Piriformis Syndrome Rehabilitation

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The rehabilitation of piriformis syndrome focuses on easing the muscle tension and correcting any muscle imbalances or biomecahnical causes which may be contributing to the condition.

Aims of rehabilitation

The guidelines below are for information purposes only. We recommend seeking professional advice before starting any rehabilitation. The first priority is to reduce pain then improve the flexibility and condition of the surrounding muscles before returning to full fitness. It is also important to look at any factors which may have caused the injury to prevent recurrence.

Reducing pain

Piriformis stretchYour Doctor may prescribe anti-inflammatory medication such as Ibuprofen. Heat in the form of a hot bath or hot water bottle applied for approximately 20 minutes three times a day. This may help to relax the muscle spasm and encourage blood flow through the muscle.

Rest from activities that produce pain. This is likely to include running. Gentle piriformis stretching exercises if pain allows. This should also reduce the pressure on the nerve causing the pain.

Flexibility and conditioning

Sports massage for piriformis syndromeAs soon as comfortable to do so, piriformis syndrome stretches should begin. Hold stretches for 30 seconds and repeat 5 times. Piriformis exercises can be done to strengthen the muscle making it less likely to tighten up in the future. On a daily basis perform piriformis strengthening exercises, immediately followed by stretching.

Deep sports massage techniques can be used to release the tension in the Piriformis muscle. Massage can be applied on alternate days. At the very least two to three sessions at the start of rehabilitation is a good idea.

Muscle energy techniques are an excellent way of improving the stretch of the muscle. In addition to the specific piriformis stretches it is important to stretch the hamstrings, groin, hip abductors and lower back.

Return to full fitness

Once daily tasks are pain-free, a return to activity program can begin. This should be a gradual process. An example return to running program is given below. How quickly you progress through the program will depend on the extent of the injury and original fitness levels.

  • Day 1: walk 4 minutes, jog 1 minute, repeat 3 times
  • Day 2: rest
  • Day 3: rest
  • Day 4: walk 4 minutes, jog 1 minutes, repeat 4 times
  • Day 5: rest
  • Day 6: rest
  • Day 7: walk 3 minutes, jog 2 minutes, repeat 3 times
  • Day 8: rest
  • Day 9: walk 3 minutes, jog 2 minutes, repeat 3 times
  • Day 10: rest
  • Day 11: walk 3 minutes, jog 2 minutes, repeat 4 times
  • Day 12: rest
  • Day 13: walk 2 minutes, jog 3 minutes, repeat 3 times

This programme should be continued until you reach 15 minutes of solid running. You can then continue to gradually increase as normal, provided there are no symptoms.

It is essential that stretching and strengthening are continued throughout the rehabilitation process and beyond.