T Nation

The Piriformis Stretch


Reading through Eric’s locker room I came across this stretch.

If you have read my previous thread, I have been experiencing belt line/buttocks pain after jumping into rigorous exercise too soon, after a long layoff. Specifically, the Squat.

Anyway, my chiropractor said I had a rotated sacrum and L5 vertebrae that needs alignment.

Back to the stretch. I noticed that when doing this particular stretch, my right leg is severely limited in comparison to my left leg. My question are:

  1. What does this mean?

  2. Can this be accounted for my lowerback/belt line/hip pain because of ATG squats.

I just received and watched Magnificent Mobility and must say it is very informative. Ill be working on my flexibility and mobility, but in the mean time, hopefully I can get some feed back .

Thanks.

  1. your R piriformis is tighter than your L

  2. it cant be helping, I’ll tell you that much…

I got the same thing. Except I can’t really stretch it much because my knees hurt.

Hopefully someone will give you (and me) a good answer :stuck_out_tongue:

Thanks guys.

Hopefully some will be able to answer.

I also forgot to mention I have an internally rotated hip.

Like KBCThird said:

This could be for any number of reasons; injury, posture, structural (I believe you were the fellow who mentioned having a bad hip and uneven leg length, correct?). Whatever the reason, the piriformis muscle originates at the front of the sacrum and inserts into the femur. An excessively tight, or shortened piriformis could definitely pull your sacrum out of alignment when squatting… or running, or jumping, etc… I know because I’ve done the same thing a few times. The way I’ve fixed it (and now keep it fixed) is a combination of the following:

  1. piriformis stretch

  2. fire hydrants (both directions), bird dogs, glute bridges, X band walks, and other hip mobility and glute activation work. Magnificent mobility is great, use it and keep using it even after the pain goes away. It took me months to get things healed up the first time I had problems with my sacrum (mostly because I finished the rugby season and just took a lot of ibuprofen for a while), and then when I finally got things healed and stopped doing the mobility work, the pain came back.

  3. massage of the low back, glutes, and hamstrings (it helped that I have a family member who’s a massage therapist)

  4. chiropractor (I don’t care what people say about chiropractic, a good chiro is worth their weight in gold if you ask me)

  5. rolling the glutes and hamstrings on a tennis or lacrosse ball. I’ll also sometimes lay with the lacrosse ball under my sacrum and apply some of my body weight to it if it feels like it’s slipped or rotated out of alignment. Note that this is most likely not recommended as you could put yourself further out of alignment or in more pain, but it’s worked for me before so I thought I’d mention it.

  6. Alternating ice and heat. Heat will help loosen things up and ice will ease the pain and inflammation

  7. Relative rest. You probably shouldn’t squat or deadlift heavy for a while. Keep the joint mobile, but don’t push it too hard. It could take a few weeks to a few months to get thing right, no need to keep reinjuring yourself by getting over-ambitious in the gym. The weights will still be there when you’re ready to get back to them.

Good luck, and feel free to ask if you have any questions.

Jay

btw, I’m not a doctor, therapist, trainer, or in any way qualified to give medical or training advice. I can only offer advice based on trial and error and personal experience so take it for what it’s worth.

How does Front Squat feel?

Front squats hold many surprises for those who don’t do them.

Try’em.

m0dd3r,

Thanks for the thorough response! I had played football for four years and during that time, lifting was never a problem. I think it stems from the fact I jumped into heavy lifting and rigorous running too quickly after a long layoff.

My right leg is very restricted compared to my left, so you are probably correct that when I squat this imbalance is causing my sacrum and to be pulled out of alignment.

I am currently seeing a good chiropractor who is giving me adjustments, and soon core stabilization work.

I wonder then, if this means Ill forever be prone to have my sacrum pulled out. I just know I need to get my right leg up to par.

The tennis ball was a great idea, I actually accidently came across it yesterday and it brought temporary relief. The pain came back though this morning.

Funny thing is front squats and rackpulls dont affect my pain. Its only the back squat that brings upon the pain.

I have MM, and I plan on ordering BTEA.

In terms of pain and discomfort, how is your sacrum, and can you lift heavy yet?

Thanks a lot

Limbic,

ATG front squats cause no pain, which is why I am kind of curious of what it could be. Back squats on the other hand hurt once I get to the 135 pound mark.

[quote]thetruth24 wrote:
m0dd3r,

Thanks for the thorough response! I had played football for four years and during that time, lifting was never a problem. I think it stems from the fact I jumped into heavy lifting and rigorous running too quickly after a long layoff.
[/quote]

Could very well be just “too much too soon” or it could be a postural thing or trauma related (car accident, skiing accident, fall, old football injury, etc…) Sometimes even minor aches or tweaks will cause you to sort of subconsciously adjust your posture to ease the pain, and over time your body adapts to the adjustment. For example, I know that if I sit in a car on a long drive I have to be very conscious of my posture (I have a tendency to rest my hand on the shifter and lean that way a little. It plays hell on my back if I don’t consciously correct it).

