Why Piriformis Muscle Stretching Is Bad | Back Pain Relief

Why Piriformis Muscle Stretching Is Bad | Back Pain Relief


I want us to take a couple of minutes talking
about an exercise that is frequently done in the gym setting, and often, unfortunately,
done in the physical therapy setting that would be very difficult on a back patient
who’s having acute or subacute pain, and that is the piriformis muscle stretching. The piriformis muscle is a small, pear-shaped
muscle in our buttock, and it helps with the stability of our hip. Unfortunately, due to its location and where
it’s innervated from, the nerve roots in your lumbar and sacrum, the muscle is often in
spasm and often aching during an acute or subacute injury. OK, so you’re going to bend your knees. Alright. We’re going to fold one leg over the other,
and we’re going to draw this up towards the chest. Now, I think a lot of people are familiar
with this kind of a stretch and usually in this position, in this case on the left hip
and buttock, there should be a stretch feeling. If we were to switch and do the other side
we would feel it on the other side as well. Alright. So, it looks like a very safe stretch, and
usually patients will describe it as feeling really good in their hip or buttock area. But, unfortunately, the spine is placed in
a very provocative position where it’s being flexed up, often stimulating the stresses
that are bringing the patient into the clinic in the first place due to too much sitting,
or bending, or carrying and lifting. So, although they’re being reinforced by the
stretch feeling in the buttock, unfortunately they’re actually putting the spine in a flex
posture and potentially harming the injury. Again, during the moment it feels pretty good,
but later on into the next day it’s often felt worse in the back or in that area. The patient will constantly stretch it, and
stretch it, and stretch it three, four, or five times per day and really not make a dent
in their symptoms. That’s why, because they’re putting the spine
in the wrong position despite the positive enforcement on the tissue. So that is the piriformis muscle stretch.

9 comments on “Why Piriformis Muscle Stretching Is Bad | Back Pain Relief

  1. Majeed Aldhayan Post author

    What can i do to undo this bad exercise, i had no pain before doing the exercise and I've been in pain for two weeks now.

    Reply
  2. Majeed Aldhayan Post author

    I also forgot to say that i already have anterior pelvic tilt and the exercise caused the pain on my sacrum and kind of changed its position

    Reply
  3. Gregg Silk Post author

    Couple of thoughts:
    1) There seems to be almost no evidence actually linking the little piriformis muscle to back pain, and it is not physically connected.
    2) Doing this stretch without pulling towards the opposite shoulder only stretches the glutes
    3) Crossing the legs serves no purpose, and extending the other leg keeps the spine in a more neutral position
    4) The glutes ARE connected to the lower back, and weak glutes can result in back pain AND piriformis syndrome.
    5).  Probably a lot of what people call "sciatica" is "non-specific lower back pain" possibly caused by Gluteus Medius Syndrome. 
    6) Stretching the glutes (not the prirformis) probably helps back pain and makes people think the piriformis is causing back pain, even though there is very little clinical evidence implicating the piriformis in piriformis and nothing in the anatomy to suggest it's even possible. 

    Just my $0.02 from the maker of the Active Life Seat Cushion for piriformis syndrome

    Reply
  4. MM Mckenzie Post author

    so i should NOT if ihave nerve issues in lumbar and ithink i have stenosisis there dont do this stretch,?? thank you for video MM

    Reply
  5. Regina McCook Post author

    If I am hearing and reading correctly you said not to do this stretch? If so then why is everyone thanking you for it and that it feels good?

    Reply
  6. WayneMandible Post author

    If you state that a stretch (which almost every physical therapist teaches) is bad, what do you recommend someone does to relieve the pain and tightness being experienced in low back, hip, and sciatic nerve pain? And why do you keep stretching the lady in your video with this stretch if it is a bad thing to do?

    Reply

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