Hip and lower back pain can come as a result of an irritation of the sciatic nerve. This pain can spread downwards and can affect the limbs and the feet. It is something many people suffer from, and the pain can affect your daily routine.
The sciatic nerve is located deep in the buttock. Because of its vicinity to the piriformis muscle, constriction or swelling of the muscle may lead to irritation of the nerve and pain.
This muscle connects the top of the femur to the spine, and it’s the main muscle that allows for outward movement of the hip, upper leg, and foot from the body. The sciatic nerve passes beneath the piriformis muscle.
However, in many cases, the sciatic nerve passes right through the muscle and this leads to sciatica symptoms caused by what is known as piriformis syndrome. This leaves them with pain in the lower back and hip region that won’t go away, and this eventually contributes to poor movement and balance.
The leading cause of sciatica is, as mentioned earlier, constriction in the piriformis muscle, or swelling, both caused by an injury or spasm. Consulting your doctor is highly recommended, as there may be other more serious causes.
Exercises for alleviating sciatica pain
To alleviate the pain, there are some piriformis stretches that you can try. It’s important to note that you must stay within the comfort limits. This means that in this case, no pain IS gain. If you take it even a bit further, you may complicate your condition.
Also, before you stretch you must warm up. You can do this by taking a walk, marching in place, or climbing up and down a flight of stairs slowly. Whatever warm-up activity you choose, you will need to do it a few minutes before starting the stretches.
After you’re done with the warm-up, here are the 10 piriformis stretches you can do – they are worth it.
Please note that these exercises must be done within the comfort zone of your body. Any unnecessary pain can lead to complications, so don’t overdo the stretches.
IMPORTANT: Before starting any type of stretches and exercises, you should always consult your spine specialist first.
Supine Piriformis Stretch
1. Lie down with your knees bent upwards.
2. Cross your affected leg over the other leg, by bending it upwards toward your chest.
3. Grab your knee with one hand and the ankle with the other hand and pull slowly toward the shoulder which is in line with your ankle – until you feel a stretch through the glutes in the buttock.
4. Hold for 30 seconds to a minute and release.
Note that you shouldn’t feel a pinch in the front of your thigh. If you do, you will need to stretch your hip flexors first.
If you don’t feel a stretch in the glutes, you cross your legs as in step 2 and pull the leg which is sitting on the floor by grabbing behind your thigh and pulling the leg toward your chest.
Here’s a video to demonstrate:
Standing Piriformis Stretch
1. While standing, place the affected leg over the other leg’s knee to get what looks like the number 4.
2. Slowly lower your hips toward the ground at a 45-degree angle, while bending your standing leg’s knee appropriately.
3. Lean forward with your torso and extend your arms parallelly to the ground, while keeping your spine straight at all times.
4. Hold for 30-60 seconds, and switch legs when done.
If you have trouble balancing, you can stand with your back against a wall and distance your feet from the wall by 24 inches. Use the wall as support and follow the steps above.
Outer Hip Piriformis Stretch
1. Lie on your back and bend the affected leg upward by placing your foot close to the back of the other leg’s knee.
2. Tuck your foot behind the other leg’s knee and twist your leg to the opposite side with the knee facing or touching the ground.
3. Place the hand which is on the side where the knee is (if you’re stretching your right leg, place the left hand on the knee) and raise the other arm in the air.
4. Slowly start lowering your other arm toward the opposite direction of the knee, with the intent to touch the shoulder to the ground.
5. Stay like that for 20 seconds and switch legs.
6. Return to the lying position and stretch both legs. Bend the two knees together and gently pull them with your hands toward your chest.
You won’t be able to touch your shoulder to the ground at first, and don’t try to achieve that with try 1. The purpose of this exercise is to achieve a stretch in the piriformis muscle, and any stretch that is comfortable is enough.
Long Adductor (Groin) Stretch
1. Sit on the floor and stretch your legs straight out and as far apart as you can.
2. Gently tilt your torso forward toward the ground and place your hands on the floor next to each other.
3. Try to touch your elbows to the ground by gently leaning forward. You should tilt forward as long as you feel a comfortable stretch and stop if you feel any pain.
4. Hold for 10 to 20 seconds and release.
If you feel pain in other parts of your legs, such as behind your knees, or your thighs, you should do some other leg stretches before attempting this stretch.
Short Adductor (Inner Thigh) Stretch
1. While sitting on the ground, put the soles of your feet together in front of your pelvis.
2. Hold your ankles with the opposite hands (left hand – right ankle and vice versa).
3. Gently push downward with your knees with the effort to touch the ground with them. You need to stop right before any pain occurs, which means that if you feel pain, get back an inch or two and stay there.
4. Hold for 30 seconds, release, and flutter your legs in that position (like a butterfly) for 30 seconds.
If you want a deeper stretch, you can use your elbows to push your knees down, and for an even deeper stretch, you can bend your torso forward while keeping your back straight.
Side Lying Clam Exercise
1. Lay on your side, with the affected hip on top.
2. Bend your legs backward to achieve an L shape, while keeping one foot over the other and your legs parallel to each other.
3. Make sure your body and spine are not bent in any way, and that your affected hip is directly on top of the other.
4. Keeping your feet together, raise the top knee upward, while paying attention that the body remains in the original position.
5. Return the knee to the initial position slowly. Repeat 15 times.
Hip Extension Exercise
1. Place your hands and knees on the ground (get on the ground on all fours). Your hands need to be in line with your shoulders.
2. Tilt your weight off the affected leg and raise the leg upward (with the knee bent) toward the ceiling.
3. Lower your leg slowly, reaching almost to the starting position. Repeat 15 times.
Supine Piriformis Side Stretch
1. Lie on the ground with your back straight and your legs flat.
2. Bend the affected leg upward and place the foot on the outer side of the other leg, near the knee.
3. Using the opposite hand, gently pull the knee of the affected leg across the midline of your body until you feel a stretch. If you feel pain, loosen up the stretch.
4. Make sure you don’t lift your shoulders and hips off the ground.
5. Hold for 30 seconds, return to the starting position and switch legs.
Repeat the whole process 2-3 times.
Buttocks Stretch for the Piriformis Muscle
1. Position your hands and knees on the ground (all fours).
2. Bring the affected leg’s foot underneath your trunk and twist it toward the opposite side, near the hip, while pointing with the knee toward the shoulder.
3. Lower your head, until your forehead touches the ground, and lean your forearms on the ground for support.
3. Slowly stretch the non-affected leg out behind you, while keeping your pelvis straight.
4. Push your hips slightly toward the floor.
5. Hold for 30 seconds and return to the initial position slowly. Repeat 2-3 times.
Seated Stretch
1. Sit on a chair and cross the affected leg over your other leg’s knee.
2. Bring your chest forward and bend slightly forward, while keeping your spine straight at all times.
3. Hold for a couple of breaths and try to bend a bit further (if you don’t feel pain).
4. Stay in this position for about 30 seconds and slowly release. Repeat with the other leg.