Tune Up Fitness® Tune Up Fitness Blog » The Pesky Piriformis Part 2 – Piriformis Syndrome Treatment

The Pesky Piriformis Part 2 – Piriformis Syndrome Treatment

In the winter of 2008 I started experiencing sharp, shooting pain that radiated from my left buttock all the way down my leg, sometimes burning a hole into the sole of my foot.  At the time I was under a great deal of stress – I had just moved across the country, was teaching a ridiculous amount of yoga classes, and charging up and down the hills of San Francisco like a mad woman (not wearing proper footwear to boot).  Later I discovered that all of these conditions definitely could have contributed to the tightening and overuse of my piriformis, resulting in the constant pain pulsating down the back of my left leg.

Before long the pain was so bad that it kept me awake at night, cramping and aching so badly that I wished I could just unscrew my leg and set it aside to get some rest.  I called upon my massage therapist friend who could barely help due to my violent twitching and flinching whenever she laid her hands on my booty.  Eventually I saw an orthopedist who recommended an MRI – what a terrifying experience that was!  The scan revealed two herniated disks, but I had never sensed any discomfort in my lower back. The doctor recommended cortisone shots to reduce the inflammation and/or surgery.  Intuitively I knew that wasn’t what my body needed, and I decided to SLOW DOWN, ease up on the forward bends and urban hiking, take a lot of baths, and just breathe like a good yogi should.

I imagine that the disks in my lower back are still herniated, however the pain is long gone since I got my piriformis to relax a little and let its hair down.  I know now that as a woman with hyper-mobile SI joints and a piriformis that is likely bisected by my sciatic nerve, regular maintenance is required to prevent that agonizing pain in the you-know-what.

In Yoga Tune Up® there are several different methods that can be used to help prevent or keep this condition at bay.  The most direct is working with Yoga Tune Up® balls, massaging right into the piriformis muscle to inspire release.  I’ve included the video demonstration below, which is also part of the 5 Minute Quick Fix for Hips video. Gravity and the weight of your body can work to your advantage here while you rock, roll, cross-fiber, stripe, or apply sustained compression to the overwrought piriformis.

Read part 1 of this article about the Pesky Piriformis.

Learn about Yoga Tune Up at home.

Watch our Free 5-Minute Quickfix: Hips Video

[youtube width=”640″ height=”385″]http://www.youtube.com/watch?v=FP3SaBtk3N0[/embed]

About This Author

Kate Duyn Cariati found yoga by way of her background in dance and has been a devoted practitioner and teacher ever since. She taught in NYC for many years before moving to San Francisco to help open Laughing Lotus Yoga Center on the west coast. Kate is currently teaching at several yoga studios and athletic clubs in the LA area and is happy to be a part of such a strong yoga community. She is deeply inspired by the refreshing approach and endlessly innovative means that Yoga Tune Up® offers to share her love of yoga.

The Pesky Piriformis Part 2 – Piriformis Syndrome Treatment

  1. Ella says:

    Thank you for this post. I also have a very tight and stressed periformis
    that refers pain down the back of my thigh. The yoga therapy balls really help with this. Also epsem salt baths!

  2. Linda Zanocco says:

    I recently experienced sciatic pain and was afraid to consult my MD for the very reasons Kate experienced—possibility of prescription for pain meds or cortisone injections. I knew the pain had to be related to something I was doing and prescriptions would not correct the underlying issue. I was fortunate to know of a “gentle chiropractor” and made an appointment with her. X-rays revealed no disc herniations (good to know for my Pilates practice) but culprit being 9 mm. subluxed S-I joint (normal should be no more than 3 or 4 mm.) Along with initially daily adjustments I was shown gentle exercises to repeat 4 times daily, told to ice frequently, change diet as much as possible to anti-inflammatory (gluten, dairy, sugar & soy free) and become aware of habitual patterns that aggravate S-I joint. My favorite position—sitting in a chair with legs crossed is now out of bounds. Recovery was slow but consistent. I now have a much better lifestyle and stronger S-I joint. I now see my sciatic pain as a blessing in disguise.

  3. Dana Healey says:

    Amazing read! I know the piriformis is connected to the sacrum and grater trochanter but I didn’t realize that tight area could slip a disk and cause sciatic pain! I am going to start rolling that out immediately, I now wonder if that is a culprit to my low back pain. I don’t want to get injections either so starting as soon as possible I’m going to roll that area are.

  4. Genevieve Herzog Genevieve says:

    I remember having performs syndrome so bad, that my left leg would go numb when I was running. I think that most of us have been conditioned to think that stretching (in this case, folding forwards with a locked knee) is a desirable thing, as in, can your hands touch your toes. It’s time to change the culture of “Stretch” into one of “mobility” and “healthy tissues”.

