“It’s My Piriformis!”

Have you heard? It’s all the rage! Everyone’s doin’ it!

What is it??

Well… it seems that everyone has got a Piriformis Syndrome going on lately! What’s going on at those parties of yours?

The Piriformis muscle is located in the back of the hip and butt. Like any muscle, if you strain it or overuse it, it will hurt. Spasms, cramps, trigger points can cause pain in the butt, back or side of the hip, and can even radiate into the back or side of the thigh. It usually happens on one side only, where pain in both hips/ gluteal regions can indicate that it is something else (usually in the lower back).

Then if I have pain in my butt, it must be my Piriformis, right??Not always… you have several other muscles back there that can hurt. The joints, muscles, discs and nerves in the lower back can also radiate to the butt. Arthritis in the hip can cause aching in the butt as well. And then there’s the Sciatic Nerve! It travels through the butt and runs right next to (and sometimes even through) the piriformis muscle.

So if I have pain in my butt, how do I tell if it’s my piriformis or something else?

The hard truth is… you don’t know! It takes a good Orthopedic exam and a good command of anatomy to tease out each structure to find the culprit(s).

So what do I do if I have pain in my butt and the back of my hip?

There are several places to start when that butt/hip pain starts up and won’t go away on its own:

  1.  Pull your knee to your chest and stretch out the back of the hip and some of those muscles. Hold and take 3-5 good deep belly breaths, then relax.
  2. Pull your knee to your chest again and then pull it across your chest toward the opposite shoulder. You’ll feel the stretch in a different place in you butt. Again, hold for 3-5 deep belly breaths.
  3. Get on your hands and knees. Rock backwards, trying to touch your butt to your heels. Let your lower back round out and take a few relaxing breaths. (Child’s pose for those who know it.) https://www.youtube.com/watch?v=4xPXuE0z19Y
  4. Back to your hands and knees. Rock forward while keeping your elbows straight, allowing your belly to sag to the floor and your back to arch into extension. (Cobra pose). Again, take a few relaxing breaths before returning to your starting position. https://www.youtube.com/watch?v=4xPXuE0z19Y
  5. Begin focusing on your core strength and your hip strength. That piriformis (or the other hip muscles) may just be over working because something else is getting weaker.
      1. Try planks on your hands/forearms and some side planks.
        https://www.youtube.com/watch?v=BQu26ABuVS0
      2. Follow up those planks with some rolling (segmentally!) to train your brain to use that
        strength that you are building.
        https://www.youtube.com/watch?v=C7Vxcb1yOro
      3. Crawling on your hands and knees (or even on your hands and toes, with the knees off the ground) can be an excellent way to strength the core and hips all at once.

Finally, try some squats and lunges for even more strengthening through a larger range of motion. If you have given these basics a try and are still dealing with pain, then it’s time to see a professional.

See a personal trainer, coach, physical therapist or orthopedist to figure out the specifics of your pain and what to do about it. Or you can give us a shout at drkurt@os-institute.com and we’ll try to figure it out with you, or at least steer you in the right direction!

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