Posted by on Jan 11, 2015

It is, literally, a real pain in the butt!

Because I train runners, dancers and sedentary people alike, I see this syndrome frequently.

It occurs when the piriformis muscle, one of the deep rotators of the hip, becomes irritated. Hip pain and sciatic pain, running down the back of the leg will result. In this way, the symptoms of PS can mimic lumbar spine issues. PS can happen:

1) through external rotation overuse in sport or work-related movement,

2) because the opposing muscles such as hip flexors/internal rotators are working hard as in running, cycling, or certain types of dance or aerobic activity, or

3) because it indicates a sacroiliac imbalance.

It can also be triggered by tightness in opposing, or antagonist muscles. Being seated for extended periods can shorten and tighten hip flexors. If you have tight quads or psoas (another hip flexor), or you pronate excessively, you can be vulnerable to Piriformis Syndrome.

If your gluteus maximus (major butt muscle, responsible for hip extension) is weak, piriformis can become overactive, leading to Piriformis Syndrome.

This video provides a good graphic explanation.

Here are some good stretches to alleviate discomfort. These can be performed dynamically, with a series of five to ten 4-6 second holds, or more statically, for one or two 20-30 second holds. Applied heat or cold often helps as well.

IMG_5419 IMG_5417 IMG_5405 IMG_5394


Additional stretches will be included later, including rolling on a foam roller or Original Worm, and the yoga pose Pigeon.

Since we always want to get to the root cause of an issue, always consider your activities or customary behavior to provide clues. I recommend a consultation to identify factors or rule out lumbar and sacroiliac issues if you suspect PS.

Thank you, MV, for posing for these photos.

Not all exercises are suitable for everyone and this or any other exercise program may result in injury. Any use of this exercise program assumes the risk of injury resulting from performing the exercise and using the equipment suggested. To reduce the risk of injury in your case, CONSULT YOUR DOCTOR BEFORE BEGINNING THIS EXERCISE PROGRAM. The advice and instruction presented are in no way intended as a substitute for medical counseling. Jennifer Westerfeld and Westerfeld Fitness disclaim any liabilities or loss in connection with the exercise and advice herein.

Feel free to post questions and comments below, or contact me via email: for a personal consultation or fitness plan.

Read More