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Piriformis Syndrome: What a Pain in the Butt!

Happy Monday Everyone!

piriformis syndromeDo you ever feel pain in your hip or buttock area after prolonged sitting or physical activity? You may be suffering from piriformis syndrome.

With the beautiful weather comes an increase in levels of physical activity such as running and high-intensity training. Jumping back into exercise using muscles that haven’t been challenged in a while can cause inflammation to form in our tissues. Sudden overuse of our muscles paired with prolonged periods of sitting at work and as we drive, ends up compressing these inflamed tissues which can end up causing us problems.


What is Piriformis Syndrome?

Piriformis Syndrome is a painful condition caused by chronic shortening or spasming of the piriformis muscle which is located deeply to the large gluteus maximus (1,4). The spasm of the piriformis muscle may result in varying levels of pain, felt from the gluteal muscles just above the sitting bone, if there is sciatic nerve involvement, a tingling or burning neurogenic pain may radiate down the back of the leg to the knee, sometimes even reaching as far as the foot (2,3).

As the piriformis is one of the main muscles responsible for external rotation of the hip, allowing the hip and leg to be turned out, it is frequently overused in the day to day activities such as walking or going upstairs (1,4). This painful syndrome can negatively impact daily life, particularly if you are sitting for long periods putting pressure on the piriformis and in turn the sciatic nerve.

For further information, Spine-Health.com has a helpful video about piriformis syndrome.


5 Home Exercises for Piriformis Syndrome

1. Piriformis Muscle StretchPiriformis syndrome

Start in a seated position. Cross your sore leg so that the ankle is resting on the opposite knee. Apply gentle pressure to the knee as you lean forward with a straight back, hinging from the hips to increase the depth of the stretch. Hold this position for 30 seconds to allow your muscle to relax and lengthen. You should feel a comfortable tension with no pain.

2. Gluteal and Hip Capsular stretch

Piriformis syndromeLie on your back preferably on the floor. Bring one knee up towards your opposite shoulder with your hand. Breathe deeply and let yourself sink into the stretch, gently pushing your flexed hip down towards the floor. You should feel a comfortable stretch, not pain, in your hip and deep buttock muscles. Maintain this position for 30 seconds.

To challenge your hip capsule you can also wrap a towel just below the knee, using it to move your knee in an arc up towards your head. When you find particular areas of tightness through the arc, pull down gently on the towel towards the hip to stretch through the posterior hip capsule.

3. Muscle Trigger Point Release 

piriformis releaseUse a small ball such as a tennis or spiky ball. Place the ball against your buttocks where the gluteal muscle is located, then bend your knees to roll the ball in circular motions or side to side over the muscle, careful not to roll over the hard bony areas. Roll the ball around or across the entire length of muscle 3-5 times. If you find areas of tenderness you can stop, lean into the ball and move the hip of the same side by bringing your knee towards the opposite knee then moving it away 3-5 times before moving on.

Scroll down to watch Katie demonstrate how to perform the Piriformis Muscle Trigger Point Release in the video below!

4. Adductor Muscle Stretch

Piriformis syndromeStand with your feet wide apart and toes pointing forwards. Lean to one side, and bend this knee, resting your hands on your knee for stability. Keep your heels flat on the floor and the other leg straight as you feel this stretch through the inner thigh. Tip your torso slightly over the extended leg to intensify the stretch and isolate your adductors further.

Localise this stretch to the back aspect of the adductor muscles by pointing the toes of the outstretched leg away from you so that your feet are perpendicular to each other.

5. Hip Mobility Exercise

Piriformis syndromeMove into a sitting position with your back straight, legs out wide in front of you and knees bent. Drop both knees to one side under control until they are each positioned at 90 deg angle formed by the upper and lower legs. Return to the start position and repeat on the opposite side.

As you become more comfortable with this exercise you can challenge your hip range of motion by leaning your torso forward and adding a slight rotation as your knees are dropped to the sides. You can also do this from a seated position at the edge of a chair.


Visit your local Chiropractor

If you are suffering from pain in the buttock or hip, visit your local chiropractor at Hands on Health Care to find out if you have Piriformis syndrome. Making sure that your pelvis and hip joints are moving properly may help decrease any unnecessary strain on your Piriformis muscle.

Chiropractic treatment for Piriformis Syndrome

  • Chiropractic adjustments or mobilisations for any pelvic, hip or low back biomechanical joint dysfunctions
  • Soft tissues releases of the Piriformis and surrounding hip muscles.
  • Dry needling to stimulate blood flow and create a healing response
  • Dynamic taping to provide functional support and proprioceptive feedback
  • Advice for home care
  • Tailored rehab program with injury prevention strategies

Call our Hands on Health Care team at (02) 9949-3017 or book online at www.handsonhealthcare.com.au


References

1. Boyajian-O’Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach. The Journal of the American Osteopathic Association. 2008;108(11):657-64.

2. Carro LP, Hernando MF, Cerezal L, Navarro IS, Fernandez AA, Castillo AO. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles Ligaments Tendons J. 2016;6(3):384-96.

3. Vannatta CN, Haberl M. Clinical Decision Making and Treatment in a Runner with Hip Pain and Neuromuscular Control Dysfunction: A Case Report. Int J Sports Phys Ther. 2018;13(2):269-82.

4. Vassalou EE, Katonis P, Karantanas AH. Piriformis muscle syndrome: A cross-sectional imaging study in 116 patients and evaluation of therapeutic outcome. Eur Radiol. 2018;28(2):447-58.


November 26, 2018
Katie MacRae