Piriformis Syndrome: Stretch The Pain Away - Next Level Physical Therapy
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Piriformis Syndrome: Stretch The Pain Away

Tingling And Numbness Down The Back Of Your Leg?

This article is for those of you who have a deep nagging butt pain that might cause some numbness tingling down the back of your thigh. The piriformis muscle is located under the butt muscle and sits on top of the sciatic nerve. So when the muscle is pressing on the nerve, it can irritate the nerve and cause numbness and tingling down the back of your thighs.

If you prefer to learn through video you can see demonstrations of these stretches and exercises

YouTube video player

The most common cause of piriformis syndrome is compensation from weak muscles around the area. You can also develop performance syndrome if you sit on uneven surfaces like a soft couch or have a wallet on one side of your back pocket.

What Do You Do?

Now that you know the common causes of piriformis syndrome, let’s talk about the treatment strategy. There’s three steps to get rid of piriformis syndrome. This is the RSS method:

  • Rest
  • Stretch
  • Strengthen
RSS stands for rest, stretch, and strengthen
Rest, Stretch, And Strengthen

Let’s break these steps down a little more.

Rest

You have to pay attention to the triggers like we mentioned before, and do as little of that as possible. Then after that you want to massage the muscle to relax it. There are several ways you can do this.

Dr. Wong demonstrates how to massage the piriformis muscle with your hand
Use Two Fingers To Find The Tender Spots And Move Them Up And Down

The easiest way is to take one or two fingers and find the tender spots in the butt area and move your fingers in up and down motion to relax the muscles. You can also use a foam roller to apply pressure to the same muscle for a more aggressive approach. If you really want to bring it up a notch, you cross your leg over while rubbing the performance muscle with the foam roller.

Dr. Wong demonstrates how to massage the piriformis muscle with a foam roller
Move Your Hip Back And Forth Over The Foam Roller To Massage The Piriformis Muscle

If the foam roller doesn’t work for you, you can always use a tennis ball to rub the piriformis muscle while you cross one leg over. Some of you might have a hard time getting into the position to use a tennis ball or foam roller. So you can also use a massage gun.

The massage head that I like to use looks like a finger and what you do is you define your tender spots on a piriformis muscle and just apply the massage gun for one or two minutes until the tender spots disappear.

Dr. Wong demonstrates how to massage the piriformis muscle with a massage gun
Move The Massage Gun Up And Down Over The Piriformis Muscle

No matter which way you decide to massage the piriformis muscle, you have to check your symptoms during the massage to make sure that there’s no increase in numbness or tingling down the back of your thigh. If you do feel numbness and tingling down the back of your thigh as you’re massaging a piriformis muscle, you want to make sure that you dial it back because you’re pressing way too hard.

After a few minutes of massaging the piriformis muscle you want to start stretching it. I’m going to show you two ways on how to do it.

Stretching

The first stretch is on your back, where you cross the right foot over the left knee. From here you’re going to pull the right knee towards the left shoulder while the right leg is completely relaxed. Once you feel a stretch in the right butt cheek you’re going to press that left knee into the right hand.

So essentially the forces are matching each other and you’re going to hold this for 10 seconds. If you do this correctly, you should feel the right butt cheek contract after 10 seconds.

Then you’re going to try to pull that right knee towards the left shoulder to get more range of motion and what you’ll feel is that tightness in the butt actually decreases. You want to repeat this 10 seconds for four more rounds.

Dr. Wong demonstrates how to stretch the piriformis muscle while laying down
Pull The Knee Across The Body Toward The Opposite Shoulder

Sometimes it’s not convenient to be on your back so I’m going to show you a chair version.

While sitting upright in a chair you’re going to cross the right leg over the left knee and pull that right knee towards the left shoulder. You’re going to feel a stretch in that right butt cheek and when you do you’re going to push that right knee toward your hands and match the force. Hold that for 10 seconds.

What you’re going to do is pull that right knee towards the left shoulder a little more to make sure you don’t pull too hard where you feel numbness or tingling down the back of that thigh. You want to repeat this for four rounds of 10 seconds.

Dr. Wong demonstrates how to stretch the piriformis in a chair
Sit Upright In A Chair And Pull The Knee Up Toward The Opposite Shoulder

The next step in eliminating piriformis syndrome is to strengthen the muscles around it.

Strengthening

The main reason people develop piriformis syndrome in the first place is due to weakened muscles in the pelvis. The first exercise to strengthen those muscles is a butt activation exercise.

You start off on your back with both knees bent, known as a hook lying position. Then you’re going to bend that right knee up and hold it with two hands. Pull the knee toward you at the same time that your right leg is trying to kick out so that the forces are matching each other. No body parts are really moving.

Dr. Wong demonstrates how to do a butt activation exercise
Pull The Knee Toward The Body While Kicking The Foot Away

You should feel your right butt cheek contract. You want to hold this for 10 seconds for four sets.

The second strengthening exercise for piriformis syndrome is a sideline clamshell hold. You lie on your side with both knees bent and stacked on top of each other. Then what you’re going to do is round the pelvis and then shift the right leg forward until you feel a slight stretch on the left hip.

Once you feel that stretch in the left hip you’re going to open the right knee toward the ceiling. You’re going to feel a sensation behind the butt cheek muscle. If you’re wearing a pant leg that has a line running through the side of your leg, you should feel the muscle right behind the line. That’s how you know you’re doing it correctly.

Dr. Wong demonstrates how to perform a sideline clamshell hold exercise
You Should Feel A Sensation Behind The Butt Cheek When You Hold This Position

You want to hold this position for 15 seconds for 4 rounds total in order to keep your piriformis syndrome away. It is critical that you perform these exercises several times a week.

Get The Treatment You Deserve

Now that you know how to resolve your piriformis syndrome, comment below and let us know which of these work best for you.

The most important thing to keep in mind is to do these exercises consistently and as often as you can tolerate. This will keep your piriformis muscle from becoming inflamed and pinching the sciatic nerve.

Please click the button below to talk to one of our sciatica specialists to get answers to all of your questions and concerns.

AUTHOR

Dr. Jack Wong

Next Level Physical Therapy

"We Help People Age 40+ Stay Active, Healthy & Mobile Without Relying On Pain Meds, Injections Or Surgery"




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