10 Best Piriformis Syndrome Exercises to Avoid

As a chiropractor and mom to three, I have always believed that exercise is the key to a healthy body and mind. However, over the years, I have come across many people who complain of pain in their buttocks and hips, which is often diagnosed as piriformis syndrome. This condition can be caused by a number of factors, including overuse of the piriformis muscle, trauma, or even sitting for long periods of time. While exercise can help manage symptoms of piriformis syndrome, certain exercises can actually make the condition worse. In this article, I will share the top 10 Best piriformis syndrome exercises to avoid, along with alternative exercises and self-care tips to help manage the condition.

Introduction to Piriformis Syndrome and Its Causes

Piriformis syndrome is a painful condition that occurs when the piriformis muscle, located in the buttocks, becomes tight or inflamed and compresses the sciatic nerve. Piriformis syndrome symptoms can cause sciatica-like pain, numbness, or tingling in the buttocks, hips, and legs. In some cases, the pain may be severe enough to interfere with daily activities or even make it impossible to sit or stand for long periods of time.

There are several causes of piriformis syndrome, including overuse of the piriformis muscle, trauma to the buttocks or hips, or even sitting for a long time. Athletes who participate in activities that involve repetitive motions, such as running or cycling, are more prone to developing piriformis syndrome.

Additionally, people who have poor posture or suffer from conditions such as scoliosis or arthritis may also be at increased risk. Lastly, piriformis syndrome in pregnancy is more common, as the increased weight of the baby can put additional strain on the piriformis muscle.

The Role of the Piriformis Muscle in the Body

The piriformis muscle is located in the buttocks and is responsible for rotating the hip and stabilizing the pelvis during walking and other activities. When the piriformis muscle becomes tight or inflamed, it can compress the sciatic nerve, which runs beneath the muscle. This compression of the sciatic nerve can cause pain, numbness, or tingling in the buttocks, hips, and legs.

The symptoms of piriformis syndrome can resemble those of sciatica, as both conditions involve compression of the sciatic nerve. However, unlike sciatica, which is caused by a herniated disc, spinal stenosis or other structural changes in the low back, piriformis syndrome is usually caused by overuse or trauma to the piriformis muscle itself. Sciatica symptoms include pain, numbness, and tingling that usually radiates down one leg, whereas piriformis syndrome may cause chronic pain in the buttocks area and referral of pain into the lower extremity.

Importance of Avoiding Certain Exercises for Piriformis Syndrome

While exercise can be beneficial for managing piriformis syndrome, there are certain exercises that can aggravate the condition and make it worse. These exercises often involve movements that put strain on the piriformis muscle or compress the sciatic nerve. By avoiding these exercises, people with piriformis syndrome can reduce their pain and prevent further injury.

Top 10 Piriformis Syndrome Exercises to Avoid

Squats: Squats involve bending the knees and lowering the body, which can put strain on the piriformis muscle. Additionally, squatting can compress the sciatic nerve, which can aggravate piriformis syndrome.
Lunges: Like squats, lunges involve bending the knees and lowering the body. This can put strain on the piriformis muscle and compress the sciatic nerve, which can cause pain and discomfort.
Deadlifts: Deadlifts involve lifting weights from the ground, which can put strain on the lower back and buttocks. This can aggravate piriformis syndrome and cause pain and discomfort.
Leg Press: Leg press machines involve pushing weight away from the body using the legs. This can put strain on the piriformis muscle and compress the sciatic nerve, which can cause pain and discomfort.
Leg Extensions: Leg extensions involve straightening the legs against resistance. This can put strain on the knee and hip joints, which can aggravate piriformis syndrome and cause pain and discomfort.
Step-ups: Step-ups involve stepping up onto a raised platform using one leg at a time. This can put strain on the piriformis muscle and compress the sciatic nerve, which can cause pain and discomfort.
Sit-ups: Sit-ups involve bending the spine and lifting the upper body off the ground. This can put strain on the lower back and buttocks, which can aggravate piriformis syndrome and cause pain and discomfort.
Toe Touches: Toe touches involve bending forward and touching the toes. This can put strain on the lower back and buttocks, which can aggravate piriformis syndrome and cause pain and discomfort.
Running: Running involves repetitive motions that can put strain on the piriformis muscle and compress the sciatic nerve. This can aggravate piriformis syndrome and cause pain and discomfort.
Cycling: Cycling involves repetitive motions that can put strain on the piriformis muscle and compress the sciatic nerve. This can aggravate piriformis syndrome and cause pain and discomfort.

Explanation of Why These Exercises Can Aggravate Piriformis Syndrome

The exercises listed above can aggravate piriformis syndrome because they involve movements that put strain on the piriformis muscle which can compress the sciatic nerve. When the piriformis muscle becomes tight or inflamed, it can compress the sciatic nerve, which can cause sciatic pain, numbness, or tingling in the buttocks, hips, and legs.

