A Pain in the Bum 2 - Piriformis Syndrome

I have already talked about pain in the front and back of the pelvis and the hips - Pelvic Girdle Pain (PGP) - caused by the hormone relaxin during pregnancy.  You can read the original post here.  Now here's another pain in the bum! Piriformis Syndrome can occur in anyone but it is particularly prevalent in pregnancy.  The piriformis is a muscle that connects the thigh bone (femur) to the spine at the sacrum.  It also blends into the pelvic floor so can affect the function of the pelvic floor too.  It's quite a small muscle that can be overused and quite tight. Because the sciatic nerve runs through/near it, a tight and spasming piriformis can press on it causing sciatic symptoms - such as pain in the bum and down the leg.

Posture (as ever!) has a lot to do with it.  If you walk/stand with your feet facing outwards the piriformis muscle is continually switched on.  Try to have your feet facing forwards instead. Another postural problem is having your bum tucked under constantly.  Instead think of your bum sticking out when standing - easier if you're not pushing your weight into your toes.  In seated position try to sit upright on your sit bones instead of slouching back.  This is essential in pregnancy anyway, to help keep the pelvic bowl open, creating lots of space for baby.  And try not to sit too much - take regular standing breaks if possible. To ease off the muscle there are a number of stretches you can do.  The main one is the figure of 4 stretch.  Sit on the edge of a chair, up on your sit bones, feet flat on the floor under your knees.  Lift one leg up and place the ankle on top of opposite knee.  Allow knee of top leg to rotate down gently.  Try to keep ankle straight - having the foot flexed helps.  Hold and breathe for a few seconds and then switch legs. This could also be done sat on the floor or lying on your back with the bottom leg up the wall Sitting on a tennis ball - not suitable in pregnancy.  Place a tennis ball under one bum cheek - you can go right on the source of discomfort if it's not too intense, otherwise place just above or below the trigger point.  From there you can just sit and breathe until the discomfort eases or you can make small circles.  Also from a seated position with feet flat on the floor allow one knee to drop out slowly then draw back in. One we often do in Pregnancy Pilates Relaxation class is a hip hinge with feet in a t shape.  Place one foot in front of the other so that the instep of the front foot is next to the toes of the back foot.  In this position, push the hips back, keeping the back straight.  You should feel the stretch in the bum cheek of the front leg. Just as important as the releases, you also need to strengthen the bum - squats, hip lifts, hip hinges all help.  These are key movements in all my classes as a strong bum will also help with posture and strength as well as looks good!!


There are no comments yet. Be the first one to leave a comment!

Leave a comment