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.
A lot of people struggle with this: They do EVERYTHING they can to relieve their piriformis syndrome buttock pain… But they NEGLECT to work out what caused the problem in the first place, and unknowingly continue to do that very thing!
This STOPS piriformis syndrome from getting better… Despite all that effort you’ve put into treating it.
The most common causes of piriformis syndrome are:
- 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. Read on for clues as to what caused YOUR piriformis syndrome:
For Office Workers
If you spend 8 hours a day sitting in an office, you 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 Periods
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.
You can test the strength of your gluteals using the following method. Watch the video below and then try it yourself – if you have a “positive Trendelenberg sign” you probably ARE suffering because of your weak gluteals!
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 last two 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.
If you run or cycle and want to test the imbalances in your pelvic muscles (highly recommended) then try the following (more advanced) video instead:
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 can see a video demonstration of this exercise here:
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, these are definitely piriformis syndrome exercises to avoid for you.
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.
For some people, this exercise works – however, if you’re like many others, it can actually make the problem worse. The only way is to test – if you try this exercise and feel worse after, certainly avoid it.
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 suggest below…
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, overworked 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.
A note of caution: 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.
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.
This video below is a great example of a method that is likely to IRRITATE a piriformis and could make your symptoms WORSE:
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 aggressively stretch a painful area, you often increase the compression on the nerve and worsen your symptoms.
A great alternative is to try stretching the opposite leg instead, gently releasing any tension on your non-painful leg.
Try this video below instead, where I describe how to effectively stretch for sciatica relief – this video is equally applicable to piriformis syndrome:
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, stretching the opposite leg, and opting for strengthening exercises instead in most instances.
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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 my full 90 Day Recovery Plan – the completely natural way to relieve piriformis syndrome and stop it from coming back.
As always, thanks for reading.