Sciatica, piriformis syndrome, restless leg: The best 5 stretches


Back pain, Buttock pain, Chronic pain, Hip pain, Leg pain, Low back pain, Sciatic pain, Stretching (Active Isolated method) / Sunday, June 21st, 2009

For anyone with piriformis syndrome, restless leg syndrome, low back pain, hip pain, buttock pain, sciatica pain, thigh pain and back leg pain, these 5 specific stretches will help. If you feel discomfort or pain when you stretch, that’s the place that needs it. You won’t harm yourself even if it hurts if you stretch for only two seconds and repeat. (Active Isolated Stretching protocol is on my web site. Here’s the link: Active Isolated Stretching) Stretches held in pain for longer than two seconds can cause harm, because an automatic reflex in your muscles (stretch reflex) will contract the very muscle you are trying to stretch to protect it. Now that’s counterproductive. Active Isolated Stretching is what we teach in my Neuromuscular Therapy center in the Boston area. Try this new method of stretching. You’ll be amazed at the results!

The following stretches are all done lying on your back. The right side is explained for clarity. Reverse it to do the left side.

1) Lying on your back, bend both knees and bring them to your chest, pulling them closer to your chest with your hands (either on top of your knees or behind them between the thigh and calf). Exhale and stretch for two seconds, release and repeat 10 times.

Be more specific by doing one leg at a time to feel which side is more uncomfortable. Extend your left leg straight on the ground. Bend your right knee and pull it toward your right shoulder. Exhale and stretch for two seconds. Release and repeat 10 times. Repeat with the right leg extended and the left one bent.

This stretch targets the low back where the sciatic nerve begins, and addresses muscle and connective tissue tension, joint and nerve compression, and Trigger Points, all of which can cause pain down into the buttock, hip, thigh and calf.

These stretches are mostly for the symptomatic side, although it will help to do both sides. When your body compensates for a problem, the opposite side gets overused and tight.

2) Now bring your right knee to the opposite (left) shoulder to stretch your right glutes (gluteus maximus, posterior portions of the gluteus medius and minimus) and, to some extent, the piriformis and it’s helpers. Stretch actively as you exhale, assisting the stretch by pulling your knee closer for two seconds. Release and repeat 10 times.

3) Here’s the best and most specific stretch for the piriformis and the other external or lateral rotators of the thigh. Bring your right knee to the opposite (left) shoulder as in #2 and hold it there with the same-side hand (R knee, R hand). With your opposite (left) hand, grasp your right ankle and rotate your entire limb by pulling your ankle toward your armpit or the floor.  Be sure to keep your knee at your opposite shoulder as you rotate the leg.

4) Stretch the back of your thigh (hamstring stretch variation #1 for the attachments at the knee). Lying on your back, wrap a rope, strap, belt or towel around your right heel or mid-foot. Bend the right leg and bring it to a tabletop position, bent at 45 degrees both at the hip and knee. Straighten your knee against the pressure of the rope until it locks, using the quadriceps muscles in the front of your thigh. Exhale and stretch for two seconds. (If you can’t lock your knee, lower your thigh to increase the angle at your hip and try again. Lower your thigh as much as you need to in order to lock the knee at the end position.)  Repeat the stretch 10 times on each side, bringing your thigh closer to your body each time.

You can be more specific with this stretch by rotating your foot inward or outward to increase the stretch of the inside and outside (medial and lateral) heads of the hamstrings.

Keep your foot relaxed at the ankle. I know you will feel more if you flex your foot, but that is the calf muscles and connective tissue you’re feeling, not the hamstrings.

5) Hamstring stretch variation #2 for the attachment at your sitting bone (ischium). With the rope or strap around your right heel or mid-foot and your leg straight, using your core muscles and quads, do a straight leg raise as high as you can using the power of your own muscles. Climb the rope with your hands to keep it taut and when you can’t go any further, assist the stretch by pulling your straight leg closer to your body with the rope. Exhale and stretch for two seconds. Release your leg to the floor and repeat 10 times on each side.

You can be more specific with this stretch by rotating your foot inward or outward to increase the stretch of the inside and outside (medial and lateral) heads of the hamstrings.

5 Replies to “Sciatica, piriformis syndrome, restless leg: The best 5 stretches”

  1. I have had piriformis syndrome syndrome with pudendal nerve involvement for 23 years. Obtaining a diagnosis was very difficult and I became very socially isolated largely because I couldn’t sit down and spent a lot of time lying down.
    This resulted in a loss of muscle tone in the gluteals and the muscles of the leg and foot. Exercises have done little to help in the past but as I age the condition has resulted in balance problems and I am once again putting effort into exercises that will assist with pain management and maintaining mobility. I also have footdrop that I think has been caused by the syndrome as the sciatic nerve pain travels the entire length of my leg into the foot.

    1. Stretching your piriformis is very important. First bring your knee to the opposite shoulder to stretch the gluteus maximus. Hold the stretch for two seconds, release and repeat 10 times. Next, with your leg in that knee to shoulder position and your knee bent at a 90 degree angle, grab your ankle and pull it toward the floor. Hold for 2 seconds, release and repeat 10 times. You will also need gluteal strengthening. You won’t be able to stand up without it. Find someone to do deep tissue work on your low back, buttock and hip muscles. Sometimes stretching just isn’t enough.

    1. Hi Rob, I’ve edited the post to give more information about the stretches. Hope that helps. I will take your suggestion and add photos. I’ll be starting a new series on sciatica next week, so more information and illustrations will be forthcoming. Thanks for your comment.

  2. Very comprehensive and helpful tips! Utilizing these stretches would save the patient a lot of money. When my wife was at the height of suffering from severe sciatica, we have never heard such stretches from specialists. She always got her dose of epidural or valium. We should have found this post early on. Thanks a lot. This is our future reference.

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