Additionally, exercises that involve bending the spine or lifting heavy weights can put strain on the lower back, buttocks and back of your leg, which can worsen piriformis syndrome pain. Running and cycling involve repetitive motions that can put strain on the piriformis muscle and compress the sciatic nerve, which can also aggravate the condition. It’s also helpful to know which exercises to avoid with sciatica as well.

Alternative Exercises to Consider Instead

While the exercises listed above should be avoided by people with piriformis syndrome, there are alternative exercises that can help manage the condition and provide pain relief. These strengthening exercises focus on the muscles that support the piriformis muscle and improving flexibility in the hips and lower back.

Piriformis Stretch: This stretching exercise helps to loosen the piriformis muscle and reduce pain. To do this stretch, lie on your back and bend your knees while keeping your feet flat on the ground. Cross one leg over the other, so that your ankle is resting on top of the opposite knee. Reach around with both hands and pull the bottom knee towards your chest for a gentle stretch in the back of the leg, hip and buttock. You can also perform this exercise in the sitting position in a chair!
Glute Bridges: Glute bridges involve lying on the ground with the knees bent and lifting the hips off the ground. This exercise strengthens the glute muscles, which can help support the piriformis muscle.
Clamshells: The starting position to perform clamshells involve lying on one side with the knees bent and lifting the top knee while keeping the feet together. This exercise strengthens the hip abductor muscles, which can help support the piriformis muscle.
Bird Dogs: Bird dogs involve getting on all fours and lifting one arm and the opposite leg at the same time. This exercise strengthens the core muscles and improves stability in the lower back and hips.
Planks: Planks involve holding the body in a straight line with the forearms and toes on the ground. This exercise strengthens the core muscles and improves stability in the lower back and hips.
Yoga: Yoga involves a series of poses that focus on improving flexibility especially in the hip flexors. Many yoga poses can also be modified to accommodate people with piriformis syndrome.

How to Modify Exercises to Avoid Aggravating Piriformis Syndrome

For people who want to continue doing exercises that are on the list of exercises to avoid, there are modifications that can be made to reduce the risk of aggravating piriformis syndrome. These modifications include:

Using lighter weights: When doing exercises that involve lifting weights it’s a good idea to use lighter weights. It can help to reduce the strain on the piriformis muscle and lower back.
Using resistance bands: Resistance bands can be used to provide resistance during exercises without putting strain on the piriformis muscle.
Limiting range of motion: Limiting the range of motion during exercises can reduce the strain on the piriformis muscle and lower back.
Using proper form: Using proper form during exercises can reduce the risk of injury and aggravating piriformis syndrome.

Stretching and Self-Care Tips for Piriformis Syndrome

In addition to exercise modifications, there are several stretching and self-care tips that can help manage piriformis syndrome. These include:

Foam rolling: Foam rolling can help release tightness in the piriformis muscle and improve flexibility in the hips and lower back.
Stretching: Stretching can help improve flexibility in the hip, buttock region and lower back muscles, which can reduce the risk of piriformis syndrome.
Ice or heat therapy: Applying ice or heat to the affected area can help increase blood flow, reduce pain and inflammation. Using cold packs for acute symptoms and warm packs for chronic symptoms.
Massage therapy: Massage therapy or pressure point therapy for sciatica related pain can help release tension in the gluteal muscles and promote relaxation.
Dry Needling: Dry needling can help reduce muscle tension and improve flexibility. It can also help reduce inflammation and pain.

Diagnosis and Treatment Options for Piriformis Syndrome

Diagnosis of Piriformis syndrome usually includes a physical exam, and in some cases may include an MRI scan or X-ray. The doctor will look for areas of tenderness and check the range of motion in the lower spine, gluteal region, hips and legs.

While exercise modifications and self-care can help manage piriformis syndrome, there are also medical treatments that can be used to reduce pain and inflammation. These treatments include:

Physical therapy: After a physical examination, a physical therapist can help you improve flexibility and strength in the muscles, which can reduce the risk of piriformis syndrome.
Medications: Over-the-counter pain relievers and anti-inflammatory drugs such as ibuprofen or acetaminophen can help reduce pain and inflammation.
Injections: Injections of corticosteroids or a local anesthetic can help reduce pain and inflammation.
Surgery: In severe cases, surgery may be necessary to release the piriformis muscle and relieve pressure on the sciatic nerve.

Conclusion and Final Thoughts

Piriformis syndrome can be a painful and debilitating condition, but with the right exercise modifications, self-care, and medical treatments, it can be managed effectively. By avoiding certain exercises, focusing on strengthening and flexibility exercises, and seeking medical treatment when necessary, people with piriformis syndrome can reduce their pain and improve their quality of life. If you are experiencing symptoms of piriformis syndrome, consult with your healthcare provider to determine the best course of treatment for you.