Relieve Piriformis and Sciatic Pain

Article by Lucas Rockwood

Do you have a tight piriformis muscle? Is it causing pain in your butt or even sciatic nerve irritation? If so, this guide is for you. We’ll look first at the anatomy of the piriformis, and then we’ll try two exercises to stretch and relieve tension in this unique muscle.

Anatomy of the Piriformis

The piriformis is a unique muscle in that it changes its function based on your hip angle. The muscle attaches at your greater trochanter, the bony part on the side of your femur, it crosses the backside of your pelvis, and then attaches to the anterior side of your sacrum (see below).

It’s primarily a lateral rotator, so when the muscle contracts, it helps to open your hip to the outside. But because of its unique location, if you flex your hip past 90-degrees, the piriformis suddenly becomes a medial rotator – this is quite unusual.

Since this muscle is involved in many hip and leg movements – and because of where it’s located – it can often become irritated, overstretched, or overused. This might happen from sitting on a wallet all day, crossing your legs one way but not the other, long hours spent driving, or any other form of overuse during exercise.

Sciatica & The Piriformis

The sciatic nerve runs right next to the piriformis, and in some people, right through the muscle; so an inflamed piriformis can be very painful and problematic. While most sciatica is caused by a lumbar spine compression injury, in an estimated 5% of cases, sciatica can be caused your piriformis muscle.

To make things challenging, because it’s both a lateral and medial rotator, it can be tricky to stretch and almost impossible to isolate during stretches. Challenges aside, the piriformis can be stretched, and it’s also a muscle that responds well to push-release massage to alleviate excess tension.

Corrective Exercises

It’s helpful to both stretch and massage your piriformis muscle. Stretching is designed to increase the actual muscle length, while massage is designed to relieve any resting tension that might be present. In either case, particularly if you feel radiating pain in your sciatic nerve, take it slowly and be gentle.

Download PDF pose chart

1) Pretzel Leg Twist

  • Cross your right leg over your left
  • Press your legs to the left
  • Stretch your right arm out in a T-position
  • Hold for 2 minutes and switch

2) Press-Release Massage

  • Use a massage ball, tennis ball or foam roller
  • Press and roll for 1-2-3-4-5 and then reverse 5-4-3-2-1
  • This press-release practice is designed to relax the muscle
  • Do not push into pain, instead ease into it

Safety Disclaimer

If you have a major injury or are suffering from severe sciatica, please go see a doctor, this is for education purposes only.

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