My hip hurts. That’s how I kept describing this ache near the top of my rump, until my PT finally said it’s your glutes and probably your Piriformis muscle.
Wait, did he just say I have a literal pain in the ass??
Indeed and it’s a truly common issue.
Here is what you need to know!
Step 1: Is it your piriformis muscle causing pain?
Could your hip pain actually be your piriformis like mine was? It’s not always easy to diagnose on your own, but there are some common symptoms and a few tests you can try.
The most common symptoms of piriformis syndrome are:
- deep pain in your bum (only on one side)
- pain that radiating down the back of the leg (can go all the way to the calf sometimes)
- numbness or tingling in the glute and back of leg
The piriformis muscle is a muscle in your glute that extends from the base of the spine out to the top of your thigh bone, which is why you could feel pain that you point to in your hip or your bum.
Tightness here can compress your sciatic nerve, which extends all the way down to your foot.
Causes in runners?
None of this will surprise you.
- Tight hips.
- Muscle weakness.
Step 2: Piriformis Syndrome Treatment
Once you’ve defined the issue, it’s time to get your pirformis to release and then move on to doing consistent exercises at home to create strength and prevent it from coming back.
Some of these are do it yourself and some require a little assistance.
- Dry needling – I’ve seen this work for a lot of people
- Chiropractic care – if a nerve is pinched this is necessary to relieve it
- At home stretching and strengthening exercises (see below)
- Using a massage ball to do deep tissue work in the glute
Step 3: Piriformis Syndrome Exercises
Do these exercises on whichever side is experiencing the pain. I am going to say right for consistency. Aim for at least three days per week, though you could benefit from daily piriformis stretch exercises.
I feel like this one is a double bonus because you’re also working on hip mobility! She does such an amazing job of explaining the exact positions that I will let her video be your guide.
Lying piriformis stretch
It’s easy to confuse this with a figure four stretch you may have done before and is so often shown as a way to stretch your piriformis, but it’s not quit hitting the muscle the way we want..
Lying on your back, drawn your right knee to your chest then with light pressure pull your knee and ankle towards the left shoulder. You won’t actual roll to the side or notice a huge amount of movement.
I wanted another video to help explain this is NOT the figure four stretch and well these guys are seriously so cute and clearly extremely knowledgeable. The first exercise is the one I mention, but the others are great too.
Side Leg Lifts
Lay on your left side with hips stacked and legs straight. Raise and lower your right leg with your foot flexed and pointed forward. Get your leggings out and go Jane Fonda if it helps.
Supported Hamstring stretch
With your right foot straight in front of you on a bench or a second step, flex the foot towards you. Slow lean slightly forward in to the stretch and hold for 30 seconds.
You can repeat this throughout the day and for a little more, do it as the 3D method my Physical Therapist provided to hit the muscle from all angles.
Step 4: Inflammation Reduction
You know I’m not a fan of runners and pain relievers, instead my focus is on how we can reduce inflammation to help the body heal. Inflammation is how your body knows there is something that needs to be resolved, so trying to mash it down with pain relievers doesn’t always get us where we want to go.
Any other running issues you’d love some guidance on?
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