Piriformis Syndrome

[tones]

I believe I have piriformis syndrome as my symptoms are almost identical to those listed on the following site - http://www.easyvigour.net.nz/fitness...piriformis.htm.

My right glute does not fire properly and I have pain in the indicated areas on the website (upper part of glute, SI joint,right groin area and tight hip flexors). My symptoms also include extremely tight abductors, quads and ITB.

While I feel i have the correct diagnosis, I need your help with a recovery plan. I've read that i should avoid hip flexor stretches as they will only increase the irritation and i assume glute bridges would be an integral part of a recovery plan.

Any help in designing a recovery plan would be greatly appreciated!

Regards,
Tones

[UConnJulie]

I'm not sure exactly what it is you are looking for ... do you want a list of exercises that might help activate your glutes and stretch your abductors, quads and ITB?

[tones]

Sorry Julie I should have been more specific. I'm looking for a list of exercises and stretches to help activate my glutes and strecth my abductors, quads, and ITB. You are probably wondering why i dont just google these exercises/stretches and put together my own workout and I would have done that if I hadn't read that there are certain stretches (hip flexor for one) that can actually make this condition worse. I was hoping to get the opinion of some on you with PT experience so that i dont end up sabotaging my efforts by doing harmful exercises.

Hope that makes sense.

[Brian A.]

I have some of the same issues and I have found that SMR is the way to go with the tight areas. Using a tennis ball or a foam roller is the best way to get in and dig out adhesions. As far as glute activation back bridges and on leg back bridges as well as balance reaches and single leg squats should get the job done. Just make sure you keep the pelvis level so you fire the glute properly.

[Steve-O-68]

In addition to the SMR, here are a few periformis stretches you can do.

Sit in a chair. Put your right ankle on your left knee. While keeping a neutral spine, gently pull your right knee towards your left shoulder. You should feel a good stretch in your glute.

I also like to do the above stretch laying down. Lay on your back, bend your left leg to 90, but keep your foot on the floor. Right ankle still goes on left knee. Keep neutral spine, and pull right knee towards your left shoulder. For an added stretch, raise your left foot off the ground a few inches while pulling your right knee to your left shoulder. Don't let your lower back round, and focus on keeping your pelvis parallel to the floor. If your pelvis starts to shift, or your low back rounds, you'll lose some of the stretch.

When doing the glute bridges, try putting a yoga block or medicine ball between your knees and squeeze them together while bridging. This will help take the abductors out of the movement allowing you to focus more on your glutes.

[LisaS]

(disclaimer: I am not a Phys Ther - but I do have piriformis "issues")

the "figure-4" stretch (seated, lying down or standing) that Steve mentions is the one that gives me the most relief - though in practice I do it differently than he describes.
Example - for the seated right leg over left - rather than move my right knee to left shoulder - I keep the right knee down and lean forward with a flat back moving the center of my chest down and towards my left knee and get the stretch in the right glute. If I want more stretch, I raise up the left heel off the ground a bit (has the effect of moving the legs upward to increase the stretch).

along with the stretch, doing glute bridges & working on core stability (planks) have had the best results for me to keep this at bay.

[jax]

Would swings (db or kb) be good or bad for this?