Pain Relief From Piriformis Syndrome – A Somatic Approach

It is never just one muscle that causes your muscle pain.

It doesn’t matter if you have sciatica, piriformis syndrome, plantarfascitis or even herniated disks. You aren’t a jumble of separate body parts randomly put together; you’re a living, breathing, constantly changing system, controlled by the brain and coordinated to move as a whole piece. Or at least that’s the way your sensory motor system sees it. I know it often can feel like, “if I can only relax my X muscle, then my life would be grand.” It would be nice if that were the case, but it’s not.

There’s always a full body pattern of contraction involved in whatever muscle pain is bothering you.

Once you address the muscles that your painful muscle coordinates with in movement, then you can fully relax that muscle for long term pain relief.

Yes, you can have a piriformis that seems to be the culprit in your pain – never relaxing – but if you don’t address all the muscles in the PATTERN of contraction that causes the piriformis to get stuck in chronic contraction – you’ll never learn the following:

  • what movement pattern got you into the problem in the first place
  • how to prevent your pain from coming back
  • how to be more aware of your body as you move on a daily basis

Here’s a video clip about what to do for piriformis syndrome. For those of you who already have my DVD, Pain Relief Through Movement, you’ll see that I’m giving you some pointers for the Back Lift, and a variation for the Steeple Twist that specifically helps for piriformis syndrome.

If you don’t have my DVD, you can get it here.

20 thoughts on “Pain Relief From Piriformis Syndrome – A Somatic Approach

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  2. Curious if there is an alternative/modification to the steeple twist for someone who is 1 year post hip replacement. Adduction/internal rotation is very limited.

    Wonderful site, thank you!


    • Hi Ken,
      I’m not sure I ever gave you a proper answer to this question. I’m so sorry! Yes, there is a good alternative to the steeple twist: the washrag. I know some people are advised not to cross their legs after a hip replacement. I have students in my class who’ve had that surgery, but have no problem crossing the legs, so I’m seeing that this is very individual to the person.
      Is there a structural issue causing the adductors to stay contracted? If not, and you have still have limited adductors 1 year post-operative, there are probably more muscles involved in this pattern than just the adductors. That’s my suspcicion, anyway. The twisting movement of the steeple and the washrag comes from the center of the body – not from the adductors. The abductors and adductors are involved, but they’re not “doing the work” of the twisting. The back, waist muscles (obliques), abdominals, and gluteals relax and lengthen in order for that movement to occur. If any of those muscles is clenched and not lengthening, then twisting will be challenging.
      If you need any one on one help, I would recommend doing an online Skype session with me. Learning all the Somatic Exercises and then taking that learning further and having your posture, and movement assessed could be very helpful in yielding more answers – and solutions – to increasing your mobility.
      Thanks so much for your question!
      Best to you,

    • Yes, you definitely need these exercises. In fact, we did these in a clinical sessions – so get on the floor and do them every day in addition to the steeple twist, human X, “reach to the top shelf,” and some swimming (now that it’s blazing hot and perfect swimming weather). Let me know how it goes!

  3. Thanks Martha you have described the problems I have been battling with for 2 years now perfectly. I have ordered your DVD and will diffidently be including these exercises in my rehab program.
    I have one other symptom than those your describe in the video.I also get an adductor that feels like a wound up elastic band, with these exercise help with that also?

    • Hi Aaron,
      I’m so glad that I can help you become aware of the pattern you’ve been stuck in for so long. The DVD will help you get a handle on how to relax the muscles that have been tight and causing your piriformis syndrome. The “trauma reflex” (see all the posts on the blog about this reflex) really puts a monkey wrench in one’s movement. Once balance is thrown off due to this reflex (which occurs in response to accidents or injuries), it’s crucial to get the trunk rotators back under the brain’s control so the left and right sides of the waist and pelvis coordinate properly.
      As to your tight adductors – yes, the movements on the DVD will help that, but the movements on one of my next DVDs (“Releasing Legs and Hip Joints”) will help you even more. If the adductor is tight on one leg only, then it’s due to the trauma reflex. It’s very normal. I’ll bet the opposite leg’s abductor is tight as well. This is compensatory in response to the twisting of the trunk rotators to one side response to an accident or injury.
      I hope this helps!

  4. I have a question about pain relief and push ups. Usually after doing push ups I feel a pain in my lower back. Is it that i’m not doing them correctly or are they bad and should I probably stop doing them before I get seriously hurt?

