Here’s what Wikipedia has to say about piriformis syndrome:
Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg.
It also explains that this syndrome can occur due to inactive gluteal muscles, which can occur due to overactive hip flexors and leg muscles. For those of you who sit all day long (which teaches the hip flexors to stay contracted), or do a lot of squatting, this could apply to you.
From a somatic education point of view, piriformis is just another example of SENSORY MOTOR AMNESIA .
the state of habitually contracted muscles that have learned to stay tight due to habituated responses to stress.It’s in the same category as neck and shoulder problems, plantarfascitis, chronic back pain, TMJ, sciatica or joint stiffness. It’s a functional problem in need of a functional solution: sensory motor re-training of the brain to muscle connection in order to get the frozen, contracted muscles to relax and release so the entire sensory motor system works smoothly again. The end result is relaxed and coordinated muscles, a greater sense of body awareness, and no more “piriformis syndrome.”
Try these simple assessment tools to become aware of what might be causing your piriformis problem:
- stand in the mirror and take a look at yourself.
- are your shoulders level?
- close your eyes and sense the weight into each leg. Is it the same on both side?
- put your hands at the waistline, right on the top of the pelvis. Are your hips level?
- lie on your back and lift your legs up to 90 degrees above your hips. Look at your ankle bones. Do they meet, or is one ankle bone higher than the other?
If you notice imbalances in your posture, then you know that your movement habits are causing your pelvis to twist or tilt and your back and buttock muscles to work harder on one side than the other. Somatics can teach you to change that.
A daily routine of Somatic Exercises to “warm up” for your body is the first step to reversing the pain of piriformis syndrome.
This kind of movement practice teaches you to hone your self-awareness in order to become more self-monitoring and self-correcting. However, there are times when it’s necessary to “tweak” those exercises, or target the offending muscles a bit more directly.
Remembering the mantra of “it’s never just one muscle,” even the targeted releases in the video below engage muscles that would coordinate together with the piriformis. Have a look and try them out for yourself. Let me know how it goes. If you don’t have my DVD, you can get it here. Learning the basic movements of Somatics goes a long way toward educating you and your muscles to get rid of chronic back, neck, shoulder, hip, knee, foot or joint pain – and keep yourself moving pain-free for the rest of your life.
My girlfriend is having some piriformis/ radiating pain in her left side. She’s pregnant. While the exercises in Part 1 don’t seem like a good idea, would the exercises in part 2 make sense for her?
Actually , i guess anything on the stomach doesn’t make sense. Any other suggestions?
Hi Bryce,
Actually, there’s a lot your girlfriend could be doing! Somatics is great for pregnant women. I wrote a blog post about a pregnant client who also had scoliosis. She got tons of relief by doing many of “the basics.” If she’s having one-sided, piriformis-type symptoms, she probably has one hip “hiked up” higher than the other. The back and waist muscles need to relax and rebalance in order for this pattern to go away.
You have the DVD, correct? She should watch it and learn the exercises. Since she can’t do the “back lift” on her belly, she should just do arch and flatten. Then go on to the rest of the movements – particularly the side bend, the washrag, the hip hikes, and the walking lessons. How far along is she? Many MDs say pregnant women shouldn’t be on their backs at all, but it’s OK for short periods of time. Arch and flatten can also be done sitting in a chair (see this article about sitting: http://www.essentialsomatics.com/index.php?/articles/detail/effortless_sitting). Does she sit in a chair all day? If so, is she’s slightly twisted in her posture (as if she got stuck reaching for the mouse)? There’s something that she’s doing, or has done, to cause that one side to become tighter than the other.
The exercises in part 2 of my piriformis vlog would be fine for her, except that she’d get better results by learning the basic movements you have on the DVD. That way she’ll become much more aware of all her other muscles that are contributing to the painful pattern she’s stuck in. Does that make sense?
I’m here to help. Let me know how it goes. Perhaps I’ll do a blog post about Somatics and pregnancy…
Thanks for the questions,
Martha
I think I’m due to write a blog post about somatics and pregnancy!
Hi,
I have had chronic pain for over 10 years and have lost a lot of flexibility and strength. With the arch and curl exercise I am not able to but my hand or hands behind by head. Should I still lift my head off the surface I am resting on even without the support of my arms/hands? Thank you.
Hi Anna,
Great question! The answer would be no. However….
