Piriformis plays a very important role for protecting the hip, sacroiliac joint, and the pelvic floor. The muscle is often seen as the "guilty party" when it comes to blaming that "pain in the rear." Sometimes this is reality and sometimes piriformis is falsely accused, but either way it is indeed a very active muscle in your toosh.
Dysfunction of Piriformis Encourages
Poor rotational stability of the hip joint
Sacroiliac joint instability
Pelvic floor instability (through connective tissue connections to the pelvic floor)
Stiffness of the hip joint which can affect your ability to squat, lunge, or simply walk
Is Piriformis My Problem?
The first step to improving piriformis pain is correctly identifying whether piriformis is indeed at fault. The video below is a treatment option for a trigger point release of the muscle but it is also an opportunity to identify if piriformis is culprit. Place a ball in an area of soreness, attempt to rotate your thigh to the outside while applying resistance. If this hurts it is an elementary sign that piriformis might be involved. Carryout this treatment technique to help reduce tension in the muscle belly.
Gaining Mobility in Piriformis
Once we can calm tension in piriformis then it is time to gain some mobility of piriformis. You can specifically isolate a stretch to piriformis in a number of ways but we like to attempt the following stretches. These stretches are for "patterns" of movement rather than for single tissues. We find these approaches often alleviate "tightness" quicker than with isolated piriformis stretches. However, if these are painful or not attainable then we have other options.
Pretzel Stretch
Sidelying Pretzel Stretch
I Have Mobility, Now I'm Ready to Strengthen
Once the mobility of piriformis is adequate and pain is reducing it is time for starting the strengthening game. We encourage a transition in the following order to improve results from strengthening. We recommend performing the following exercises 4 times a week (rest days in between), 2 sets of 15 repetitions.
Clamshell Progression
Standing Piriformis Exercises
So you you have some tools to start the process of easing the pain in your rear. While these are guidelines to initiate a treatment don't wait too long before seeking specialized intervention from our therapists if your symptoms aren't easing within 7-10 days.
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