Piriformis Syndrome, Sciatica, and Back Pain.

     Located deep in the hip underneath the Glutes are the ‘Deep Six’ lateral rotators of the leg; Gemellus Superior and Inferior, Obturator Internus and Externus, Quadratus Femoris, and last but not least, the Piriformis. The Deep Six not only rotate and stabilize the legs, they also play an important role in pelvic balance. If one hip is tight then the pelvis will be pulled to the side and rotated causing an imbalance in the lower back. If both hips are tight then pelvic movement becomes restricted and the lower back has to contend with the torsion created. Triggerpoints in the Deep Six can refer pain into the legs and pelvis and can contribute to other dysfunction such as ‘Restless Leg Syndrome’. One leg or both will usually be rotated outwards and the joint compressed contributing significantly to arthritic hip joints as well as problems with the knees and ankles.

     One of the Deep Six, the Piriformis muscle, is particularly important because of its tendency to cause sciatica pain. Sciatica pain starts in the lower back or the butt and often travels down the back or side of the leg or around the hip depending on the individual situation. Piriformis Syndrome is caused by pressure on the sciatic nerve where it exits the pelvis through the sciatic notch. If the Piriformis is tight and knotted then the nerve gets pinched between it and the hipbone. Often people will have one leg or the other that they tend to hitch up on. Some may sit for hours at a desk every day causing the entire pelvic girdle to be tight. Often truck drivers will get Piriformis Syndrome simply by driving long hours with a wallet in their hip pocket. By keeping the Piriformis and the Deep Six loose you can reduce the chance of lower back and sciatica pain and increase mobility.

     One great way to stretch the Piriformis and the deep six is the “Desk Stretch”: Find a table or a desk that stands about waist high. Facing straight in towards the table, bring your foot up in front of you with the knee bent outwards as though were trying to perform an inside kick while playing hacky sack. Place your leg on the table with your knee rotated and bent outwards so that your foot is right in front of you. Like you were about to sit cross legs on the edge of the table in front of you, only one foot is still on the floor. Bend the supporting leg a little. Try to keep your spine straight as you lean forward at the waist bringing your chest down towards the foot on the table in front of you. You should feel a stretch in the butt or up the outside of the leg or even in your lower back. Lean into the stretch and breathe deeply allowing the muscles to release. Then move the foot and inch to the left or right, slightly altering the stretch. Lean into the stretch again and breathe away the tension. Repeat several times, changing the angle of the stretch each time by moving the foot or by bringing the chest down to the inside of the shin or knee rather than the foot. Then repeat with the other leg. Finish up by doing some hula-hoop type movements to help reestablish balance. You should find that your hips and lower back are much more mobile.

     Remember that self-care does not take the place of professional health care. Low back and sciatica pain can be caused by a variety of different issues. Be sure to consult a physician or chiropractor if you are in pain or suspect that you have an injury.