DIY Friday: Piriformis Syndome, The Literal Pain in the Ass

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*Do it yourself! Every Friday we do a roundup of great posts, videos, or other resources around a theme that help people to turn their bodies from cranky to happy.*

498391534_e8873818ac_zSometimes when it rains it pours, and right now it is raining pains in the ass in my life. Fortunately not of the icky people variety, but rather in the actual ass department. For whatever reason not only am I seeing a lot of clients in my Rolfing® practice with piriformis syndrome at the moment, but one of my closest friends is also currently in agony from the same thing. So for all of you who are dealing with this rather unpleasant pain syndrome, this DIY Friday is dedicated to you.

Before we dive into the resource round up for the week, just a little bit about piriformis syndrome. Your piriformis is a small muscle in the back of your pelvis which connects to your sacrum and hip and is deep to your glutes. This muscle and the sciatic nerve have a special relationship: depending on your anatomy it either passes right next to the piriformis and they are close neighbors, or some people have a split piriformis muscle and the sciatic nerve passes right through it. It causes pain, you guessed it, in your ass, and because of the nerve agitation can also travel down your leg and into your foot. The pain can be severe and is frequently caused by the thing we do most commonly in our culture: sitting (especially sitting on your coccyx/tailbone with a rounded low back!). Now on to the good stuff:

  1. First, check out what the divine Katy Bowman, founder of The Restorative Exercise™ Institute has to say about stretching the piriformis, and also preventing and resolving piriformis syndrome through sitting appropriately. Sitting on your tuberosities instead of your coccyx is one of my big important causes that people have to listen to me yammer on about all the time. So now you can listen Katy for a change. Here’s her post where she declares Stretch Your Piriformis Day a holiday. I’m all for it! This also includes one of my favorite alignment nerd videos of all time.
  2. Next, Brett Blankner of Zen and the Art of Triathalon has a very handy video that covers how to do nerve flossing to relieve the pain on your own. That sounds like fun, right? But it’s thoroughly useful. We’ll forgive Brett for sitting on his tuberosities in the video since it’s just so dang helpful. Also I choose to believe that it’s because he filmed it in a cramped hotel room. You sit on your tuberosities, right Brett!? I digress, you can watch that video here.
  3. Next up, Dawn Adams tackles it on the Yoga Tune Up® blog. This talks about how you can use the therapy balls to work it, and includes a video of another great stretch. Here’s all that goodness.
  4. And, oops, since the magical Alpha Ball is new, there isn’t any video of how to use that (which Dawn mentions in her post and which I am a huge fan of), so I made up up right quick for you which you can watch right here:
  5. Lastly, hey now, there’s a book! And it’s written by all around great body nerd Jonathan Fitzgordon who created the Core Walking Method! Right on! Sciatica/Piriformis Syndrome to the rescue.

Photo by Erik Mallinson


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6 Responses to “DIY Friday: Piriformis Syndome, The Literal Pain in the Ass”

  1. mz April 26, 2013 at 11:45 pm #

    omg! I don’t know if you were talking about me… but man, I have a pain in the ass! I have done the nerve flossing (very helpful), and I often roll out the muscles in my piriformis, but the wall is a nice change. will try. you rock.

  2. mz April 26, 2013 at 11:49 pm #

    Also – just a note on stretching (and I’m curious about your take on this) – I’ve noticed that if my piriformis is really upset, stretching aggravates it. I have learned to distinguish between releasing tension, and stretching. They are not one and the same. Stretching a muscle that is tense does not help my pain the ass. I have to release the tension first, THEN stretch. I can release the tension with a ball or roller, and I notice that heat helps, too. Then I stretch – and this is really good in a hot epsom salt bath after the tension release.

    Is there something to this tension/stretching sequence? I’d love your perspective.

    thanks again for the awesome site.

    • Brooke April 27, 2013 at 7:37 am #

      I totally agree with you, and this is particularly true when a nerve is involved, especially a big bad boy like the sciatic nerve. If/when it gets trapped in the fascia, without releasing the soft tissue first you can just be tugging on it and agitating it without release. I often liken it to trying to pull out a drawer that is stuck- you can either keep tugging on it to no avail, or you can gently push it back in a little bit, unhooking it, and then pull the drawer out smoothly. Go forth and release your piriformis! : )

  3. Terral April 29, 2013 at 8:17 pm #

    I’d like to know more about what actually causes it. You mentioned sitting which I know I do too much of but are there other things that can cause it? Pain relief is nice but getting to the root of the problem is best.

    • Brooke April 30, 2013 at 7:44 am #

      With any soft tissue condition the route to how it started can be pretty diverse, as it’s either a matter of a traumatic injury like a car accident or a sprain or break (in which case people know how they wound up with the problem), or a more subtle case of a broader compensatory pattern in one’s movement habits and structure that causes the body to lay down additional collagen and elastin fibers, thereby “glueing” up the area. So in the case of piriformis syndrome it can be a wide variety of things like standing (sleeping and sitting) with one leg turned out for many years, or misusing and overusing one side (as in a martial artist or dancer who always leads with and overuses one leg), to an anatomical leg length difference. So the detective work of unraveling what structural imbalances might be causing the problem is really an individual thing, but a worthy journey to go on!

      • Terral April 30, 2013 at 12:50 pm #

        That helps. Thanks!

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