Piriformis Syndrome Exercises

Piriformis syndrome exercises, like all exercise, should have a purpose or goal and should not be performed just for the sake of exercising.

These exercises should focus on overall strength and fitness and not just the piriformis muscle.

Piriformis Exercises May Be Harmful

Keep in mind, just performing piriformis syndrome exercises, will not correct your piriformis syndrome. It is usually a complex problem and will more likely fully correct if you address all contributing factors.

You may get lucky and get relief. However, there is a great chance that relief will be short-lived. More than likely, the syndrome will return or remain a nagging recurrent problem. You must correct any and all deficits, weaknesses and imbalances that are contributing factors or you will spend needless money and countless days suffering.

For example, if you choose to do stretching for a supposedly tight piriformis that is causing or irritating the sciatic nerve you may in fact cause more pain. The piriformis may be tight due to trigger points. Stretch all you want and unless you eliminate the trigger points the piriformis will resist any attempts at stretching and will remain tight and painful.

Also, if the sciatic nerve is being irritated due to compression by chronic piriformis tightness, further stretching will cause more compression and more pain if the stretch exercises cause you to exert more pressure on the nerve. The secret is isolating the piriformis without compressing the nerve.

Keep in mind... tight muscles will demonstrate weakness.

*Do not assume a tight muscle is weak. The muscle may be strong, it could just be functionally weak due to trigger points. Nor should you try to strengthen a muscle just because it tests weak. A muscle that harbors active trigger points that tests weak may in fact possess strength. Once the trigger point is successfully treated that same muscle will test strong. If trigger points are not treated adequately, the shortened muscles will resist any stretching and will remain functionally weak. If you attempt to strengthen a functionally weak muscle due to trigger points, without first eliminating the trigger points, it will remain shortened and functionally weak. So what you have is a muscle that is tight and tests weak due to trigger points.

Treat All Contributing Factors

There are some conditions that you should check for and then take active measures to treat and correct, along with performing any piriformis syndrome exercises, in order to achieve success. Here is what you should do:

  • Identify and eliminate all trigger points in the piriformis and related muscles. Other related muscles that will probably harbor trigger points are the glutes, hip flexors, hamstrings and lower back muscles.
  • Correct for flat feet and pronation. If left uncorrected abnormal structure and function will persist and make any piriformis treatment difficult, lacking in permanency or down right impossible.
  • Develop and maintain proper sitting, sleeping and standing postures.
  • Attain and maintain a normal weight.
  • Avoid prolonged sitting, standing and forward bending positions.
  • Treat Morton's Foot if present.

Once you have identified all causative or contributing factors and are taking appropriate corrective measures, then you should incorporate piriformis syndrome exercises into your fitness program.

Work On All Exercise Components

These are the three exercise components to consider:

  1. Strengthening of weak muscles.
  2. Stretching overly taut muscle.
  3. Improving muscular endurance.

Piriformis Strength

In my opinion, the piriformis may be weak, but so are all your other hip muscles.

Weak glutes, hamstrings and quadriceps and core muscles will only add more imbalance and stress to the piriformis muscles and the end result will be chronic or recurrent pain.

Piriformis syndrome usually affects those with a sedentary lifestyle or those whose job requires them to sit a lot. My approach to exercise is efficiency.

No one wants to spend more than an hour a day exercising. So you must incorporate exercises that have a more global impact or that affects muscle groups and overall function. Specific exercises that isolate a muscle and in one direction of movement do not strengthen the body in the same manner that it is used throughout the day.

The exercises I recommend are:

  1. Walking. At first you will walk on level surfaces. As you become fit you will graduate into walking on uneven terrain. Ideally, climbing hills and mountain hiking/ trail walking is your goal.
  2. Squats. Start doing this with just the body weight and at first only do half squats. The best way to do this and the safest if your balance is not what it needs to be is with a bench or chair as your target level to squat to. Watch the video for a full description.

Piriformis Stretch

Stretching is essential. However, if you have sciatica due to overly tight piriformis muscle then stretching will most likely just make your sciatica worse. Get sciatica under control before you focus primarily on stretching the piriformis.

You can do some mild stretching to the point of mild discomfort but never stretch to the point of pain.

If you notice an increase in your sciatica following stretching of the piriformis, discontinue any further stretching until you consult your doctor or therapist.

Piriformis Endurance

Finally, endurance needs to be considered. The best exercise for endurance of the piriformis is to just do more repetitions of your exercises and longer walking. 

Don't spend hours in the gym or at home exercising each individual muscle. Rather, you should perform multi-joint exercises that are of a natural function. If you don't you will soon tire of your routine and that new years resolution or any consistent exercise program will be abandoned. Therefor, you accomplish little to nothing in the long term.

Make exercise fun, easy and limited to about an hour a day for real, lasting success.

Exercise Variety Is The Key

Mix it up to max it out.

You should use a variety of activities for fitness. Cross-training is the key. One day hike, the next swim, the following day ride your bike, the next day play tennis or basketball, go bowling frequently, dance, etc.

You need to be exercising the entire body in many manners of activity and not be focusing on just piriformis syndrome exercises. If you only have one activity then you set yourself up for strains and pains. So when you do something out of your routine you are not conditioned to handle it and you risk injuring yourself.

Just like a three-legged stool, the piriformis will only perform properly if all three legs are fit and balanced: strength, flexibility and endurance.

A full body fitness program is your key to success. Targeting the piriformis muscle and neglecting overall fitness will only prolong your recovery and result is short-term relief.

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