Restoring functionality in 4 effective steps
Hip dysfunction can have a profound effect on performance. When we think of the hips, we don’t always consider a rather important—yet very tiny muscles—the piriformis. The piriformis is responsible for external rotation, abduction, extension, and stabilization of the hip. That makes this muscle vitally important in everyday tasks like walking, running, and getting in and out of a car. Now let’s say that muscle has become overactive. Well, you can bet it’ll cause a lot of pain … and dysfunction.
Becoming a pain in the butt!
Like any other muscle, when the piriformis gets tight, it can get nasty. It can spasm and begin to impinge on the sciatic nerve causing pain to diffuse through the glutes, lower back and legs. This is called piriformis syndrome and can often be confused with sciatica. The pain and discomfort alone can cause faulty recruitment pat-terns in hip-based movements effectively disrupting the kinetic chain.
What to look for
- Feet turnout during a static postural assessment or squat (may not be a guarantee that the piriformis is tight, but would make it likely).
- Pain in the buttock region while sitting.
- Tenderness when pressing against the area.
How to restore functionality
Focus on Inhibiting, Lengthening, Activating, and Integrating the piriformis
Inhibiting a muscle is done by self-myofascial release (SMR) techniques. These techniques are used on muscles that are identified as shortened and overactive. When done correctly, SMR will reduce tightness in a muscle and help reestablish optimal length.
Lengthening techniques include static and neuromuscular stretching. Static stretching is a flexibility method used to in-crease elasticity in a muscle and its connective tissue effectively increasing joint range of motion. Neuromuscular stretching is a method that involves isometrically contracting a muscle while in a lengthened position to produce
a relaxation response in the tissue, causing it to further lengthen.
Activation techniques involve corrective exercises used to increase activation of under-active tissues. Isolated strengthening exercises and isometric holds are the primary types of methods used during the activation phase. These exercises teach the body new movements to replace faulty recruitment patterns. Finally, once underactive muscles have been strengthened and overactive muscles have been lengthened, these tissues can work synergistically during compound movements. The increased neuromuscular efficiency results in appropriate movement patterns. This is known as the integration phase, and is the final component in the corrective exercise continuum.
Foam roll the piriformis
– Start seated on the foam roller with the affected leg crossed over the opposite knee. Gently position the affected glute onto the foam roller.
– Slightly rotate the body toward the affected side putting pressure into the glute muscle. Relax and allow body weight to sink into the foam roller.
– Slowly slide the buttock up and down the foam roller, focusing on the tender areas.
– Release pressure and repeat.
Supine piriformis stretch
– Lie in a supine position. Cross the affected leg over the opposite side.
– Put one hand on top of your knee, the other over your ankle. Slowly pull the affected leg toward the opposite shoulder until you feel a stretch through the glute.
– For a more intense stretch, keep the same position, raise your leg by grabbing the opposite thigh, and pull toward the chest.
– Hold for 30 seconds.
– Lie sideways, with knees bent forward towards hips.
– Stack feet, knees, hips, and shoulders.
– Lift top knee as far as possible while keeping hips stacked and fixed in place.
– Place hand gently on top hip to feel for activation.
– Keep the upper body relaxed. – Use slow repetitions for about 15 reps.
Glute Bridge, Body Weight Squat with band, Side Lunge, Curtsy Lunge
For the integration phase, which is the final phase we have four exercises to choose from1.
- Glute bridge
- Squat with hip circle
- Side Lunge
- Curtsy Lunge
To perform the Side Lunge
– Place hands together, pull shoulders back keeping an upright posture.
– Sweep affected leg to the side, keeping feet pointed straight. Sit back and down, squatting on the affected side while keeping the opposite leg straight.
– Feet should still track forward.
– Push explosively through the affected side returning to the starting position.
– Repeat for 10-15 repetitions.
A.J. Brye, is a New York City based National Academy of Sports Medicine certified personal trainer and fitness nutrition specialist. With 10-plus years in the Fitness and Athletic Industry, A.J. develops fitness programs that are functional and complement anyone’s lifestyle, in turn making daily life more enjoyable.