PIRIFORMIS SYNDROME EXERCISE, CAUSES, SYMPTOMS, PRECAUTIONS

PIRIFORMIS SYNDROME

Also known as DEEP GLUTEAL SYNDROME, PELVIC OUTLET SYNDROME, INFRAPIRIFORMIS FORAMEN SYNDROME, FAT WALLET SYNDROME

• The piriformis syndrome is an entrapment neuropathy of sciatic nerve almost always accompanied by an anatomical abnormality of the piriformis muscle that may be internal to the muscle or external to it.

The sacroiliac dysfunction v/s piriformis syndrome.

• Sacroiliac joint dysfunction is different from the piriformis syndrome. The latter may though include not only the myofascial pain from trigger points of the muscle and structures adjacent to it but also the entrapment of nerve from adjacent structures as discussed above.

CAUSES OF PIRIFORMIS SYNDROME

• It can be idiopathic (unknown cause)

• Trauma or fall involving the gluteal region or sacroiliac joint

• Joint dysfunction

• Pregnancy

• Anatomical variants

• Spasm of the piriformis muscle

SYMPTOMS OF PIRIFORMIS SYNDROME

• A deep, boring, ill-defined pain at buttock

• Tenderness on buttock

• Radiating pain that resembles sciatica

• Posterolateral thigh pain that may be running down along the course of the sciatic nerve

• The symptoms may get aggravated by sitting, walking, climbing stairs, or performing squats or repetitive rotations on the planted foot

• Sitting intolerance, especially on hard surfaces

• Dyspareunia, sexual dysfunction, or pain with bowel movements

• Pain with active or passive provocation/stretch of the piriformis

TREATMENT FOR PIRIFORMIS SYNDROME

• NSAIDs

• Muscle relaxant

• Physiotherapy

• Trigger point injection

• Operative release

WHAT IS THE FASTEST WAY TO HEAL PIRIFORMIS SYNDROME?

• Most of the patients respond successfully to conservative treatment.

• Physical therapy plays a very important role in the treatment of piriformis syndrome and can also be very effective with combination of Rest, suitable modalities, stretching, and exercises.

Which Physiotherapy Modalities can be used to relieve symptoms of piriformis syndrome?

• Ultrasound

• Thermotherapy

• IFT (Interferential Therapy) for radiating pain

STRETCHING IN PIRIFORMIS SYNDROME

• Supine piriformis stretching

• Gluteal/piriformis foam roller exercise

• ITB (iliotibial band) foam roller

Initially start with SUPINE PIRIFORMIS STRETCH, once your pain reduces to a little extend switch to stretch with a foam roller

 EXERCISES FOR PIRIFORMIS SYNDROME

Level 1

• Back isometric exercise

• Supine pelvic tilt exercise

• Single knee to chest exercise

• Double knee to chest exercise

• Bridging exercise

• Clam exercise

• Prone knee bend exercise

• SLR (Straight leg raise) only up to the pain-free range

 

Level 2 (As the pain subsides)

• Seated Piriformis stretching

• SLR (straight leg raise)Do the full range

• Single leg bridging exercise

• Prone leg Raise exercise 

• Side Leg Raise exercise

• Adductor lift exercise

• Clam exercise with Resistance band

• Stationary Lunge exercise

 

Level 3 (after 2 weeks of level 2)

•  Mini squats exercises

• Forward Walking lunge exercise

• Plank from knees exercise

• Prone Plank exercise

• Side Plank (Level 1) exercise

 

If you are an athlete, fitness novice, or gymholic, to increase more strength you can include weights and high-intensity exercises.

 

What should be AVOIDED in piriformis syndrome?

• Avoid sitting or walking for too long, always take a break in between.

• Avoid sleeping on the affected side till your pain subsides

• Avoid lying down in the same position for a long time

• Follow proper lifting and carrying techniques, as the wrong position may put undue pressure on your piriformis muscle leading to injury.