- In this video, I'm gonna show you four exercises
to help you deal with the painful symptoms of
Piriformis Syndrome and fix the underlying root causes
so it doesn't come back again.
So, I have four exercises for us
to help deal with Piriformis Syndrome,
two of which are more about stretching
and looking after soft tissue health
and two of which are more about strengthening
and creating stability,
really waking those glutes up, in particular.
So, we're gonna start out with the foam rolling,
We're gonna then move into the stretch work.
Now, of course, this type of work alone is not the answer
when it comes to Piriformis Syndrome.
It's an important part of dealing with symptoms,
particularly when you feel that tightness
and you feel that pain deep within the buttock region
or even starting to radiate down into the back of the leg,
but, ultimately, when it comes to dealing long term
with Piriformis Syndrome or fixing a long term problem,
strengthening and stability is the answer.
But let's start out, because these are useful tools.
Firstly, foam roller, secondly, lacrosse ball.
This guy is where we're gonna begin.
We're gonna begin sitting on the foam roller.
Now, weight at this point, evenly distributed.
Left and right, okay, not favoring one side,
but to go looking for tightness let's say in my right hip
in Piriformis, we need to shift our weight onto that side,
so right hand goes down, right ankle comes up
onto opposite side knee.
That puts piriformis under a little bit of a stretch
straight away, which is good,
but from there, we can start rolling up and down
and looking for a little bit of tightness,
looking to find any spots that feel particularly tender.
And when we find a spot, there is one for me,
just going to hover over that and put my weight
down onto that spot, so breathe nice and relaxed.
Obviously, I'm talking to you guys,
so my breathing is not gonna be quite as relaxed,
but you should really focus on nice relaxed breathing
as you hold on there for about 10 seconds,
and then off we go again.
It's up and down, just working to find those tender spots.
Again, shift your weight a little bit,
but we should be specifically putting the weight
on this hip of the leg that is up and across.
Now, again we find another spot, we can just hold on there.
You can even start to just ever so slightly
oscillate your weight across what feels
like a tender spot there.
And work into that area.
Again, 10 seconds or so,
not putting your full weight through,
so you've got your weight obviously on the supporting arm
there, as well.
You'll want to do this three to five times through.
You can do both hips, but I'll just demonstrate
the right here.
You should feel that you're really able to get in
and hit a spot.
Now, you can get in deeper and hit even more
of a specific spot with this little chap,
a little lacrosse ball.
Now, this is more intense
because it provides a lot more point loading.
Let's just put the old foam roller away.
And the same setup really applies.
So we're gonna start out, we're gonna put the roller,
sorry, not the roller, the ball, just underneath
right hip here.
We're gonna get into the same kind of position.
So, ankle up onto knee,
and the weight now is gonna be supported on both hands.
I want to simply now go looking for those similar
kind of tight spots, those similar areas that provide
that little bit of discomfort,
and, again, we can just put a little bit more weight now
through the area.
Now, I've found it, that little trigger point.
Keep regulating the amount of weight you put through
by how much weight you're putting through your arms.
And, again, just oscillating side to side over it now.
I'm just gonna maintain this, 10 seconds or so,
nice relaxed breathing, and then we can move on
and do the same four or five times through.
Okay, now, this kind of soft tissue work
is all well and good.
It does a great job for beginning to deal with
some of the tightness in the piriformis muscle
that you might be experiencing
that might be starting to cause the irritation
to your sciatic nerve and, therefore, the neural symptoms,
but, ultimately, you've got to think about why
the piriformis muscle, in particular, is getting tight.
A lot of the time it's down to weak glutes.
So, we can move into a few exercises,
which start to target weak glutes, in particular.
So we can kick off with an exercise
which actually starts in this position,
which is our glute march.
Matter of fact, we'll start with
a regressed version of that.
We'll start with our glute bridges,
and then we'll move into our glute march.
So, from here, heels close in towards your butt.
Before you even lift your hips up off the ground,
I want you to think about the pelvic position.
I want you to gently draw your belly button in.
Don't hold your breath.
You should feel like you're squeezing those lower
abdominal muscles,
not maximally, but you should feel
that you're able to engage those core muscles
on a scale of two or three out of 10, effort-wise.
And then, from there I want you to squeeze your butt
as you push your heels down into the ground
and come up into a bridge.
It's not as high as you can possibly go, okay?
Because that would have you start
having you arch your lower back.
We just want to use a comfortable position
where you can feel your clinching those butt muscles
and you're lifting yourself off the ground.
So, pushing down through the heels,
weight through your shoulders.
