Piriformis syndrome
Piriformis syndrome (sciatica) indicates that there is irritation of a large nerve that runs through the back through the entire leg, the sciatic nerve. This nerve runs down the leg from the spine. However, before he gets to the leg he has to pass some glutes. For example, it runs through the m.piriformis, although there are many variations on this (it can be below, above or through). In piriformis syndrome, the nerve gets pinched in the buttock.
Phase 1 of revovery
During this phase the goal is to reduce the muscle tension by stretching the gluteal muscles and lower back.
1. Glute and Lower Back Stretch
Lie on your back. Bend the leg on the side you wish to stretch. Grasp the knee of that leg. Then, pull the knee toward the side of the extended leg and toward your chest. Hold this position.
2. Gluteal Muscle Stretch
Place the leg you wish to stretch, in a bent position, on a bench, with your foot hanging off the edge. Position your forearms in front of your leg and lean your upper body forward. Hold this position for a moment.
3. Glute Stretch
Sit on a bench or chair. Place the leg you wish to stretch over the other leg, with the knee pointing outward. Use your arm to press your knee downward and lean your upper body slightly forward. Hold this position.
4. Lengthening one leg
Lie on your back, keeping your knees straight; then push one leg away (making that leg longer than the other) and alternate the movement between legs.
5. Let the knees drop to the left and right.
Lie on your back, bend your knees and place your feet on the floor, then slowly let your legs fall to the right and then to the left.
6. One leg to the chest
Lie on your back, grasp one leg with your hands, pull it towards your chest, and continuously alternate legs.
7. Bring both legs to your chest.
Lie on your back, grasp both legs with your hands, and then pull them towards your chest.
8. Wagging the tail
Get onto your hands and knees, position your legs slightly apart, and move your buttocks from left to right, alternating sides.
9. Pelvic tilting
Sit on a chair, then slump down completely, and afterwards straighten yourself back up fully.
Phase 2 of recovery
During this phase, the goal is to strengthen the tendon and muscles through exercises.
1. Bridging
Lie on your back, bend your knees and place your feet on the floor, tilt your pelvis backward, engage your abdominal muscles, and then lift your buttocks.
2. Bridging with one leg
Lie on your back, bend your knees and place your feet on the floor, tilt your pelvis backward, engage your abdominal muscles, and then lift your buttocks. Next, extend one leg.
3. Bird Dog on hands and knees
Get down on your hands and knees, straighten your back completely, then extend one arm and the opposite leg, and bring them back to the starting position.
4. Clam shell
Lie on your side with your shoulder and pelvic girdles aligned vertically, using your upper arm as an anchor against the surface. Bend your hips to 45 degrees and your knees to 90 degrees, keeping your feet together and slightly lifted off the surface. Move your top knee outward/upward while keeping your feet together, then close it again. Your pelvis must remain vertical.
5. Abduction in side lying position
Lie on your unaffected side, rotate your top leg inwards, and lift it slightly. Ensure that your hips and pelvis do not rotate backwards.
Phase 3 of recovery
During this phase, the goal is to build up to sports activities.
1. Squat
Place your feet hip-width apart and perform the movement as if you were sitting down on a chair. Push your hips back and keep your knees behind your toes. Rise back up and repeat the movement.
2. Standing lunge
Perform a forward lunge. Step forward with one leg. Lower the other leg towards the ground, though it does not need to touch it. Ensure that the knee of the leg you stepped forward with does not extend past your toes.
3. Hip thruster 1 leg
Support your shoulders on an elevated surface. Place a barbell—optionally with added weight—across the front of your hips, and position your feet close to the elevated surface. Lift one leg off the ground, then raise your hips as high as you can. Return to the starting position in a controlled manner.
4. Deadlift from a standing position
Stand with your feet hip-width apart, holding a stick or barbell. Lower yourself by pushing your hips back, keeping the stick or barbell close to your legs. Then, rise back up explosively while maintaining a straight back.
5. Gluteus medius walk (resistance band above the knees)
Stand with your feet slightly wider than hip-width apart and a resistance band around both legs just above the knees; keep tension on the band throughout the exercise, bend your knees slightly, and walk sideways back and forth.
Resistance band
Hard. Compact. Qualitatively.
Fitness mat
Hard. Compact. Qualitatively.
Barbell
Hard. Compact. Qualitatively.
The meaning of a piriformis syndrome
Piriformis syndrome (sciatica) means there is an irritation of the large nerve (sciatic nerve) that runs from your lower back down the back of the entire leg. Before reaching the leg, the nerve has to pass through the gluteal muscles. It runs through the piriformis muscle although variations of its path are possible (it can run through, under or over the piriformis muscle). Piriformis syndrome is caused when the sciatic nerve is impinged by the piriformis muscle.
The causes of a piriformis syndrome
This syndrome is caused by overuse or weakness of the lower back muscles. The gluteal muscles have to work harder to maintain lower back and pelvic stability. This leads to increased muscle tone in the gluteal muscles causing pain with sitting, putting your shoes on or reaching to the ground.
The symptoms of a piriformis syndrome
Piriformis syndrome usually causes local pain in the gluteal muscles that can radiate down the back of the leg and even into the foot. In more severe cases tingling, pins and needles and numbness can be experienced. Sitting on the gluteal muscles is often uneasy or painful.
The treatment of a piriformis syndrome
You can start with exercises and stretches to reduce the muscle tension in the gluteal muscles. The physiotherapist can use manual techniques to further reduce the stiffness. Recovery times for piriformis syndrome range from 3 weeks to 6 months.
Did you know?
Scientists are unsure if solely the piriformis causes this injury. There are a lot of muscles in the gluteal region and this syndrome is now often referred to as ‘deep gluteal syndrome’, meaning the pain is caused by some of the deeper gluteal muscles.
Synonyms
Piriformis syndrome, sciatica, sciatic pain, gluteal pain, pain when sitting
Advice
If you have any questions regarding the exercises, doubt if you are doing them correctly or aren’t sure they are suited for your condition, please contact your physiotherapist for support.
Attention:
Yourbody.coach offers a range of exercises. Yourbody.coach can not be held responsible if you develop injuries. Always consult your physiotherapist or specialist.