Pain in the butt? There’s a high chance it could be due to the piriformis muscle.
This is a common problem encountered by people of all ages and activity levels. It can become tight and painful and even cause sciatica if it becomes worse.
Piriformis syndrome type pain typically will stay in and around a small portion of the buttock, but its effects can lead in to the back of the upper thigh – and when at its worst can aggravate the nerve that leads down your leg.
A tight and painful piriformis muscle can restrict hip movement and limit function for exercise.
Piriformis problems can be known as piriformis syndrome and it can typically develop in runners but even someone who is not as active as a runner can develop this type of problem.
Stretching of the piriformis is helpful to help relieve the symptoms that are caused by having a tight muscle within the hip region.
This article will provide you with some basic education and also the solutions to piriformis pain by teaching you the stretches and also some prevention strategies.
What is the piriformis?
The piriformis is a small strap like muscle of the gluteal complex.
It is located in the buttock and sits behind the gluteus maximums. The sciatic nerve can run either behind the muscle or in some individuals it will run through.
This is why the piriformis muscle has such an influence on sciatic symptoms due to the compression of the nerve it can cause when there is an issue with it.
The main job of the piriformis is to rotate the hip and leg. It is key to help control the lower limb during dynamic movement.
Piriformis is placed under demand with running as it helps to stabilise the leg but also to change direction. Multidirectional sports such as football and tennis will place demand on the piriformis as there is constant direction changes which are helped by the piriformis.
Equally – sitting on the piriformis for long periods of time acts to compress it but also to not use it. As a modern society we do spend a lot of time sitting down and this can have a detrimental effect on this muscle.
If we do not use certain movements or muscles – we tend to lose them/weaken them. This could be a huge reason why a high prevalence of people suffer piriformis pain and tightness in the hips as we just aren’t using this muscle effectively?
Why do we stretch the piriformis?
As previously discussed – the piriformis if either overused or underused can become tight, weak and provide restriction of movement.
One of the solutions to this? Stretching of course.
Mobilising the tissue and using it can be a great short term symptom reliever. Lengthening the tissue in the short term can help to take pressure off the sciatic nerve but also to promote more movement and better function.
Stretching helps to reduce symptoms but also to create a better foundation for movement of the hip and buttock. Our hips can be a naturally tight region and stretching of the hips is very effective in order to help promote better hip health.
Stretching isn’t the only way to reduce symptoms and may not be the permanent fix – you first have to identify why it’s being caused and what aggravates it. If you are unsure – book in to see a physiotherapist!
Top 4 piriformis stretches
Now that you know a little more about the piriformis and why it can get painful, here are the stretches that are going to help maintain this area and relieve pain.
All stretches are best when performed for a an extended period of time. A common mistake with stretching can be doing it for too short a time.
This does not help to activate the stretch reflex properly and can actually cause the muscle to shorten. This will obviously not help you if you are looking for pain relief or to lengthen the muscle.
To get the most out of these stretches, it is recommended that you perform them for a minimum of 20 seconds – trying for longer if you can. Repeat 3 times over after a small rest between each stretch.
The Cross Legs Stretch
This is by the easiest way to stretch the piriformis and help to open the entire hip and glute region.
You may have done this before without knowing – it’s simply sitting cross legged and this helps to stretch the outer part of the hips where the piriformis sits.
To enhance the stretch you can take your knees as far as they can go down towards the seat or floor – and then add a further stretch by pushing down on them.
Knees to the side
This stretch is another basic but can be done when lying in bed. Ideal for when you first wake up to mobilise your piriformis for the day.
Simple have your knees bent, with your feet flat on the floor or bed and simple allow your lower back to rotate and your legs to fall to one side (keep them together).
This places a stretch on the outside of your hips. You can of course push down with your hands to stretch the piriformis more.
This stretch is popular in yoga circles. It’s commonly known as one of the most effective stretches for the outside of the hip.