From there, you're gonna hold for 10 seconds,
and you're gonna come down, slow and controlled.
Lower back presses into the ground,
so we're not arching the back.
I should not be able to get my hands under here.
Lower back presses into the ground
and draw your belly button there in again,
push through the heels, tense your butt,
and come up again.
We're gonna hold this.
Squeeze those butt muscles,
clinch the whole way through this 10 seconds,
and at the end of 10 seconds, again,
you're gonna come down.
Good little glute activation exercise,
beginning a little bit of strengthening
through those glute muscles.
10 times 10 second holds is a good place to start with this.
From there, we can then take that an extra stage forwards.
We're gonna come up into our glute bridge, as well,
as we did previously,
but from there, if I'm going to straighten out my left leg,
we can initially create stability by clinching glutes
on the right hand side.
So, squeeze your butt and lift the opposite leg.
We're not coming up here anywhere.
It's just to a point where the knees are staying level
with one another.
You're holding that for 10 seconds and then coming down.
Push through the heel on this side,
squeeze your butt on this side,
release the other side.
We're looking to maintain this, slow and controlled.
After 10 seconds, we're down.
In this transition, between right leg weight bearing
and left leg weight bearing, there should be no movement
through the pelvis.
We're looking to keep those fingertips absolutely still
as we're going from left to right
and right to left.
What we see all too often
is where people don't have the control and stability here,
and we'll see a flip down.
Ill show you the other side.
We'll show from here, you lift the leg up
and the pelvis drops.
We're looking to create the stability by squeezing the butt
on the standing leg and lifting the moving leg, and down.
Again, 10 times 10 second holds, five on each side.
So that's the first foam rolling exercise
and the first strengthening exercise.
The second mobility or stretching type exercise I want
to work through is a figure-4 piriformis stretch,
very straight forward.
While I'm down in this position, perfect time to do it.
From here, ankle onto knee.
Again, looking to press the lower back into the ground,
engage your core.
I want you to put your hand on the inside of the knee,
and from there you're going to push.
For many of you doing this alone,
creating external rotation in a hip-flexed position
will create a piriformis stretch,
if you're particularly tight through there.
You can hold this anywhere from 20 to 40 seconds,
nice, relaxed breathing,
but for some people, this won't create much of a stretch
and it should be in this piriformis region
that you're feeling it.
So what you can do is you can intensify this
by reaching your hands through the hole that you've made
and taking the knee back with you of this hanging leg.
That will force you into, on this side, more hip flexion
in that externally rotated position.
And, for me, this feels like quite a piriformis stretch.
Again, holding this 20 to 40 seconds.
That's a good timeframe to work through,
and I do this three or four times on each side.
Okay, from there, we can move now into the next
of our strengthening/ stability exercises,
an exercise which actually, again, focuses on those glutes,
an exercise we need a step for.
So, with our step, there we go,
with our step we can balance on one side.
This is a single leg exercise,
really good for hip stability.
A lot of the reasons why a piriformis starts getting tight
in the first place is because of a lack of control
coming from our glutes, a lack of stability coming
from our glutes around the hip,
and when our glutes aren't doing a good job of stabilizing,
the piriformis starts to tighten up in compensation.
So, one of the areas that we see,
when people are running in particular,
is we see this kind of hip drop type movement,
as they're moving from left to right.
What we can do is actually recreate that movement
but be very specific about how we come
from this hip drop position to reset it using glute med,
the muscle that we want to use to stabilize the hip.
So, from this position, where hips are level
and you're balancing on one leg off the side of the step,
always put your hands just around your waist
and you can intentionally,
without bending the standing knee,
you can add the hips.
Allow yourself to drop into this hip drop position.
From here, draw your belly button in.
Squeeze your butt.
And it's that butt squeeze that encourages you
to come back up to this level position.
We're gonna drop again, slow.
And again, squeeze your butt and use that butt squeeze
to draw yourself back up,
down to up,
down to up.
What it isn't, let me show you from side-on.
What it isn't is a single leg squat, okay?
So we're not simply coming down and up, down and up,
bending the knee.
The knee stays in position, slightly bent but locked,
and it's very specifically around the hips.
The other thing that it isn't, if I show you from
a rear-on perspective, is not a hip hike, okay?
So, we're not doing this, using the muscles on our back.
You'll soon feel that in your back if you are.
We're instead focusing on the effort to come from here.
Squeeze, and down, and squeeze,
and down, and squeeze.
And I've worked through three sets of 15 on each side,
really focusing on trying to feel the effort
coming from those glutes, glute med in particular.