Thursday, July 30, 2015

When exercise becomes a pain in the butt

Back pain, hip soreness and leg ailments can sometimes be traced to one simple source - a pain in the butt.

When exercise becomes a pain in the butt

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A pain in the butt. Sometimes that is how the infamous athletic injury begins — just a pain in the butt. Many times I see runners, cyclists and other athletes who have pain in their back, legs and hips. Often they all can point to one specific spot that hurts.

This spot that hurts is generally in the piriformis muscle. When it is irritated it is called piriformis syndrome, sometimes it is lumped into the broader term of sciatica.

The piriformis muscle is a small muscle located in the glute region. It attaches from the tail bone to the hip. It is the cause of a lot of pain in the butt, the back and the hip. It is a common injury of many recreational and professional athletes, but also for people who sit for most of the day. Many people classify as generic back pain or sciatica but in fact it is a different diagnosis all together. The good part about piriformis syndrome is that if caught early, it can be easily treated.

Stretching of the piriformis muscle should be an active part of everyone’s daily routine whether they are an athlete or not. Tightening of this muscle can cause pain that can radiate down the leg due to the fact that nerves run directly underneath it. This muscle can be stretched in a variety of ways. The way to position the muscle to stretch is shown in the video below:

  • Place the ankle over the opposite knee. This gets the muscle into position to be stretched. From here there are a number of positions to stretch it in. There is rolling on the foam roller, which is shown. There is sitting on a chair, like when you are at your desk.
  • Sit up nice and straight, place your ankle on your knee and then lean forward, you will feel a stretch in the butt.
  • The next position is lying down. Position yourself as seen in the video, minus the foam roller. Grab the leg that has the ankle resting on it and bring it up to your chest. Hold this for 30 seconds, repeat 6 times.
  • Finally you can perform this exercise while standing. Stand at something about counter height. The counter will provide the support that the other leg would normally have. Your knee and lower leg and foot should be lying on the counter.
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This stretch should feel good, it should not be painful. If you feel pain or sensations going down your leg as you are performing the stretch, stop and call your doctor. Otherwise it should feel like a good deep stretch. This muscle is tight on most people and stretching it regularly throughout the day will help loosen it up.

Loosening this muscle will also allow you to be stronger in your sport. Hip strength allows for faster movements within a sport. Allowing this muscle to operate at full length will give you more strength and stability. Weak hip muscles lead to a lot of problems with athletes of all ability levels.

So whether it is resolving back and hip pain or training to become a stronger, better, faster athlete, the piriformis is not a muscle to ignore. It can and will become a pain in the butt.


Read more Sports Doc for Sports Medicine and Fitness.

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About this blog
J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Justin D'Ancona Philly.com
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
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Tracey Romero Sports Medicine Editor, Philly.com
David Rubenstein, M.D. Sports Medicine Surgeon, Rothman Institute
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Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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