…you need to work backwards: what is the reason you can’t put your hands behind your head? If it’s not due to an anatomical problem or structural deficit – and it’s muscular/functional in nature (meaning your shoulders are extremely tight and “frozen”), then you need to first address the muscles that would, when fully released, allow you to put your hands behind your head. Then you can go on to do arch and curl.
Are you stuck in more of a slumped posture (“red light reflex”)? How far CAN you reach your hands to attempt to put them behind your head?
I wouldn’t advise doing arch and curl without your hands behind your head. You want to be able to curl up without putting any strain on your neck. That Somatic Exercise is meant to get your abdominal muscles back under the control of your brain, so you can curl/flex inward as you lengthen the back muscles at the same time.
If you’ve been in chronic pain for 10 years, I would be more than happy to help you learn to begin to eliminate your muscle pain. Where do you live? There are many options for learning the methods and exercises of Hanna Somatics – whether in private clinical sessions, by using my DVD or one on one in an online Skype session with me. Please get in touch if you’re interested in learning how to do this. I would love to help you be able to both put your hands behind your head and begin to reverse your pain!
Be well,
Martha
I’ve had sciatica for several months after a person fell on me. I was told by a physical therapist that have sacral torsion, which is probably one of the factors contributing to the sciatica. Recently I bought your book, Move Without Pain. Are there any specific movements (found in the book or elsewhere) that I can do to get my sacrum back to where it should be? Thank you!
Hi Catrina,
Sciatica is a combination of the “green light reflex” (overly tight back muscles) and the “trauma reflex” (waist muscles tighter on one side). An accident could certainly contribute to your muscles tightening on one side, which can cause your sacrum to twist. Think of all the muscles that attach into the sacrum and pelvis: the back, waist, abdominals, gluteals…
The movement that I find that really helps to realign the sacrum is the second part of the “walking lessons.” Now – it’s imperative that you release the muscles of the back, waist and abdominals first! If your back is tight it won’t help your sacrum, so start at the beginning. My best suggestion would also be to purchase my “basics” Pain Relief Through Movement DVD (available on my website), which shows you how to do the most basic exercises I think everyone should know.
I’d do this list of exercises FIRST before doing the walking exerises part 2 (“knee pushing forward”): arch and flatten, arch and curl, back lift, cross lateral arch and curl, side bend (VERY important!), washrag, hip hikes, steeple twist and then the walking exercises, part 1 and 2.
I hope this helps! Let me know how it goes. I also do video Skype sessions should you need more guidance.
I hope you’re enjoying my book as well…
Martha
Thank you! I am enjoying the book… I am so excited about all that I am learning right now through your book and blogs!
Thanks, Catrina! Let me know how it goes, and please – if you enjoy the book, write a review on Amazon and spread the word of Somatics so other people can be helped. Please feel free to send feedback and questions as well.
Thank you for posting these videos for piriformis syndrome, I’ve just stumbled into your website and had yet to find someone that explains and ties all the symptoms I’ve been having for almost 10 years now. I’ve seen a laundry list of chiros, osteopaths, sports massage/drs, all with little to no improvement and very often a worsening of symptoms. I’m curious to hear your thoughts on foam-rolling/tennis-ball release type self-treatments. I try them off & on but am wondering whether it’s advisable.
Many thanks again,
Josee
Hi Josee,
You’re very welcome! I’m glad what I’ve written has helped you out. Hanna Somatics is a very methodical approach to muscle pain; this is why I like it. While it is very helpful for you to explore your own movement and become more aware of the subtleties of how you sit, stand, lie down, etc., Somatics gives you some solid information about what to look for (the somatic reflex patterns to begin with!).
My thoughts on foam rollers and gadgets designed to relax muscles are these: they don’t really work. I was a massage therapist for 25 years (still am)…and I used all these gadgets. They FEEL good, but they don’t retrain muscles that are stuck in sensory motor amnesia. In fact, they can invoke the stretch reflex, which tightens the muscles back against the forced flattening/stretching/pushing of the foam roller or thera-cane or what have you.
The best analogy I can think of is like trying to improve your tennis serve by buying a different tennis racket. It won’t work. You have to retrain your muscles so they know what they’re doing – improve your form. Same with chronic muscle pain; learn to release the muscles at the level of the brain/nervous system and you won’t need foam rollers and gadgets. Trigger points will disappear over time as will knots in your muscles. It takes time, but so does anything you want to truly master.
Thanks for reading. Feel free to send my blog on to your friends, or to suggest a topic you’d like me to write about.
All the best,
Martha