis, why do we not see it on a scan such as an MRI scan? Ultimately because sciatica is most commonly caused from a trapped nerve in the back, and not at the piriformis. However, there are research articles supporting piriformis syndrome, as a recently interviewed physiotherapist sent me after I failed his interview for what I can only describe as this physio talking nonsense.

People who do believe in piriformis syndrome typically see that it’s caused by prolonged sitting and they recommend to get mobile, and do stretches. Even if the condition is not piriformis syndrome, often exercising gently and reducing a sedentary lifestyle will be beneficial.

There’s a split among the profession, many who believe in the diagnosis, and those who think its very rare. But anyway, let’s look at five good exercises for piriformis syndrome.

Top 5 Exercises for Piriformis Syndrome:

1. Foam roller Glute and Piriformis Stretch: Lay a 4 inch (10cm) diameter foam roller on the floor. Lie on the roller so the roller is situated under your buttocks. Bend your knees. Simply lie there and move the roller backward and forward to create a stretch to the buttock (gluteal) muscle. Its normal for your back to arch slightly. Progress to a 6 inch (15cm) diameter roller.

2. Spikey Ball Piriformis Stretch: Sit down on the floor, and place a spiky ball under your right buttock. Straighten your right leg, while your left leg remains bent. Use your hands to support your body, and to control movement over the ball in a circular direction. You will feel the ball massaging deep into your gluteal (buttock) muscles.

3. Glute Stretch Lying: Lie on your back, and bend your knee to 90 degrees (i.e. pointing straight up). Place your ankle across your knee. To make the stretch stronger, pull your ankle towards you, while pushing away with the opposite knee (the side getting stretched). You should feel a stretch in your bottom.

4. Piriformis Stretch Sitting: Place your ankle across your opposite knee. Lean forwards to create a stretch in your buttock and piriformis.

5. Modified Pigeon Stretch: Adopt the four point kneeling position, and bring your knee under your body, resting against your stomach, while your leg turns inwards. Now slowly lean forwards to create a stretch in the buttock muscle. Place your opposite leg to an Oblique angle to the side. Hold this position, and when you are ready, come back to the start position. Alternate each side. This will stretch your piriformis muscle.

Whatever your view is on piriformis syndrome, doing exercises like the ones mentioned above can help relieve pain in your button, and can feel good to stretch. They can also help improve mobility in your hip and lower back. Overall, doing exercises can help most musculoskeletal conditions so try them to see if they help you.

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