Unpleasant pain in the buttocks and back of the thigh causes the so-called Piriformis Syndrome. A “swollen” piriformis muscle causes pressure on the large sciatic nerve, which causes the burning stitches. In the following, the background is explained and suitable exercises and measures from physiotherapy are explained in order to achieve freedom from pain as soon as possible.
6 simple exercises to imitate
1st Exercise – “Rolling out” 2nd Exercise – “Stretching while sitting” 3rd Exercise – “Stretching in supine position” 4th Exercise – “Swivel position” 5th Exercise – “Relaxed dog 6th exercise – “Abduction
Physiotherapeutic intervention
The be-all and end-all of physiotherapy for Piriformis Syndrome is the relief, relaxation and stretching of the affected muscle. At a later stage, when pain is no longer experienced, specific muscle building training can be started. Passive techniques for muscle relaxation are the painful but effective cross-frictions, trigger point therapy and fascial techniques, which have the advantage of treating the entire muscle chain where the problem often lies or is passed on.
Ultrasound and electrotherapy in physiotherapy also have a relaxing effect in Piriformis Syndrome and help the structures to regenerate. 1st exercise A self-exercise for at home is rolling out on a tennis ball or a fascial roller. This is placed under the tense muscle in a sitting or lying position and is moved back and forth under the body’s self-adjustable load by rolling slowly.
2. stretching exercises for Piriformis Syndrome should be performed in the supine, seated and rotating-stretching positions. The simplest form of stretching that can be performed anywhere in everyday life is the following: In the seat on a chair, the legs are parallel to the hip width on the floor, now the foot of the leg to be stretched is placed on the opposite knee or thigh. Now gently push the knee towards the floor or lean the upper body slightly forward so that a stretch can be felt in the buttocks area.
Hold this for about 30 seconds and change the leg. It is recommended to always stretch and exercise both sides. 3rd Exercise The same exercise can be performed in the supine position.
The legs are upright, one foot is placed on the opposite thigh. The hands grasp the positioned thigh, pull the leg gently towards the chest and the thigh pushes the knee of the leg to be stretched away from the body. 4th Exercise A rotational stretching position from physiotherapy in case of Piriformis Syndrome for the entire muscle chain looks as follows: From the supine position, the leg to be stretched is bent and placed on the floor over the other leg.
The lower back turns to the side and the upper body remains lying straight on the back. Try to relax and let the rotating stretching position drop completely. 5. exercise Active exercises to strengthen the abductors and support the piriformis are to be performed as follows: From the quadruped position, spread one leg out to the side at right angles and return it under the body without putting the knee down.
Repeat this exercise 3 x 12 times on each side to train the strength endurance area, which is appropriate for everyday stress. 6th exercise Another exercise from physiotherapy for Priformis syndrome is performed in the lateral position. The knees are slightly bent.
Now the upper leg is turned outwards and upwards without the feet coming apart. Lower again without putting the leg down completely and do the same 3 x 12 times on each side. Strength exercises should be done slowly and with tension, without using much momentum.
In this way the muscles are trained optimally and, if possible, without evasive movements. In order to build up stability in physiotherapy and to train the whole muscle chain, balance exercises on a wobble board, soft ground or in a one-legged stand are recommended. For example, try standing on a rolled up blanket, lifting one leg forward at a right angle and holding it for a while.
This can be varied by tip-toeing or additional arm exercises or a slight knee bend in the standing leg. The musculus piriformis is a small deep muscle at the back of the buttocks. From the sacrum it moves almost horizontally to the large rolling mound on the upper outer side of the thigh bone.
Its functions include stabilizing the hip joint – by pressing the femoral head into the acetabulum at the pelvis, spreading the leg, stretching the leg backwards, and outward rotation. Direct branches from the sacral nerve plexus supply the muscle.The great sciatic nerve runs through a point of passage between piriformis and bone – in some people it even runs through the middle of the piriformis muscle. Because of the narrow point of passage, the sciatic nerve is prone to pressure problems in this area – especially in people whose sciatica runs through the muscle.
Overloading – especially in the case of incorrectly loaded runners -, after injuries or after long periods of sitting with additional pressure load, for example a wallet in the back pocket, leads to the so-called Piriformis Syndrome. Burning, stabbing, deep and sometimes radiating pain in the back or leg puts a strain on the patient. Increased muscle tension and spatial demands irritate the nerve and make it send unpleasant signals.
The pain occurs particularly when bending, sitting or the above-mentioned muscle functions, spreading and external rotation – in other words, in all positions that compress and strain the muscle and thus the nerve even more. Sensory disturbances in the supply area of the sciatica or muscle function disorders can also occur in Piriformis Syndrome. If you are interested in this topic, this article may be just what you are looking for: Exercises for sciatica pain during pregnancyIt is important to determine the cause of Piriformis Syndrome.
Whether it is a wrong walking technique, wrong shoes, the wrong posture, a problem in the muscle chain,. The original cause must be treated in physiotherapy for a final success. If only treated symptomatically, the problem is very likely to reoccur again and again after repeated overuse or incorrect loading.
There are various tests to stretch the muscle or to provoke it by muscular activation. Often the symptoms of Piriformis Syndrome are associated with a herniated disc. This can be ruled out by clinical tests or medical imaging examination.
To prevent piriformis syndrome, a stabilizing muscle corset should always be available. The different muscles must be in balance. A correct running style and the right shoes protect against injuries and tension.
Regular stretching exercises, especially after sport, also help to relax the muscles. Do not ignore pain – listen to your body! With the application of Kinsiotape, good results can be achieved with the Piriformis syndrome. A detailed instruction and experience them in the article Kinesiotape. More exercises to prevent hip pain can be found here: Physiotherapy for hip pain
