Are you experiencing intense sharp pain in your buttock region radiating down the back of your thigh especially after sitting still for extended periods of time?
You might be having piriformis syndrome. The spasm in the piriformis muscle causes irritation of the sciatic nerve and if left untreated, you may have difficulties performing your daily tasks such as driving, sitting to work on computer, climbing stairs and doing house chores.
Here are some useful tips to alleviate piriformis syndrome pain and prevent the recurrence of the injury:
- Piriformis Stretches
Gentle piriformis stretching exercises helps to release the tension and spasm in the piriformis muscle, thus reducing the pressure on the sciatic nerve and relieve symptoms.
The below are 4 simple ways to stretch your piriformis muscle effectively. Each stretch should be held for 15-20 seconds, repeated 3-5 times and stretch at least 3 sets a day.
i) Lying pretzel stretch
- Lay on the back with both knees bent. Cross an ankle over opposite thigh.
- Grasp hand behind the thigh and pull the knee towards your chest until you feel a gentle stretch in the buttock.
ii) Knee-to-chest piriformis stretch
- Lay on the back with both legs extended.
- Grasp one knee with opposite hand and gently pull it towards your opposite chest until you feel a stretch in the buttock
iii) Seated piriformis stretch
- Sit on a firm chair and cross an ankle over the opposite thigh.
- Slowly lean your chest forward while keeping your spine straight until you feel a gentle stretch in the buttock.
iv) Standing pigeon stretch
- Stand in front of a firm desk or bed. Bring one knee up and place your shin parallel to the edge of the desk/bed.
- Slowly bend your chest forward while keeping your spine straight.
2. Self-Massage
Deep tissue myofascial release massage using a foam roller or a lacrosse ball can be useful to ease the tightness in the piriformis and reduce pain caused by piriformis syndrome. You should apply firm pressure that is slightly uncomfortable but shouldn’t be agonizingly painful or feel tingling down your leg.
i) Foam roller massage
- Sit on a foam roller with both feet on the floor in front and both hands supporting your weight behind.
- Cross an ankle over your opposite knee.
- Rock back and forth on the roller for up to 60 seconds or until the discomfort subsides.
ii) Lacrosse ball massage
- Sit on the ground and place a lacrosse ball (or tennis ball) under the side your hip. Support your weight behind with both hands.
- Cross an ankle over your opposite knee.
- Roll around on the ball over the discomfort area for up to 60 seconds as tolerated.
3.Strengthening Exercises
Strengthening the hip muscles and piriformis itself is important to ensure the muscle is strong to cope with the demands placed on it and prevent the injury recurring.
i) Glute Bridge
- Lay on the back with both knees bent in hip width apart. Keep both arms at the side with our palms facing down.
- Tuck in your core, squeeze your glutes and slowly lift your hips off the ground until our knees, hips and shoulders form a straight line. Slightly external rotate your hips to engage the piriformis muscles.
- Hold for 5-10 seconds and return to starting position. Repeat 10 times, 2-3 sets.
ii) Side Lying Clam Exercise
- Lay on your side with both knees slightly bent, one leg on top of the other.
- Keeping both feet together, lift the top knee up slowly until you feel the contraction on the hip while keeping your upper body stationary.
- Slowly lower the knee back to the starting position. Repeat 10-15 times, 2-3 sets.
4. Avoid sitting for extended periods
i) Get up and move around every 20-30 minutes sitting at work. Our body is not designed to remain in one position for prolonged period of time.
ii) Choose a firm chair that keep your knees on the same level or slightly lower than the hips.
iii) Stay active and exercise regularly.
iv) Warm up before exercising and stretch well after your workout. Gradually build up the intensity of exercise.
Prepared by Charlotte Yip Chiang Yee
Physiotherapist of Your Physio Ampang