    • Hi,
      Are push ups bad for you? Not if you’re doing them correctly and your muscles are balanced and coordinating properly. If you’ve got sensory motor amnesia (SMA), and aren’t aware that your back muscles are tighter than necessary – resulting in, say, a slightly arched lower back, or in one side of your body working harder than the other – then you’re probably going to hurt yourself over time. If you’re symmetrical, balanced, and equalizing the efforts of the muscles needed to do a proper push-up, you shouldn’t have any problems.
      If you’re new to my blog, my suggestion would be to go back and read up on Sensory Motor Amnesia (on my blog and website), how it occurs at the level of the nervous system, and how that relates to most chronic muscle pain (that isn’t related to a pathology or structural deficit). If your muscles are too tight due to habituation to stress, your movement won’t be balanced, and symmetrical and your brain will recruit muscles it doesn’t actually need in order to do the desired activity (like push-ups). Regaining awareness of these habits, then learning to relax the muscles involved will help you be able to do push-ups without pain. You can learn to reverse the situation yourself with the methods and movements of Hanna Somatics.
      Any other questions, let me know!
      Best to you,

  5. Can we say IMMEDIATE RELIEF?! Martha, thank you so much for sharing this. I had never experienced sciatica before last year when training for the Disney World Marathon. I saw a chiropractor and went to yoga and was able to experience some relief but it’s been about a year and I still feel a dull ache in the piriformis muscle on my right side. I did this set of exercises once and was immediately able to relax. AMAZING! I always knew you were wonderful.

    • Thank you so much for this, Laura! I can’t imagine trying to do a marathon with sciatica! It would throw your entire gait off. Combine these Somatic Exercises with all the fun, functional movements of Exuberant Animal that can teach you integrated Somatic ballistic movement, and you’ll be able to keep yourself out of pain. Keep up the good work, and tell all your friends!
      Best to you,

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  8. I started doing these exercises last night for the first time, and I slept pretty well (usually I have pain in my back which I didn’t realize was linked to my piriformis, but since I felt the pain after activating my muscles properly in the exercises I realized it was all linked!). But I did the exercises again tonight, and my left hip is in a bit of pain. Not sure if I overdid it, or if my hip was more sensitive because I was out walking a lot today, but we will see what happens overnight. Martha, you say in the video that you had piriformis, do you continue to do the exercises to keep it at bay, or have you eradicated it from your body all together?

    • I’m so glad you got results from just doing the video one time! In the blog post I write that “it’s never just one muscles” causing the pain. It’s probably that you have other muscles in a state of sensory motor amnesia, so you have a few other patterns to work out. OR…as can happen with some people, the releasing of muscles that very extremely tight caused a bit of soreness the next day. It’s not uncommon.

      For this reason I suggest you consider learning all the basic Somatic Exercises, and do them over the course of several weeks. This will give you the ability to self-sense, self-adjust and self-correct your movement and muscular responses to stress. Most importantly, you will learn to eliminate the unconscious movement pattern that is at the root of piriformis syndrome. This is key. You’ll also learn how to prevent it and/or eliminate it should it crop up again. The point of Hanna Somatics is to teach you how to regain awareness and control of your muscles and movement so you move efficiently and are aware of when you’re accumulating muscle tension that is impeding your movement and causing pain.

      No, I don’t have piriformis anymore I’m happy to say! The reason is because I’m very aware of what it is that I did, movement-wise, that causes it to develop! This applies to many other conditions I write about.

      My suggestion for you, should piriformis be a real problem for you, would be to purchase my book, the “basics” DVD and my Pain-Free Legs and Hips DVD. As you understand the concepts/techniques/principles of Hanna Somatics and learn the exercises, apply the awareness, principles and movements to your life I feel certain that piriformis syndrome will be a thing of the past.

      I see that you’re in Mongolia! I would gladly come to Mongolia to teach if you had a large group of interested people in pain who want to learn how to eliminate pain and move freely. My mission is to teach this profoundly important work all over the world.

      Thanks so much for your comment!
      All the best,

  9. Great Video, thanks! question, if I have pain on one side, would I only exercise one side until I’m balanced? or do both sides even with unilateral pain?

    • Hi Darlene,

      So glad you’re enjoying the video. The answer is yes, you should always do both sides. There’s always compensation of a slightly different kind on the other side and allowing your brain to be aware of the differences between the two sides only serves to stimulate the brain and facilitate change. I would, however, do several more repetitions on the tighter side than the less tight side.

      For more great videos purchase my DVDs. The more somatic exercises you know and use to release tight muscles and sensory motor amnesia, the better!

      Happy Somaticizing!

  10. Wow, what a great site. I have lots of the trauma reflex due to an injury and I am amazed at how these exercises have given me some relief. However when I did the washrag it really seemed to hurt my the muscles around my one shoulder blade and side and pull on my spinal muscles. Is there an alternative or modification?

    • Hi Jan,

      I apologize for the delay in responding to your comment. I have a feeling that when you do the washrag you may not be allowing the shoulders to “go along for the ride” and move with the arms/hands. A lot of people have trouble sensing how, when the arms/hands roll, the shoulders are also gently spiraling with the movement. The more you allow the shoulders to get into the movement, the more you will sense how as you roll one shoulder forward (as the arm rolls down), the shoulder blade slides along the back, and as you roll the other shoulder back (as the arm rolls up) the shoulder blade presses into the floor.
      Since you are in the UK I would recommend looking for some Somatics workshops that you can attend. You could learn with more personal guidance. I also work over Skype with people in order to help them become more aware of what they are sensing and feeling and how they are moving so they can get the most out of the Somatic Exercises.

      I hope this helps.

      All the best,

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