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 the piriformis syndrome exercises to avoid. That’s where we come in!
Today, we’re going to talk about the top piriformis syndrome exercises to avoid in 2020, and which ones may be better instead. We’ll also talk about how to go about exercising with piriformis syndrome at the end of the article.
First, for a complete guide on piriformis syndrome and how to treat it safely at home, click here.
If you aren’t sure whether you have piriformis syndrome but you do have persistent buttock pain, try this article instead.
Before we dive in, please be aware that we are part of the Amazon Affiliate programme. This page may contain Amazon affiliate links, so if you choose to purchase a product for your sciatica that we recommend through a link on this page, we will receive a small commission at no extra cost to you. This helps us keep Overcome Sciatica alive! Thank you for your support. Please be assured that we only ever recommend products that we truly believe can help.
Before we begin, let’s quickly recap what piriformis syndrome is:
The piriformis is a muscle that lies deep within your buttock region and helps to control the hip when you walk. In most people, the sciatic nerve passes right by the piriformis muscle. For these lucky people, piriformis syndrome is very rare.
However, in around 10% of the population, the sciatic nerve actually passes THROUGH the piriformis muscle. In these people, when the piriformis contracts or spasms, it can sometimes compress the sciatic nerve, resulting in pain that starts in your buttock and can run all the way down your leg (otherwise known as sciatica).
The Problem with Piriformis Syndrome
One of the main problems with this condition is that piriformis syndrome will usually continue to be problematic unless you can successfully avoid doing the things that aggravate it or caused it in the first place.
It should be better communicated that choosing the RIGHT piriformis syndrome exercises is only half the battle in getting better. Avoiding certain movements, positions and exercises is the lesser known, yet equally important, second half of the battle against piriformis syndrome.
A lot of people struggle with this: They do EVERYTHING they can to relieve their piriformis syndrome pain… But they NEGLECT working 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’re putting in to treating it.
The most common underlying causes of piriformis syndrome are the following:
- Prolonged sitting and sciatic nerve irritation as a result
- Weakness in the gluteal muscles causing an over-worked piriformis
- Biomechanical abnormalities (movement problems to do with 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, based on a few key facts that are relevant to your circumstances.
The biggest key here tends to be your lifestyle. Here are some clues as to what caused YOUR piriformis syndrome:
For Office Workers
If you spend 8 hours a day sitting in an office, or you count yourself as unfit and possibly overweight… chances are that 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, in the area where it passes under the piriformis muscle. Once aggravated, the sciatic nerve and piriformis muscle 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 tends to be weakness in the gluteals (a set of muscles that make up your buttocks).
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, overworked and tight.
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”, there’s a good chance that you 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.
Gluteal weakness as the 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 less fitness-focused population, piriformis syndrome also plagues runners and other endurance athletes.
So, why is that?
The answer is that it usually comes down to problems with 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 identify 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 of People?
To answer this question, again we must split our piriformis syndrome sufferers into three groups, 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 using a ring cushion to sit on when you are at work.
This can alleviate pressure from the affected buttock and significantly improve your comfort at work. What’s more, you’ll be maximizing the chances of your piriformis syndrome recovering quicker by avoiding the number one aggravation for your problem – pressure on the affected area.
Here is a fantastic option that I’ve recommended to clients before to great success:
Supportiback® | The #1 Donut Seating Cushion
This gel cushion allows excellent comfort at work while relieving the pressure on your piriformis. It is discrete and portable, making it a great choice for the office.
So, in summary, if your piriformis syndrome was caused by sitting, any exercise that involves sitting is an exercise that is likely to irritate the piriformis, and should be avoided.
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. I see lots of people come into my clinic who have been stretching the hell out of that poor piriformis muscle… Only to make the problem worse.
If this sounds like what you’re going through right now, STOP stretching that piriformis muscle. For some people, relentless stretching can make the problem 10 times worse.
But it isn’t just stretching that can aggravate piriformis syndrome. There are some strengthening movements too, which are commonly prescribed yet often make the problem worse inadvertently.
One of the piriformis syndrome exercises to avoid for many people is “The Clam” exercise, despite it being very commonly prescribed for this issue.
The reason I recommend avoiding “The Clam” for many of my clients is because it involves external rotation of the hip – a movement that the piriformis is directly responsible for. Your piriformis is ALREADY severely over-worked. Why would we want to thrash it even more than we are already?
For some people, this exercise can work – 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 around the piriformis (rather than the piriformis itself) to allow them to take some pressure off the poor over-worked piriformis.
Even for people who don’t get a bad reaction, “The Clam” is much less 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 gluteals and take some pressure off that overworked piriformis.
It may take you a fairly long time to correct a muscle imbalance like this – we’re talking about 2-3 months – but the results should be long-lasting (and you’ll also benefit from relief from knee pain and other hip problems too).
Another option is to find pain relief through the use of a TENS machine. TENS machines are small electrical units that pass a current through a muscle and stimulate it to release positive endorphins and allow the muscle to relax.
Below are two great options for sciatica pain relief:
#1 – TENSCare Perfect TENS Pain Relief Machine
This TENS machine for sciatica has 8 preset programs so you don’t need to “tune it” yourself – just pick a setting and off you go! There is an option to purchase a ‘Value Pack’ which includes spare pads which I would definitely recommend.
#2 – TPN 200 Plus TENS Machine
A super-simple yet sleek design, this TENS machine is perfect for those who want a highly effective model and are confident with using a TENS machine for sciatica pain relief. This unit doesn’t have a fancy display, so you can customize the settings to best suit your needs, tweaking and changing the frequency until you find one that works best for you.
Thinking of buying a TENS machine for sciatica relief? Click HERE to view our top 10 TENS machines for sciatica in 2020.
For Runners and Athletes
Runners and athletes will probably also benefit from the strengthening exercise above, but more advanced athletes may be better assessed by a professional who can work out the muscle imbalances causing your particular problem.
In athletes, muscle imbalances can be very subtle, but because their activity is usually repetitive and performed over a long time, the repetition brings out problems over the long-term if left unchecked.
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 pummeling a tight piriformis 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 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 – yet hardly known – 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 only, and opting for strengthening exercises instead in most instances.
What About Exercising with Piriformis Syndrome?
As different people find different forms of exercise either aggravate or relieve their piriformis syndrome, I can never give an accurate, one-size-fits-all answer for how to go about exercising with piriformis syndrome.
However, for many athletes, there will have been a certain type of exercise that CAUSED the problem in the first place, or at least contributed to it.
For example, if you are a runner and you started to slowly develop piriformis syndrome, it makes sense to cut back on running when exercising with piriformis syndrome. For this athlete, I might recommend swimming or using the cross-trainer instead.
Similarly, for a cyclist, sometimes just taking the pressure OFF the piriformis by getting out of the saddle for a while can help to relieve piriformis syndrome pain after a period of rest.
For non-athletes, exercising with piriformis syndrome is important. You should continue to walk and do your usual activities as much as you can, as long as it doesn’t aggravate your problem and you haven’t been told not to by a healthcare provider.
Just be sure to listen to what your buttock and leg are telling you! If they are crying out in pain and asking you to stop, don’t continue to push through with your exercise routine out of sheer stubbornness. We talk more about pacing strategies, when to keep walking and when to stop, and all manner of things health related in my book, Thriving Beyond Fifty, which you can see below:
Top Tip: Grab a copy of my #1 Best-Selling book, Thriving Beyond Fifty for more health, wellness and recovery strategies!
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.
As always, thanks for reading.