- Kiley Holmes, PT
Piriformis Syndrome, Sciatica, and How To Treat It
In my last blog post I explained the difference between piriformis syndrome and sciatica - now let's talk about how to fix them.
If you are dealing with piriformis syndrome, I would recommend doing some tennis ball massage over the area before starting a light stretch. Laying on your side, take a tennis ball and roll it over the area that most of your pain is coming from for 2 to 5 minutes per tolerance.
Whether or not you have piriformis syndrome, it's a good idea to start with a light stretch to the piriformis, and I mean light - this muscle does not like being messed with. Be careful!
There are many different ways of stretching your piriformis depending on your athletic level. But I am going to show you two different ways of doing it depending on how aggravated your piriformis is.
First, go ahead and sit in a chair and cross one ankle over the other knee. There is a good chance you already feel the piriformis stretch. If not, go ahead and lean your upper body towards your lifted leg. Hold a light stretch for between 20 and 30 seconds, no more than three times in a row.
In the second version of this stretch go ahead and lie on your back, bring one knee into your chest, and take your opposite hand and pull your ankle up and towards your opposite side. Hold for between 20 and 30 seconds, no more than three times in a row.
As the piriformis begins to loosen up you should add in some glute strengthening to prevent it from getting tight again.
Some great examples of glute strengthening are:
Now, to address that sciatica. Obviously the trouble with sciatica is that it could be coming from almost anywhere.
When are your symptoms bothering you the most? Is it when you're sitting for long periods of time? Or is it when you are standing for long periods of time? Believe it or not, most people who do not have piriformis syndrome and do have sciatica will fit into one of these two categories - I have a blog post coming to talk about these two groups in more detail later.
If sitting is where you're getting most of your pain, go ahead and lay on your stomach for a little bit and if you're able to come up onto your elbows, you'll notice a change pretty quickly. If standing is where you're getting your symptoms go ahead and lay on your back and bring your knees to your chest and relax - this should relieve your symptoms.
Now, back to those of you who are having your classic piriformis syndrome with a little sciatica mixed in: it's time for some nerve glides!
Laying on your back in a hook lying position go ahead and bring one knee up, holding on to it with both hands, go ahead and straighten your symptomatic leg up. Does this cause any of the symptoms that you were complaining about? If it does, lift that foot up and down 20 times. You have just finished your nerve glides.
However, if that did nothing for you, go ahead and keep that foot up in the air and point the toes down towards you, and then up towards the sky. Does this bring on your symptoms? It should - do this 20 times and that is your nerve glide.
If you're still not having any symptoms, go ahead and lift your head up and try it again, completing 20 times.
These nerve glides will actually floss that nerve through your other tissues, loosening it up and unkinking the nerve.