The Ultimate Piriformis Stretch

This active resistance stretch not only helps repair and prevent sciatica, but also most low back pain. If you feel any sudden, sharp pain doing this stretch, stop, rest, and check with a doctor, because something else may be going on.

Sciatica
One of the leading causes of low back pain is sciatica, and the leading cause of most sciatica is over-tight muscles in the buttock region, deep beneath the glutes. 

​The nerve that supplies the hip and leg is the sciatic nerve and it exits the spine at the low back. Any irritation of the sciatic nerve can cause myriad symptoms from the low back down the legs to the toes, and is called sciatica.  

There are many common activities that can trigger sciatica, including but not limited to: hiking, driving (right side due to gas pedal use), cycling, and ballet dancing. These activities tend to cause tightening of the muscles surrounding the sciatic nerve.

It is helpful to understand in which direction the muscles touching the sciatic nerve run in order to generate the optimal stretch for releasing those muscles and their associated connective tissue structure. The typical touch-your-toes stretch does not help this condition, and here’s why:

There are two groups of muscles in the buttock region. One group, the outer glutes, runs vertically from the top of the hip to the sitz bones and is stretched by such vertical movement as touching your toes. The second group lies beneath the glutes and runs horizontally from the sacrum to the hip joint and can only be stretched by creating horizontal movement. Within this deeper, horizontal group, are the muscles that run just under the sciatic nerve, and only one runs over it: the piriformis. The location of the piriformis muscle is the reason it takes most of the blame (right or wrong) for any irritation of the sciatic nerve. The name for this particular form of sciatica is piriformis syndrome.

Relief
There is an easy, active stretch routine that relieves the low back and sciatica pain caused by overly tight and adhesed structures of the hip; it feels good to do and can be done straight from bed (or even in bed) each morning. The following routine will take less than two minutes and will not only ease most sciatic related pain, but will also help prevent it from recurring.

• Lay on your back.
• Bend one knee, which will flex your hip, until your upper leg is at a 90 degree angle to your abdomen.
• Maintaining the 90 degree angle, drop your raised knee, horizontally across toward the opposite hip. Keep your back connected to the surface you are lying on.
• With the palm of your hand opposite of your raised knee, press down on the side of your knee until you feel a nice stretch, then hold that position. Again, do not let your back rise off the surface you are lying on. Feel the stretch only in the hip joint.
• Here’s the tricky part: begin to push your knee down with your hand as hard as you can, deepening the horizontal stretch, AND at the same time push back with your knee against your own hand, as hard as you can without causing pain. Do this for three full seconds, then release. This is the active part of the stretch and this is where the magic happens: You are contracting the piriformis from a stretched state, which helps the muscle to relax; but mostly you are releasing adhesions and bringing new circulation within the supporting connective tissue, creating long-term change.
• Give the leg a little wiggle to put some movement into the hip joint.
• Repeat the magic two more times, for three full seconds each. (Notice each time how much further your range of motion is.)
• Repeat with the opposite side, three times for three seconds each.
• Repeat each morning before climbing out of bed.
• That’s it!
• After a few days or a few weeks, when that becomes "too easy", change the angle of the stretch by pointing the knee toward the opposite shoulder instead of the opposite hip. This will identify and release any tightness on the lower aspect of the hip joint. 

Original post date: 8/14/2014