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Piriformis Syndrome #1 Reason It Gets Irritated

This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2023. For the original video go to https://www.youtube.com/watch?v=LcVxpPuOsfk&t=21s

Mike: Stop the pain in your butt with these three simple exercises.


Brad: And learn how to fix piriformis syndrome.


Mike: The piriformis is a small muscle located in the buttock, and it generally crosses over the sciatic nerve. The problem is the piriformis muscle can become irritated, and press down on that nerve, resulting in pain.

Brad: That's right. The question is, why does it get irritated? Well, the answer is obvious, at least to me. Actually, it's because the large gluteus maximus muscle is not doing its job. It becomes weak or is not activated. It's called gluteal amnesia, and that muscle gets weaker, and doesn't do its job, the piriformis muscle tries to compensate for that. It overworks, pinching the sciatic nerve, causing pain in the buttock, as well as all the way down the leg like sciatica.


Mike: So how do we fix this problem? Well, it's pretty simple. You just have to get your gluteus max to start firing properly again.


Brad: That's right. We're going to show you three exercises to jumpstart that glute max and get it moving so that it works and lets that piriformis relax. The first exercise is glute pumps. It can be done in two different positions. Mike's going to show it in the quadruped position, I'm going to show it in a standing position. Go ahead, Mike.


Mike: So get down on all fours. You're going to rest on your forearms and bring your leg up. You're not going to go too high or too low, just kind of in the middle. Find a neutral ground, and you're just going to pump up with little oscillations. We're not going to go up super high. And if you're able to keep your balance, you can put your hand on your butt to make sure it's firing. If it's not firing well, you can kind of turn your leg inward and do the same thing. And just little pumps, do 10 of them up to 30 reps.

Brad: How many sets?


Mike: You can do up to 30 reps, however many sets it takes you.


Brad: Sure. Alright, the other option is standing. You'll go up to a table or a countertop, it's nice to put your forearms down so you get the right angle to isolate that glute max. And then the same idea that Mike mentioned, we're going to go up, do a little external rotation, bring the foot over, and do your pumps, and just kind of work it like this, counting away. Yeah, I feel that glute max working. It does help, even though it's a little weird, it does help to actually feel that glute max working, that tactile information gets it firing a little more. Let's go onto the second one.

Mike: So the second step to get your glutes firing more, when you're walking, is to take shorter strides, or how far do you put your foot in front of the other. So we have a little tip here, where we're taking some popcorn kernels and taping it to the heel of your foot.

Brad: I think it's important. It's not only shorter strides, but the reason the popcorn is on the heel is because you want to walk with soft knees, and the weight is on the forefoot, as opposed to the heel strike, that turns the glute off. When you go on your forefoot with a slight knee bend, it initiates the gluteus maximus to fire. Go ahead, Mike.


Mike: If I try to walk with the popcorn on my heels, it's not very comfortable. It's like stepping on Legos if you've ever done that. So it's going to make you naturally land on the front of your foot, not put pressure on your heels. In order to do that, you're going to have to shorten your stride length and walk on your forefoot.

Brad: Now, we don't expect you to do this all day long, of course. simply take out 10, to 20 minutes at home, do this every time you get up. You don't have to think about your pattern, because the popcorn under there is going to remind you. So it really works out well. Easy training technique.


Mike: And this actually goes into the third recommendation, which Brad kind of recommended already, is when you step, you're going to step with a soft knee. I'm not going to lock my knees. So if you land on your heel, you're going to lock your knees into extension, putting more stress on your joints here, and not engaging your butt muscles. To engage your butt muscles, you're going to stay on your toes, just like we talked about before.

Brad: One little addendum there, is you can actually, after you put the popcorn tape on the heel, you can put your sock over the top of it, slide your foot into the shoe, and it works very well, also. It depends on the cushion in your shoe, you won't feel the popcorn as much, but simply put more in, and you'll get a feel for it.


Mike: So if you're still having piriformis pain, and you're starting to get your butt firing properly, and you want to get it to calm down, a good thing to do is massage it. Some free things you can use are a lacrosse ball, a softball, a baseball, or a tennis ball, which is a little softer. The others are a little harder. You just kind of put it on your buttock muscle. You kind of have to get to a position to put some pressure on it. I've even done it in a figure four, and that really digs in there. But Brad has an alternative if you have a massage gun or want to buy one, you can try it that way too, right?

Brad: That's right. So with the massage gun, you simply are going to use the round head, or probably the airhead, whatever you want. The round head I like, and I'll show you why. You lay on your side, and typically flex your hip to get to the piriformis muscle. It connects from the side of the hip, all the way up to the sacrum. But you'll find it. You just get on there, and don't get too aggressive, and you start massaging around. You'll feel a tender spot, and that is where that muscle is tightened up, and you need to release that knot. And you work over it for about 30 seconds or so, and you should start to feel it to release. If it's really tender, and it hurts, you simply go away from it and work around it. And after time you can zero in more on it, and work it. So you can go straight in, but it gets a little aggressive, so sideways with the massage gun works a little bit better, not so aggressive. Typically, you'll be there for a couple of minutes before you get it worked out. What do you say?

Mike: I say cut. So Brad, what are the four Bs again?


Brad: Be careful, be healthy, and behave. Be helpful. Something. There you go. That's enough, let's go. Bye.


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