To begin, kneel down and place one of your legs in front of you and the other behind, rotate your hip outwards and place your shin in front of you with your ankle and foot.
Ensure your shin is horizontal to your pelvis and fix your ankle with your hand if you can. The next part of the stretch is to lower your pelvis and hips down to apply a stretch to the piriformis.
When beginning this stretch it can be difficult. When more advanced you will be able to slowly lower your body over your shin and rest your head on the floor as your hips gets more flexible.
This is an ideal stretch for when you aren’t lying down and potentially for when you are at work to help stretch your hip.
Place one of your ankles on the opposite knee and push your knee downwards to apply a stretch to the hip.
This is a relatively easy stretch and we advise this to be done frequently when sitting to maintain hip mobility and reduce the chances of getting gluteal pain.
Tool assisted piriformis release
The piriformis sits underneath the gluteus maximums and can be quite difficult to palpate with just fingers.
A therapist can dig in to this area using their elbows, but if you do not have a therapist or a spare elbow at hand then use of a mobility tool release will help.
The glute responds very well to hockey ball style mobility tools which can be sat on and help to effectively take the tension out of the piriformis muscle.
The best technique for this is perform the seated piriformis stretch first (see exercise number 4) and place a ball under the buttock at the point of the piriformis. Then place all of your bodyweight on to it and roll over the muscle.
When you do this – it may be quite uncomfortable but also nice at the same time. You will build a tolerance to this it can be an effective reliever of sciatic pain and also local buttock pain.
Best ways to reduce piriformis pain
So obviously – stretching the hip and performing regular mobility work is ideal for reducing hip and glute pain, but there are other things you can be doing to prevent symptoms occurring.
Here are a few suggestions which can help to limit your chances of developing piriformis pain.
If you have a job where you sit – you should move more!
It’s not rocket science but inactivity and sitting in a fixed position leads to poor mobility, weakening of the glutes and all round reduced function.
Ensuring you take regular movement breaks from your seat to either do small walks or stretching routines can help to keep you on track.
Sitting for long periods causes compression of the glute muscles – including the piriformis. Consistent pressure where the bottom of the pelvic bones compressed against the muscle and also the nerve contributes to reduced circulation which in turn can lead to development of pain.
So while your buttocks are designed to be sat on with their ample cushioning……give them a break from time to time.
Perform strength training!
Stretching and mobility is great, but strength training is even better. Strength training is recommended to all adults by the world health organisation for a minimum of 2 sessions per week.
This is because it helps us to age healthily. Strength training allows us to strengthen muscles and tendons whilst also ensuring we maintain healthy joints.
Strength training also takes us out of our normal routines and challenges our bodies in different positions with resistance which allows us to be stronger and better – and to function with greater efficiency.
Mobility tools are used for assisting you with how you perform your stretching and mobility routines.
They can often be things like foam rollers, tools and mobility balls – they act as a massager which can help to relax soft tissues which then allow you to get more movement out of the body part you are stretching,
Mobility balls are great tools for tight hips – they can really help to unlock extra movement.
Get your steps in
The recommended amount of steps per day for optimal health and weight management is 10,000.
Our modern day lives tend to be more sedentary than active due to how we work in offices and now, from home.
If your hips remain inactive for long periods this can be detrimental to the hips – if you have a daily step target around 10k – this will total 4-5 miles of walking which ensure use of the hip muscles and regular movement of the hip joint.
Structure your exercise properly
Piriformis pain can be caused when your activity levels spike and you perform too much too soon. A classic example could be a runner trying to increase their mileage or time.
Weight lifters or CrossFit athletes also adding extra sessions or weight too quickly can cause havoc with the piriformis.
The sudden change in stimulus [places too much demand on certain areas and can trigger piriformis problems. Always follow a program, ensure you get enough rest and gradually progress your exercise.
That concludes our guide to the best piriformis stretches and we hope that it has given you some good information on how to maintain healthy hips.
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