Piriformis Stretches to Address Piriformis Syndrome

by | Apr 22, 2021 | Fitness Exercises

Before we get to the steps on performing piriformis stretches for beginners, let’s get to know more about the piriformis muscle and piriformis syndrome.

The Piriformis Muscle

The piriformis muscle is a powerful muscle that rotates laterally and works alongside other hip rotators to turn your hips and upper leg outward. It’s located deep beneath your buttocks, just behind the gluteus maximus, and also plays a vital role in keeping your hip stable and flexible.

The piriformis runs diagonally from the lower spine to the upper surface of your femur or thighbone, with the sciatic nerve running vertically directly under it (although in some cases, the nerve runs through the muscle).

Ensuring your piriformis muscle’s proper functioning is essential to accomplish daily movements, such as chasing after small children or your pets and turning to catch a falling object. It’s also critical for athletes who compete in running sports that involve sudden changes of direction, like soccer or basketball.

Piriformis Syndrome

Tight piriformis muscles cause lower back pain and eventually disrupt the function of your sacroiliac joint. Injuring or irritating your piriformis muscle often leads to muscle spasms, swelling, and tightness.

Piriformis syndrome occurs when the tightness or swelling of your piriformis muscle compresses the sciatic nerve. When this happens, you’ll experience deep hip and buttock pain, as well as tingling at your back down to the affected leg. While tight muscles can cause this, piriformis syndrome can also be caused by external irritation, such as staying in the same position for a prolonged period (while driving, for instance.)

This condition isn’t easy to diagnose since it appears and feels similar to lumbar radiculopathy. To pinpoint its underlying causes, you’ll need to conduct a thorough investigation with the help of a medical professional.

Causes of Piriformis Syndrome

You can attribute having piriformis syndrome to your anatomy. When you have a split piriformis muscle, a split sciatic nerve, or an atypical sciatic nerve path, you likely have primary piriformis syndrome. 

Meanwhile, the more common secondary piriformis syndrome is caused by muscle spasms, soft tissue inflammation, or both, which results in nerve compression.  Inflammation, scarring, and contractures of the piriformis muscle may result from direct trauma to the buttock.

Although significant accidents, such as a car crash or fall, may contribute to this condition, the most common cause remains to be the tightening of the piriformis muscle due to poor muscle health.

Long-distance running or prolonged standing without adequate piriformis muscle stretching and strengthening is a typical scenario in piriformis syndrome patients.

Piriformis Syndrome Symptoms

While piriformis syndrome doesn’t manifest in the same way all the time, typical symptoms include buttock pain that becomes worse when sitting, especially with your legs crossed in a figure four position. Maintaining that position for an extended period will cause pain that radiates down one leg.

Other symptoms and telltale signs to watch out for include:

  • Pain in the opposite sacroiliac joint.
  • Pain while sitting, standing, or walking for more than 20 minutes.
  • Intense pain while squatting and when standing after sitting. 
  • Paresthesia that radiates from the sacrum down to the back of your leg, usually ending above the knee.
  • Foot numbness

Piriformis Syndrome vs. Sciatica

Piriformis syndrome is often mistaken for sciatica since they share many symptoms. Although both conditions impact sciatic nerve function, sciatica is induced by spinal dysfunction such as a herniated disc or spinal stenosis. On the other hand, piriformis syndrome happens when the piriformis muscle, situated deep in your buttock, compresses the sciatic nerve.

Although there are sciatica stretches you can perform, it’s best to consult medical professionals to know more about the sciatic nerve’s structure, function, and relationship to the piriformis muscle. Their experience and expertise are key to telling apart discogenic sciatica and piriformis syndrome. 

Piriformis Stretches for Beginners

The following exercise sequence is specially designed for those who are getting started tackling piriformis syndrome with stretching. 

Supine Position

As a beginner, it’s best that you perform stretches in the supine position. In this scenario, you’ll bend your knees while lying on your back. Then,  place your feet flat on the floor, a technique known as hook-lying.

Warm-up

Warm up your hips at the start of every piriformis stretching routine. This portion provides you with a nice back stretch to jumpstart the piriformis syndrome stretching progression.

To perform the warm-up stretch, follow these steps:

  • Lie on your back in a supine position and bring one knee up towards your chest, followed by the other.
  • Hug them at the top of your shins or the back of your thighs near the knee.
  • Draw your knees towards you. Hold this position for 5-30 seconds.
  • Set one knee down gently, followed by the other.

Cross One Knee Over 

Continue warming up, although this time, bring just one knee up towards your chest. Perform the Cross One Knee through these steps:

  • Bring one knee up towards your chest from a supine position with both knees bent and feet on the ground.
  • Shift the raised knee over to the other side. Consider pointing the knee towards the opposite shoulder to target the “out hip” where you can find the piriformis. The “standing” leg will be brought over while you do this, which is perfectly normal, hence doesn’t need to be corrected. 
  • Maintain this stretch for 5-30 seconds.
  • Carefully return to your starting position. 

Note that the distance you move your leg will depend on how strong your piriformis and other hip muscles are and how much pain you experience. Keep things pain-free at all times, meaning go only as far as you can without experiencing pain, soreness, or other muscle-related discomforts.

However, since you’re stretching, expect to experience muscle pain, or else you won’t benefit much from the stretch. Take care not to go too far into the stretch, though, to the point that you feel some nerve sensation or your sciatica starts to act up.  

Knees to the Side

Perform this routine to bring the outer hip stretch to the next level. Do the following steps:

  • Try getting both your knees down to one side.
  • Again, go only as far as you get to that point where you feel something’s taking place in the muscle but neither overwhelming nor painful.
  • Stay in this position between 5 and 30 seconds.
  • Gently return your legs to the original “standing” position. 

If you wish to perform a more intense routine, you may proceed to intermediate piriformis stretches

Nerve Sensations When Performing Piriformis Stretches

Since the sciatic nerve is beneath the piriformis muscle, you may experience sensations apart from those caused by muscle tissue. Most likely, they’ll resemble an electric sensation that goes down to your leg. Apart from shock, tingling, or even burning, you may also feel weak or numb in one of your legs.

As soon as you experience any of these symptoms, stop the exercise right away and seek medical advice from your doctor or physical therapist. 

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