  5. Gabrielle Acher says:

    I really appreciated part 2 of your Piriformis article, especially with its specific reference to hyper mobility in the SI joint. It’s kid of mind blowing actually. I am also grateful for the attached Jill Miller video and the reference to Yoga Tune Up ball work and the important e of regular maintenance.

  6. Rachel says:

    I was so happy to see that you explained the pain you went through with your pirifomis so clear and descriptive at the beginning of the article 🙂 I have had yet to have an issue with my piriformis that I know of or have felt so this has been really helpful in understanding the pain that someone may be experiencing.

  7. Megan says:

    I love the use of therapy balls and have tried this particular exercise and it feels great. However, I’m wondering- in your last article, you mentioned that 15-30% of people have the sciatic nerve pass right through the piriformis; would pressing into the sciatic nerve with the balls not cause more pain/trouble in the area?
    As I mentioned, I have no issues with it, but I am wondering if others might have this problem? Thanks!

  8. ellen says:

    Hi Kate,
    Hope you are well. Great article! I only wish I had read it a long time ago as I too did the MRI’s, shots, and meds to treat this nagging pain in the butt” linked to herniated disks when in fact it was piriformis syndrome. The YTU tools have really helped keep this syndrome under control . Thanks for sharing…

  9. Kate, my sense is that not only is piriformis syndrome is much more common than many of us realize, it also seems to be one of the ‘peskiest’, to use your word, to treat.

    I, too, suffered from piriformis syndrome for a very long time and did not respond to treatment. To be fair, for along while my physiotherapists concentrated on the lower back, concerned that the lumbar disc were the cause of the sciatic pain (given that the sacral nerve derives from L4 through S3 vertabrae). However, in my case, one ART (Active Release Technique) session with a highly-trained practitioner completely release the piriformis and my symptoms went away completely.

    It is also noted that piriformis syndrome can be caused by activities that involve considerable forward movement such as running and cycling, caused by the resultant tight adductors and weak abductors. So the treatment may involve strengthening the abductors and lengthening the adductors. Abductor LIfts are an obvious YTU pose.

    But simply stretching a tight piriformis may not provide relief as the fibers may still be inflammed enough to press on the sciatic nerve. Here, the YTU therapy balls can be of great benefit.

  10. Kate says:

    This is fantastic and incredibly helpful. For years I’ve been waitressing, therefore spending A LOT of time on my feet. After working a shift, especially one that’s been 12+ hours, I have extreme tightness in my booty and legs. Basically it feels like every muscle is contracted. Never knowing what really caused the pain or where it radiates from left me never doing anything to help relieve the pain/pressure other than sitting or laying down. After relaxing for a long enough period of time, that usually seemed to help the pain go away. Now that I’m a little bit older, that method hasn’t been doing so well for me. Now I find myself kept awake by my leg/legs that won’t stop twitching. It starts in my butt and radiates down my leg. It’s so annoying.
    I’m thankful I came across this article. It’ll definitely make a difference in my life. I only wish I would’ve known this a loooong time ago. 🙂

  11. Kate Hall says:

    I started working with a friend of mine who has been complaining about her sciatica for years. I have been giving her yoga poses to practice, but having recently discovered Yoga tune-up balls, I showed her a few ways to target the Piriformis using the balls. After just one week working with the Yoga Tune-up balls, she called me to say she had experienced relief for the first time in years. I have shown her this website for more tips as she continues to heal. Thank you!

  12. Piriformis Active Release Technique » Treatment for Piriformis Syndrome says:

    […] syndrome ?myth or reality is that it leaves you with more piriformis injection procedure code. http://www.yogatuneup.com/blog/2010/07/30/piriformis-syndrome-treatment/ If you’ve watched that, stick around. This decision is up to you. It will be from a large […]

  13. Linda Webster says:

    I have definitely experienced the pain that you have described. After carrying my children around when they were young first on one hip and then the other, I used to be in a state of constant sciatica. The yoga tune up balls are a great way to give yourself a massage,and I really love massage. It is also important to maintain good body alignment after your self massage. Thanks for the great tips.

  14. Lisa Larivière says:

    It is funny that I clicked your name, cause that is what I am teaching in YTU course tomorrow… Also, I deep tissue this area to release for people who have bowel movement problems…

  15. I thank you for sharing, I do know about the piriformis and I have deep tissued this on my 75 year old client who is not so willing to work with the balls, and he is ok for one hour, but as soon as he leaves and sits too long, the pain comes right back!…If you have any other suggestions, I would appreciate… Thanks

  16. We via my personal palms upwards inside air some periods, saying AYOO, LEGO OUR EGGO

  17. chau says:

    We tried ball work on our hips yesterday in class and I never heard so many moans and groans in one room. Love!

  18. regina says:

    i love the ball work at the s.i. joints that andrea mentioned. in pilates we stretch the piriformis after some exercises that call for some intense hip flexion. rolling it out really helps recovery!

