What is Piriformis Syndrome?

Piriformis syndrome is a condition in which the piriformis muscles, which are located in the bottom of your buttock region, spasm, causing pain and discomfort of varying levels. You can feel the discomfort, and it can even be painful. This can also affect the sciatic nerve, which is nearby, causing pain, numbness at the back of the leg and sometimes at the bottom of the feet.

This can be a result of a history of injury or trauma to the lower back, continuous sitting in one posture, uncomfortable seating arrangements, or lack of exercise. It is important to make sure that the muscles are active, which can be achieved through the simple piriformis syndrome treatment exercises mentioned below.

Piriformis Syndrome Physiotherapy Exercises

Most of the exercises to help aid piriformis syndrome focus on improving the condition of the piriformis muscles in your lower back. This usually involves simple stretching and strengthening exercises for piriformis syndrome that involve the legs, hips, and back, depending on the intensity of pain. This is usually charted out by a physiotherapist, after extensive tests, based on your body and its abilities.

Here are a few simple piriformis exercises that will help you in reducing the intensity of your pain

Simple Seated Stretch

Yes, it's simple and seated. For this exercise, you need to:

While seated on a chair, cross your sore leg on the knee of the other, and keeping your back straight, lean forward, until you feel a gentle pain in the back. Repeat it on the other leg. Do not strain your back, and only lean forward until the pain is gentle. This one of the exercises for piriformis syndrome that is seen to be effective.

Standing Piriformis Stretch

While standing, place one leg over the knee of the other, creating a “4” shape. You can use a chair, or a wall for support if you have trouble balancing. As you place your knee, gently lower your hip towards the ground, and try to reach out with your arms, leaning forward.

Do this till you find yourself in a comfortable position. Repeat with the other leg.

Supine Piriformis Stretch

This is an exercise that can be performed by lying down on your back. Bend your knee upward, cross one leg over the knee of the other and bend it towards your chest. Grab your ankle with one hand and the knee with the other and pull it towards your chest, till you feel the glute muscles stretch. Hold the position till comfortable, repeat with the other leg.

Outer Hip Piriformis Stretch

Lie down on your back and bend your sore leg upward. Place your foot close to the back of the other knee. Tucking your foot behind the knee, twist your legs the opposite way. Your knee should either touch the floor or be close to it. Hold till comfortable, repeat with the opposite leg.

Hip Extension

Get down on all fours, and lift your foot upward. Now bend your knee and bring it to the floor.

Alternate between the two legs until comfortable

Piriformis Syndrome Exercises to Avoid

While exercise can be relieving, it is also important to ensure that you do not strain the muscle and cause further damage. The piriformis muscles can be injured by the wrong kind of exercises. Here is a list of exercises to avoid.

Clamshell

This needs to be avoided as it strengthens the glute muscles, and does not aid in the strengthening of the piriformis muscles. You can introduce clamshell in the regime once the glutes are strengthened, and there is a significant reduction in pain of the piriformis muscles/

Side-lying leg lifts

This can worsen the pain, as it adds stress to the piriformis muscles as it involves the stretching and rotating of the piriformis muscles.

Cycling

It is of the common assumption that cycling can improve hip strength and other muscles in the lower body. While it definitely has its own set of benefits, it is important to ensure that you don't cycle when you have lower back pain, as it creates stress on the lower body, which includes the piriformis muscles. This can lead to severe injuries if you are not careful.

Plyometrics

These are exercises that require you to jump or engage in high-intensity movements, that can lead to severe stress on the hop joints and muscles. This can cause stress on the muscle and delay recovery, or lead to further injuries.

Piriformis Syndrome vs Sciatica

Sciatica is a set of symptoms that occur when the sciatic nerve is compressed, inflamed, or injured, while Piriformis syndrome occurs when the piriformis muscles compress the sciatic nerve in the lower back. This occurs when the muscle is injured. Some of the main differences are that the pain occurs in the lower back (hip and buttocks) for piriformis syndrome, while the pain shoots down to the toe in the case of sciatica.

When to See an Expert?

It is always advisable to consult a qualified medical professional for any kind of persistent pain in the body. If the pain is frequent and does not reduce after simple home exercises and improved posture, it is advisable to see a doctor, as it can have underlying health conditions that require medical attention. It is also important to reduce the pain as early as you can, in order to prevent it from worsening into something larger. Usually, if the pain persists for more than a couple of days, with no signs of improvement, it is good to see a doctor.