What do you mean when you say “restricted”? Is the reduction in ROM of the right leg because of the pain in your back or just general tightness and/or weakness. Basically what I’m trying to figure out is whether the slipped sacrum is a function of the tightness and restricted ROM in the right leg, or vice versa. Think about it, while tightness and imbalance in the hips could cause the sacrum to slip out, it can work the other way too. The sacrum could have just slipped out (loss of balance or something with heavy weights on your back) and is now pulling to one side, causing the tightness and restriction in the right leg. This would be something to discuss with your chiro.

Could be. But either way, you should concentrate on doing what you can to fix is now and prevent it from happening in the future. If you’re prone to it happening again, you’ll just have to be more proactive in your preventative measures.

I’d try working as much of the hip and thigh musculature as possible (either with the ball or a foam roller). Glutes, hamstrings, ITB, TFL, Psoas, quads, pretty much everything from belt to knee. You could also ask your chiro to recommend a good massage therapist (actual LMT who knows sports massage, not some cute little college chic who took a weekend course in how to give fat guys a rub down at the resort hotel). This will hurt even like hell (don’t let the therapist fool you either, deep down they’re evil people who enjoy inflicting pain). My massage therapist (who also happens to be my little sister) is literally half my weight and almost a foot shorter than me. She’s damn near reduced me to tears on a few occasions.

Different exercises, your back and hips are held at different angles and the weight and center of gravity are in different places in relation to your hips. Front squats make it harder to tuck your butt under and round your back at the bottom. Rack pulls don’t involve nearly the ROM. One recommendation though, stay away from cleans, snatches, and any jumping exercise for a while. They’ve fucked my low back a couple times. Rapid extension and explosive stuff always seems to do it for me. My guess is it’s the rapid change in compressive forces on the spine and sacrum.

My back seems to be ok right now. I first hurt the SI joint a little less than a year ago (middle of last spring rugby season). Took the summer off and experimented with different ways to heal it finally got back in the gym in the early fall. Was fine by the time fall season rolled around (september). Tweaked it again around xmas and was able to fix it much quicker this time. Took about a week off and just did mobility and tissue work. Been deadlifting and squatting up to heavy doubles and singles since the first week of january now and had no problems. Spring training just started so we’ll see how things go (sore as a mother fucker right now).

m0dd3r

The pain I am feeling now, occurs when I sit in a chair, slouch over and in away, put all my weight or “gravitational pull to my lower back/hip” It feels kinda like I’m pulling on sore or strained muscles across my a little below belt line area. Occasionally Ill feel like I irritated some nerves causing tingly electric feeling run down my right hip/butt. I should also mention that when i bend over to spit out my toothpaste, I feel kind of unstable. In the MM video, I tried to do the squat stand, and found myself bending at the knees and pushing my butt back to get my toes. I don’t know if this is a thoracic and/or hip and hamstring flexibility issue.

When I say restricted, I mean its tough for me to push the leg down. There is no pain when i force it, but it feels very tight, almost like its impossible for me to get it down like my left leg. I think you are possibly right. I was squatting ass to the grass, and maybe since one hip is severely limited, it pulled my sacrum and L5 out of place. Does this still involve the piriformis? I know my chiro said I have internal hip rotation on my right side. I wonder if it could just be the tightness of that hip.

Foam rolling and tennis ball rolling are extremely painful. Especially around the quads and ITB. What are the “TFL, Psoas”? I heard that if it hurts when you do it, its good because its breaking up some of the “buildup”

Thanks for the advice on the lifts. Ill steer clear of anything that can put my spine in a compromising positionf or now. I guess rack pulls and front squats will have to suffice.

I’m glad you’re able to lift heavy. I hope your season goes well!

Thanks

Oh yeah! I am going to get a soft tissue massage tomorrow. What should I ask her to specifically massage. I have a 30 minute period with her.

TFL is tensor fascia latae, hip abductor and flexor, psoas are hip flexors. Do yourself a favor and google/wikipedia piriformis, tensor fascia latae, psoas, and any of the rest of the muscles in and around the hips. There’s a lot of them but it will really help you out if you understand what they are and what they do. For example, if you read up a bit on the piriformis you’ll find that it acts to externally rotate the hip. So if your hip is inwardly rotated, it’s going to be pulling on the musculature that creates the oppossite movement right? i.e. the piriformis (plus others).

As far as your massage goes, I’d just explain to her your problem and tell her what your chiro said and ask what she thinks. If you’ve done some homework first you’ll be able to guage her reaction and also discuss it a little bit with her to figure out the best course of action. I’d imagine she’ll probably want to work the glutes, hammies, upper quads, hip flexors, etc… But she should be able to judge what’s tight and what needs work by feel too.

Good luck, keep us updated.

Jay

M0dder,

Thanks for the definitions. I looked up psoas and piriformis, and both seem to fit what I was/am experiencing now.

I remember after a particular flag football game, I felt like I had no control over my core, and it was really difficult just walking, suggesting maybe I messed up my psoas. My source of aches comes from the area an inch above my butt line. When I sit, lean forward (put my hands on my table and chin on my hands), and exhale, I feel like I’m stretching sore/strained ligaments in my hip area.

Well I got back from my massage and I guess my back is really really right, especially my Quadratus Lumborum.

The only thing I can really find on this particular muscle group is, if overactive, it can throw off your hips and affect your sacroiliac joints. Can any provide further explanation.

I guess my problem can be attributed to:

Piriformis
Psoas
Quadratus Lumborum

Thanks