While piriformis syndrome may be “over-diagnosed”, it can prove stubborn and troublesome for those unlucky enough to be afflicted with it.
While there may be loads of online articles and videos with exercises to help this condition, there aren’t many clear guidelines on piriformis syndrome exercises to avoid. That’s where we come in!
First, for a guide on what piriformis syndrome is and what you need to do about it, click here.
If you aren’t sure whether you have piriformis syndrome but you do have persistent buttock pain, try this article instead.
The Problem with Piriformis Syndrome
One of the main problems with this condition is that piriformis syndrome will continue to be problematic unless you avoid doing the things that aggravate it or caused it in the first place.
The most common causes of piriformis syndrome include:
- Prolonged sitting and sciatic nerve irritation as a result
- Weakness in the gluteal muscles causing an over-worked piriformis
- Biomechanical abnormalities (sub-optimal movement patterns in the hips)
Working Out What Caused Your Piriformis Syndrome
In order to best identify the piriformis syndrome exercises to avoid for your particular circumstances, you need to have some knowledge of what caused your piriformis syndrome in the first place.
It is often possible to make an accurate assumption as to the cause of your piriformis syndrome.
The biggest key here is your lifestyle.
For Office Workers
If you spend 8 hours a day sitting in an office, count yourself as unfit and possibly overweight, chances are your sitting has contributed to the development of piriformis syndrome.
Spending prolonged periods of time sat down can cause a chronic compression on the sciatic nerve. Once aggravated, the sciatic nerve and piriformis can remain inflamed and tender for a long period of time unless the correct measures are taken to relieve that pressure.
For Those Who Don’t Sit for Long Period
If you don’t sit for long periods of time but have developed piriformis syndrome, it isn’t likely that direct compression from sitting is the cause.
For most people in this situation, the cause of their piriformis syndrome is weakness in the gluteals and surrounding muscles. The muscles in the buttocks all work together as a team to stabilise the pelvis and allow movement when walking. When one muscle group becomes lazy, others have to pick up the slack.
This is often what causes a tight piriformis – the gluteals have become weak and the piriformis is having to do extra work, causing it to become fatigued and overworked.
Fatigued and overworked muscles become tight and lose their strength capacity, and when this happens in the piriformis, it can cause piriformis syndrome.
This cause of a piriformis syndrome problem is more common in women than men, and is more common in those who are unfit, overweight or out of shape.
For Runners and Athletes
While the past 2 causes of piriformis syndrome are more prominent in the unfit population, piriformis syndrome also plagues runners and other endurance athletes. So, why is that?
The answer is that it usually comes down to their running (or cycling) styles and movement patterns.
Similar to the cases above, when a particular running style leads to the overuse of one muscle group, an imbalance occurs. This leads to tightness in one group of muscles and weakness in others.
Let’s talk about the gluteals again: if the gluteals are weak in a runner, the piriformis must then pick up the slack to stabilise the pelvis during each stride. This can lead to a tight piriformis which compresses the sciatic nerve.
So, What Are the Piriformis Syndrome Exercises to Avoid for These Groups?
To answer this question, again we must split our group of piriformis syndrome sufferers into three, based on what caused their problem in the first place.
For Office Workers
As sitting caused your problem, the main piriformis syndrome exercises to avoid are any which involve sitting.
If you have been given movements to do in a chair, like crossing your leg over the other to stretch the buttock, you might want to consider replacing this exercise with a similar version while lying on the floor.
Avoid THIS exercise if your problem was caused by sitting
Do THIS instead!
You may also want to consider a ring cushion for your workplace to take the pressure off your painful area.
For Those Who Don’t Sit for Long Periods
The piriformis syndrome exercises to avoid for those who don’t sit for prolonged periods include any which aggravate your symptoms while you are doing them.
For example, for many people, stretching the painful buttock or piriformis actually makes their symptoms worse, not better. If this is the case for you, avoid these stretches.
One of your piriformis syndrome exercises to avoid in this case could be “The Clam” exercise, despite it being very commonly prescribed for this issue. The reason I recommend avoiding “The Clam” is because it involves external rotation of the hip – a movement that the piriformis is responsible for.
It is best to strengthen the muscles other than the piriformis around the hip to allow them to take some pressure off the over-worked piriformis. Plus, “The Clam” isn’t especially effective when compared to the next exercise that I will suggest.
What to Do Instead
For people in this group, your priority should be strengthening the GLUTEAL muscles in the painful buttock. While there are hundreds of exercises to choose from to achieve this goal, you only really need one to get a good result – the video below shows exactly what you should do to strengthen your gluteal and take some pressure off that poor piriformis.
It may take you a fairly long time to correct a muscle imbalance like this – we’re talking about a month or two – but the results will be long lasting and you’ll also benefit from relief for knee pain and other hip problems.
For Runners and Athletes
Runners and athletes will probably also benefit from the strengthening exercise above, but in your case it may be better to be assessed by a professional who can work out the muscle imbalances causing your particular problem.
From my experience, runners and athletes LOVE to “release” muscles and “trigger point” painful areas! For this reason, the piriformis syndrome exercises to avoid for runners and athletes are heavy foam rolling and intense stretching of the piriformis. Here’s why:
When you insist on pummelling a tight muscle with a foam roller or even a golf ball, if you are too rough then it can cause the muscle to tighten up even further.
What’s more, where the sciatic nerve sits in the buttock is actually quite close to the surface of your skin. If you pummel and rough massage that area, you risk directly irritating the sciatic nerve even further, leading to worse symptoms than before.
The same is true of stretching. When you stretch a painful area, you can worsen then compression on the nerve and lead to a worsening of symptoms.
A great alternative is to try stretching the opposite leg instead, gently releasing any tension on your non-painful leg.
Try this stretch on your GOOD leg!
I know that it may FEEL like your tight buttock needs a good stretch to relieve it, but you are far better off going gently and opting for strengthening exercises instead in most instances.
I hope my reasoning behind the piriformis syndrome exercises to avoid has made sense for you today! It can be extremely confusing trying to choose the right exercises for piriformis syndrome and sciatica in general, so if you are confused about anything I have written here then please do feel free to reach out and let me know.
If you would like guidance on a complete exercise regime for sciatica and piriformis syndrome, click here to view some of our 90 Day Plans – the completely natural way to relieve sciatica and piriformis syndrome.
As always, thanks for reading.