I know we sometimes say that staying in shape can be a pain, but we also know running shouldn’t cause pain. The calves, knees, and back can quickly tell us when we’ve done too much. But if running becomes a literal pain in the butt, it might be piriformis syndrome. The main cause of piriformis syndrome is overuse during exercise — like overdoing a new workout routine — or sitting too long.
The piriformis muscle runs from the lower spine to the top of the femur, on top of the sciatic nerve. If the piriformis gets tight or stressed, it can press on the sciatic nerve and cause pain. While the origin of sciatica is different from piriformis syndrome, they often share the same symptoms like pain in the lower back, buttocks, and down the leg.
A doctor can help you sort out whether your pain is a serious problem, or if it’s just sore muscles and a few stretches can help. We asked Will Hayes, Performance Manager at Novant Health Sports Performance, and Taylor Pigg, Clinical Exercise Physiologist, for suggestions. They remind us to do these gently, especially at first!
Foam Roller
“If your piriformis is tight and you want to alleviate that, and low back discomfort, you could use soft tissue work,” says Hayes. “If you have a foam roller, you can use that for soft tissue manipulation.”
Roll for about a minute on each side with the roller or a ball. It will take the tightness out of the tissue and allow the muscle to relax.
Figure 4 Stretch
Lie on your back and bend one knee up, and cross it over the other. Pull the bottom knee up to your chest. A couple of other variations include twisting the opposite way to stretch the muscle, or pulling the knee up to the opposite shoulder.
“Piriformis is a hip flexor and also external rotator, and Figure 4 will open that up,” says Hayes. “Lower back pain is usually caused by tightness above and below the sore area. When we open that up, we alleviate those symptoms,” he says.
Seated Twist
Sit with legs criss-crossed and place your right foot over the left knee, pointing your right knee upright. Place your left elbow on your right knee and gently twist to the right. Hold, then switch legs and repeat.
“The key to relieving piriformis irritation caused by over tightness of this muscle is to gently get in poses that lengthen and release the tightness and ease the inflammation of this muscle,” says Pigg.
Standing Forward Fold
Stand with feet flat and legs mostly straight, but knees slightly bent. “Fold” over and touch the mat in front of you, stretching the lower back. If you can’t reach the ground right away, take your time. You’ll get there eventually.
Pigg likes both the seated twist and standing forward fold to gently lengthen the piriformis muscle, while strengthening the surrounding muscles.
“It’s important to note that the piriformis muscle is the key muscle in keeping the SI joint stabilized,” says Pigg. “A lot of times, when there is tightness in the piriformis muscle, the sacrum may be out of proper alignment. Once you have found some ease in the piriformis joint by gently stretching this muscle, you can then refocus on building proper pelvic alignment.” From there, says Pigg, you can work your way into the Tree Pose, which strengthens the piriformis muscle.
Pigeon Pose
And while you’ve got your mat out, slide into the Pigeon Pose. Facing forward, bend one knee under you and slide the other leg back. Bring the foot of the bent leg towards the opposite hip and gently lean forward.
“This targets your piriformis area,” says Hayes, “and will bring relief.”
These are great stretches to do before and after running, too. Don’t forget that part, Hayes reminds us. Getting muscles into work mode prevents injuries, and taking time to cool down afterwards allows the body to “rest and reset” after the “fight or flight” activity of exercising. Hopefully, this will let you both run and sit more comfortably.