WHAT IS THE PIRIFORMIS MUSCLE?
The piriformis muscle sits deep below the gluteal (buttock) muscles, connecting the sacrum, which is at the bottom of the spine, to the top of the femur, which is also more commonly known as the femur. This muscle helps with external rotation (turning out) of the hip joint along with stabilization of the hip. The fibers of this muscle run horizontally through the sciatic nerve (the longest nerve in the body). Strong and flexible hip rotators keep the hip and knee in proper alignment during walking, running, and side-to-side movements.

WHY DO I NEED TO STRETCH THIS MUSCLE?
When this muscle contracts, it can cause lower back pain or pain anywhere in the buttock or hip area and can travel down the leg causing referred leg pain. After the buttock and hip area, the next most common complaint is pain in the back of the thigh and can cause pain in the knee, calf, and even pain in the foot or toes. Numbness is another symptom in the same areas just mentioned due to pressure on the “Sciatic Nerve”. Your doctor may diagnose this as “Piriformis Syndrome” or “Sciatica”, especially if the pain is deep in the hip and buttocks. Weakness and/or stiffness in the hip and restriction of movement are also quite common. Pain in the hip and thigh can also be a sigh of “Bursits” of the hip.

WHAT CAN CAUSE THIS “PIRIFORMIS SYNDROME”?
The most common cause of the symptoms described above is a shortening or stiffening of the piriformis muscle. This can be the result of faulty body mechanics, poor posture, or even the way you sit. On the other hand, the strain can be attributed to an overload in the piriformis muscle or trauma to the hip, back or leg. You don’t have to be an athlete to overload your muscles. In what follows, I will differentiate between body mechanics and overload.

FAULTY BODY MECHANICS CAN BE ATTRIBUTED TO:

• Wear worn or inappropriate shoes,
• Walking or running with the toes turned out,
• Other gait abnormalities: toe-heel vs. heel-toe
• Tight, stiff muscles in the lower back, hips, and buttocks,
• Spinal “stenosis” or “slipped discs” in the lower back,
• Bad posture, standing and/or sitting,

OVERLOAD OF THE PIRIFORMIS MUSCLE:

• Starting an exercise program after a long rest,
• Exercising on hard surfaces, such as concrete,
• Sitting or standing for long periods of time
• A chair that is too soft or a chair that is too hard
• Walking or running on uneven surfaces,
• Again, wearing worn or inappropriate shoes,
• Increasing the time or intensity of the exercise too soon,
• Bad technique during a squat or lunge,

HOW TO STRETCH THE PIRIFORMIS MUSCLE:

1. The easiest way to stretch the Piriformis Muscle is to sit on a chair:

Begin by crossing one leg over the other with the ankle resting on the knee of the opposite leg, then gently push down on the knee of the bent leg and slowly lean forward until you begin to feel a stretch in your hip and buttocks, hold for 15 to 30 seconds. Repeat on the opposite side.

2. Another stretch is lying on your back:

Begin by lying on your back and both knees bent with your feet on the floor, then begin by crossing your right leg over your left leg with your ankle resting on your left knee, gently lift your left foot off the floor toward you while at the same time gently pushing the right knee, hold 15 to 30 seconds. Repeat on the opposite side.

3. The third stretch is an advanced stretch called “Pigeon Pose.”

This position is also used a lot during “yoga” programs. It is recommended that before attempting this stretch yourself, you have one of our physical therapy staff guide you. These are the key points of this section:

Start on the floor in a pushup position, and then slide your right knee toward your right hand with your right knee bent inward so your right ankle is also touching the floor. Now carefully slide your left leg back to the point where you can feel the “stretch” in your right buttock, hip, and outer thigh (your “IT band”); also make sure your hips don’t rotate. If you feel like you need more of a stretch, you can reach your arms forward for a deeper stretch, hold for 30-60 seconds. “If you made it this far, repeat on the opposite side.”