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Why Piriformis Muscle Stretching Is Bad for Back Pain

Learn how piriformis muscle stretching can make back pain worse from physical therapist Eric Sampson in this Howcast video.


I want us to take a couple of minutes talking about an exercise that is frequently done in the gym setting, and often, unfortunately, done in the physical therapy setting that would be very difficult on a back patient who's having acute or subacute pain, and that is the piriformis muscle stretching. The piriformis muscle is a small, pear-shaped muscle in our buttock, and it helps with the stability of our hip. Unfortunately, due to its location and where it's innervated from, the nerve roots in your lumbar and sacrum, the muscle is often in spasm and often aching during an acute or subacute injury.

OK, so you're going to bend your knees. Alright. We're going to fold one leg over the other, and we're going to draw this up towards the chest. Now, I think a lot of people are familiar with this kind of a stretch and usually in this position, in this case on the left hip and buttock, there should be a stretch feeling. If we were to switch and do the other side we would feel it on the other side as well. Alright.

So, it looks like a very safe stretch, and usually patients will describe it as feeling really good in their hip or buttock area. But, unfortunately, the spine is placed in a very provocative position where it's being flexed up, often stimulating the stresses that are bringing the patient into the clinic in the first place due to too much sitting, or bending, or carrying and lifting. So, although they're being reinforced by the stretch feeling in the buttock, unfortunately they're actually putting the spine in a flex posture and potentially harming the injury.

Again, during the moment it feels pretty good, but later on into the next day it's often felt worse in the back or in that area. The patient will constantly stretch it, and stretch it, and stretch it three, four, or five times per day and really not make a dent in their symptoms. That's why, because they're putting the spine in the wrong position despite the positive enforcement on the tissue.

So that is the piriformis muscle stretch.

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