  19. Andrea Penagos says:

    Whenever I do ball work at home (or in class), the balls always have a way of finding themselves in the dimples where my SI joints are. The fact that I find lots of tenderness and deep satisfaction rolling out this area seems to point to the fact that I most likely have a tight piriformis that has uptight neighbors, too. While I don’t personally have sciatic pain, my mother does, so I’m happy to be able to share this information and video with her, and also continue doing these exercises as part of my self-care regimen to prevent sciatica pain from happening in my own body. Love it.

  20. Dawn Adams Dawn Adams says:

    I agree with Tracy — Kate’s wisdom in deciding to slow down and focus on self-care is a lesson for all of us Type A personalities. Gripping in the hips is such a common condition in our society, where most of us seem to naturally externally rotate one or both hips, shortening the piriformis and causing a lot of congestion in the hip rotators and low back. I had piriformis syndrome about 11 years ago, and it took a long time to heal. If I had had YTU balls then, my road to recovery would have been a lot smoother. Now I’ve collected several sets, and travel with them always.

  21. Tracy says:

    Life puts so much pressure and wear and tear on our bodies day in day out. What I love about Kates blog is many women live this busy life until something finally gives, wears out. I love that she chose to listen to her intuition, breathe and heal herself. The piriformis ball sequence is one of my favorites. 🙂

  22. YuMee Chung Yumee says:

    Thanks so much for sharing this video demo of a YTU therapy ball technique for the piriformis. The first time I tried this one I was shocked at the strong sensation–I had no idea the muscles were so tight. The good news is each time I roll out the area, it feels a little better and now I actually look forward to it!

  23. Leslie says:

    It would be interesting to compare the difference between rolling on a foam roller and on the YTU balls which are much more targeted. Perhaps people with REALLY sensitive prifiromis muscles/sciatica would be better to start with the foam roller first, and work their way up to the YTU balls?

  24. Dagmar Khan Dagmar Khan says:

    Our modern lives put so much toll on our bodies,creating all sorts of aches and pains that are truly newer to us.It is so interesting to see and notice that the cause of sciatic pain is not only the well know herniated disc,but also the tightness in piriformis.I have a student of mine who does experience strong sciatica in her left leg and since she has been introduced to using YTU balls to massage into the attachment of piriformis she is able to get much deserved rest much more regularly.

  25. Hayden says:

    Very useful, Thank you, I find that sometimes after doing ball work, the nerve pain still lingers for a day or two but then subsides.

  26. JS says:

    Using the YTU balls has provided great relief after running and Spinning classes. Thank you for the reminder to listen to our body and rest when our body is telling us to rest.

  27. Laura H. says:

    Self massage of the piriformis using is bittersweet for me. Hurts so good!

  28. Jaime S says:

    I found the video clip of piriformis self massage to be very helpful.

  29. CSK says:

    so glad i logged onto part 2. part 1 left me wondeing how i could use my ytu balls to get to my piriformis. thanks!

  30. Greta says:

    We did this in our TT training class and felt great on my piriformus! I love this article Kate and how you listened to your body on what you needed to do relieve the pains in your body. Thanks for sharing!

  31. Zvia says:

    As a runner and cyclist, I need to be careful as my piriformis muscle may become tight (due to continued contraction) and cause pain by compressing my sciatic nerve. Thanks for sharing this deep lateral massage technique. I am looking forward to trying this out with my new Yoga Tune Up balls!

  32. Martin says:

    Great stuff Kate! I had a herniated disk and got the surgery 15 years ago. I wonder if a better understanding of the support muscles in the pelvic region and the knowledge that I gained in working with teachers like Maura and you could have prevented the surgery.

  33. Anne says:

    Ah, just when I thought the ilipsoas wasn’t getting enough attention, here’s a chance to bring awareness and conscious love (with the help of gravity and the Yoga Tune Up (R) balls!) to the piriformis! Thank you!

  34. Juliana Salas says:

    this feels great after a cardio strength training bosu class!

  35. Karen Komenkul says:

    Great stuff. Never knew that by the piriformus being so tight could lead to sciatc nerve pain.

  36. Ko says:

    Great blog! As a runner I’ve come across many newbies who complain about sciatic pain. Much of it is due to weak muscles and support muscles in the pelvic region, legs and feet. This causes an imbalance and in order to compensate the body utilize the muscles that inevitably cause pressure to be placed on the sciatic nerve. It was interesting to find out about variations for the path the sciatic nerve makes. I can’t wait to try out the exercise with my yoga balls.

  37. Liz says:

    so helpful! thank you

  38. excellent video. My only suggestion is that the balls be placed in a long sock, that way, they don’t move around too much.

    Great work. I am suffering from this ailment right now. I think too much bike riding and yoga.

    thank you.

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