Piriformis Stretch: Lower Back Pain

The Piriformis Stretch

The peerawhatsis? I get that a lot when I am explaining to someone about their back pain and sometimes their sciatica.

The Piriformis is a small pear shaped (where it get’s it’s name) muscle that resides in your buttocks region. It is responsible, when it’s tight, for a lot of sciatic type symptoms that shoots back down the leg and a lot of cases of lower back pain.

It can be a real bugger for people who have to sit at a desk or in a car all day. And let’s not forget those truck drivers either. They’re behind the wheel for long stretches sitting in static postures and not getting to move much until they reach where they’re going.

When the muscle gets tight it can limit the amount of movement you have in your hips and lower back. Naturally, this will make you feel stiff. And if you’re tight and stiff, there’s more potential for a strain or injury.

Anatomy of Piriformis region

So, like with most all things in the body, you have a piriformis muscle on the left and right sides of your body.

It runs from the outside edge of your tailbone to the back side of the top of your hip bone. It’s a short muscle but can cause a lot of problems with the hip and lower back.

What the muscle does

So what does it do? Well, this little guy, for the most part helps to rotate your leg outwardly and it also helps to stabilize your body when you’re standing on one foot.

It may make more sense by asking “when it’s in good shape and feeling happy, what does it allow me to do? Well, a healthy piriformis muscle will allow you to lift and cross your legs to put on your shoes comfortably.

A healthy piriformis also allows you to move laterally from side to side and also pivot or turn easily when you’re standing on one foot.

When the muscle gets tight, your hips lock up and you move more like a robot than a ballerina. With tight and stiff muscles, your reflexes and reaction times are slowed down and so, if you trip or drop something, you may not have the flexibility to recover fast enough to prevent a potentially embarrassing and injurious fall or accident.

How it gets tight

The piriformis muscle gets tight in the same way that other muscles get tight. Namely by not moving it. Things like sitting all day at a computer or in a car are the most probably culprits. But, unlike the hamstrings or psoas, it’s not a matter of the hip or knee being bent. It’s really a matter of prolonged sitting with the knees apart.

When you sit with your knees apart this shortens up the piriformis muscle. It’s even worse if you’re sitting with your knees apart and have your feet relatively close together. Being stuck in this position or not being able to really stretch the legs out like when you’re running or some other moderately strenuous activity is a recipe for disaster when it comes to your piriformis muscles.

And, unfortunately, while it’s good to get up and go take a bathroom break. Afterwards you just go back to sitting and the muscles in your lower body go back to getting tighter and tighter.

Problems caused by tight piriformis

Because the piriformis attaches to your tailbone at the bottom of you spine, when it loses it’s flexibility the lower back and hips feel stiff. This stiffness makes it relatively harder for you do bend forward or from side to side. It also makes is difficult for you to cross your legs to put on socks or shoes.

And as with most tight muscles, when you stretch it a little bit you get some pain and sometimes a strain, which leads to even more pain (this is the vicious cycle you’re always hearing about).

But, one of the hallmarks of a tight piriformis muscle is the dreaded sciatic pain (sciatica). This is the searing pain that starts in your hip and travels down the back of the leg all the way to the foot (and parts in between).

The reason sciatica is so uncomfortable is because it’s caused by irritation of the nerve directly. The big sciatic nerve gets trapped between the tight piriformis muscle and other tissues and gets squeezed and sometimes “entrapped” or “hung up” in the muscle tissues and isn’t able to move freely (called “Piriformis Syndrome”). When this happens, you get a zinger down the leg anytime the tissues of the leg are stretched even a little bit.

Many people with this type of pain think something is wrong with their spine or think they have a bulging disk (and they may). But the pain is often a direct cause of a tight piriformis muscle from sitting too long.

How to stretch the piriformis

And if this is what’s going on with you then a good way to treat your sciatic pain is to stretch your piriformis muscle(s). As with any stretching, you need to be gentle and consistent over time.

Remember, it took a long time of sitting to get you to where you are right now. You’re not going to be able to stretch your pain away in a day or two. Plus, if you still have to sit for long periods of time, you’re going to need to make daily stretching part of your life.

If you do a google search for “piriformis stretch” you’ll see pictures and videos with fit and trim athletic types (who don’t seem to have any issues) lying on their back and twisting their arms and legs into a pretzle type configuration. While these are technically accurate depictions of a piriformis stretch, they are totally not practical to do.

A better way to stretch your piriformis is to sit with your ankle crossed over your knee and to pull your knee toward your chest. Or, you could gently lean your chest toward your knee. You should feel a stretch or tension in the hip of your raised leg. Hold this for 30 seconds or so and release. Then do the other side.

By doing your stretch this way, you can avoid having to get down on the floor and you won’t have to figure out how to weave your hands through your legs. By using my method, you can stretch out your hips while sitting at your desk and fielding phone calls.