T Nation

Piriformis Syndrome Rehab Exercises


#1


Hi guys,

I got injured about 2 months ago. I got my right piriformis muscle really angry and tight. Sharp pain in my butt down my right leg into the foot. Sciatic kind of pain. Terrible.

Now the pain is much better I can still feel some numbness and little pain.

I am interested in some exercises for strengthning of the piriformis and the hole butt area without damaging the piriformis.

By the way I have never had any problems with this. I used to play tennis professionaly and never had any major injury. I stopped [ COMPLETELY ] about a year ago and being inactive [ not doing any execise a part from walking a lot ] might have caused this injury.

Thanks a lot everybody who has got any experience with this.

Wiki>

Treatment

Symptomatic relief of muscle and nerve pain can be obtained by non-steroidal anti-inflammatory drugs and/or muscle relaxants. Conservative treatment usually begins with stretching exercises and massage, and avoidance of contributory activities, such as running, bicycling, rowing, etc. Some clinicians recommend formal physical therapy, including the teaching of stretching techniques, massage, and strengthening of the core muscles (abs, back, etc.) to reduce strain on the piriformis.

Stretching exercises will target the piriformis, but may also include the hamstrings and hip muscles, in order to adequately reduce pain and increase range of motion. Patients with piriformis syndrome may also find relief from ice and heat. Ice can be helpful when the pain starts, or immediately after an activity that causes pain.

This may be simply an ice pack, or ice massage. Alternating heat and ice is often helpful. Custom foot orthotics also help with both treatment and prevention. Gait correction can reduce the use of the piriformis, allowing the muscle to relax and heal itself.


#2

First, what were you doing when you started to feel pain or just before it?

Second, have you tried a foam roller or a tennis ball to do self massage around the area? I use PVC pipe and a lacrosse ball with great results, but if you are in pain these might be too intense until you can work up to it. Check out Joe Defranco's youtube videos on hip mobility drills and myofascial release.

Hope it gets better soon.


#3

Well, what was I doing? I had had pain in my ankle and leg for weeks as I could not rest and needed to keep going until one day when it became so painfull I had to stop and just lie still in agony.

Now I am getting flexibility back and need to start strengthening the muscle.


#4

No back pain at all? Sciatic pain from piriformis is pretty rare from what I've been told.


#5

Sciatic pain from the piriformis is not that uncommon, as the sciatic nerve usually lies beneath the piriformis muscle. The sciatic nerve even runs through the piriformis muscle in a small percentage of people. Tightness or trigger points in the piriformis can put pressure on the sciatic nerve causing the pain running down your leg. I would recommend starting with a chiropractor to use ART and Graston techniques on the piriformis muscle and thus relieve the sciatic nerve pain.


#6

I have bad piriformii, if thats the correct plural. Things that have helped me are PVC pipe/hockey ball for working on the tissue, and stretches/hip mobility.

My father [60+] was also told his sciatic pain would greatly diminish from this, and has seen success with stretching and tissue work.

Avoid things that act it up until its close on 100%

You still havn't answered the question of what you were doing before it started acting up, or if you took any measures to try and rehab it from the start.


#7

Given your sharp decline in activity since your tennis playing days, your gluteus max and medius would have gone under a considerable amount of atrophy and significant loss of strength. Thus forcing your piriformis to work harder to produce external rotation of the hip.

My point being, assuming it doesn't cause irritation of the area begin a exercise and stretching program that emphasis' glute activation and strengthening (particularly endurance). By doing this you will reduce the tension on the piriformis by reducing its workload (glutes take over as prime movers) and elongating the muscle through its active ROM allowing the sciatic nerve to slide by without irritation.

In regards to treatment, i agree with most that ART will give you great benefit and trigger point release with a tennis ball or like will give you some relief


#8

@JuicyLucy, just wanted to check in and see if you've had any progress. I realize that I didn't elaborate too much on exercises to strengthen the piriformis and related hip muscles in my original post. The videos that I mentioned from Joe Defranco on hip mobility would be one place to go for this I think. Also on T-Nation I do believe that Bret Contreras is the hip and glute expert, so his articles would be a good read also. I had some immobilizing pain a while back that I never figured out the cause and it was terrible. I hope it is getting better for you.