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"&amp;lt;h3&amp;gt;Intermediate Piriformis Syndrome Stretching Routine - Background Info You Should Know&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;If you have piriformis syndrome, you probably already know it can cause sciatica. \u00A0But did you know that it is only one of a number of potential things that can lead to nerve pain down your leg? \u00A0Other causes include\u00A0herniated\u00A0disc, spinal stenosis, or a tumor that presses on the nerve.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Although many people attribute their sciatica symptoms to piriformis syndrome, in the scheme of things, it is actually pretty rare.. \u00A0Authors of an article published in the November 2008 &amp;lt;em&amp;gt;Journal of the American Osteopathic Associatio&amp;lt;/em&amp;gt;n\u00A0report that at least 6% of low back patients - and up to 36% - have piriformis syndrome. \u00A0(And females, take heart: \u00A0You are 6 times as likely to get piriformis syndrome than males.)&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;As a syndrome, this condition it presents itself as a cluster of symptoms. Possibly because of this, it is often confused with other diagnoses - in particular, radiculopathy. \u00A0Radiculopathy, if you have it, will likely be more serious for you because it is the result of an irritated spinal nerve root, often by a herniated disc. \u00A0That said, leaving your piriformis syndrome untreated, may lead to changes in your sciatic nerve.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;So if the stretches in this and other articles on piriformis exercise don&amp;amp;#39;t relieve your leg pain, speak with your doctor and/or physical therapist about your symptoms.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;To learn more about piriformis syndrome, check out my article:\u00A0&amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-piriformis-syndrome-297241&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;What is Piriformis Syndrome?&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Piriformis Stretches - Should You Do the Intermediate or Beginner Version?&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;This article assumes you&amp;amp;#39;re past the beginner phase in terms of hip stretches and flexibility exercises. \u00A0If that&amp;amp;#39;s not the case, you may want to start with\u00A0&amp;lt;a href=&amp;quot;https://www.verywell.com/beginners-piriformis-syndrome-stretching-routine-4012558&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;2&amp;quot;&amp;gt;Beginner&amp;amp;#39;s Level Piriformis Stretching Routine.&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Otherwise, consider warming up for intermediate level stretches with beginner moves. Most beginner&amp;amp;#39;s stretches are\u00A0done in the hooklying position. \u00A0This is a supine position in which you lie on your back with your knees bent and feet flat on the floor. \u00A0The hooklying position is one of the most supported positions to be in, which helps make stretching accessible for beginners and people in pain. \u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Another thing that may get in your way of successfully performing intermediate level stretches is the inability to sit on the floor. \u00A0Ideally, you&amp;amp;#39;re able to do so without slumping (your back.) \u00A0If you can&amp;amp;#39;t sit upright, start with the beginner&amp;amp;#39;s level. \u00A0If you still want to try the intermediate level, consider skipping stretch #4 in this series until your hip flexibility has improved enough to allow you to sit upright on the floor without pain or strain.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The next few pages give you a few ideas for warms ups, and then it&amp;amp;#39;s off to the races!&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Warm Up for Your Piriformis Muscle Stretch&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;As mentioned on the previous slide, even though you&amp;amp;#39;re doing intermediate level piriformis stretches, it&amp;amp;#39;s still a good idea to warm up with easy moves first. \u00A0You might try a few from the Beginners Routine also mentioned on the previous slide, for example:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/beginners-piriformis-syndrome-stretching-routine-4012558&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;Cross One Leg Over&amp;lt;/a&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/beginners-piriformis-syndrome-stretching-routine-4012558&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;2&amp;quot;&amp;gt;Knees to the Side&amp;lt;/a&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;Or try this &amp;lt;a href=&amp;quot;https://www.verywell.com/back-pain-relief-through-outer-hip-muscle-stretching-297195&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;3&amp;quot;&amp;gt;outer hip stretch.&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Related: &amp;lt;/strong&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/back-exercise-for-relieving-muscle-tension-and-pain-296850&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;4&amp;quot;&amp;gt;Release Your Low Back Tension with this Easy Program&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Piriformis Warm Up - Cross One Knee Over to &amp;amp;#34;Get&amp;amp;#34; The Hip Muscle On That Side and Challenge Your Oblique Abdominals.&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Let&amp;amp;#39;s continue the supine warm up with a couple more moves before trying our &amp;amp;#34;hands,&amp;amp;#34; so to speak, with more challenging positions.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;In this one, you&amp;amp;#39;ll stretch your hips and flank, wake up your coordination and work your abs - all at the same time. \u00A0Ready? \u00A0Here goes:&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Instructions:&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Lie on your back with your knees bent and your feet flat. \u00A0Interlace your fingers behind your head; your elbows should be pointing out to the side (but don&amp;amp;#39;t force this if you have limitation or pain in your arms or shoulders. \u00A0In that case, simply do your best.)&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Put one ankle over the opposite knee, and then gently drop both knees towards the side of the &amp;amp;#34;standing&amp;amp;#34; leg (which is the leg that is &amp;lt;strong&amp;gt;receiving&amp;lt;/strong&amp;gt; your ankle.) \u00A0Only go as far as you need to feel the stretch.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;\u00A0At the same time, bring your arm and head up. \u00A0Aim your outstretched elbow towards the top knee. \u00A0(To get better ab work, keep it outstretched, which means you&amp;amp;#39;ll have to imagine pointing the elbow toward the knee without actually doing so .) \u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Slowly return your head, neck, shoulders and upper back to the floor.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Do up to 10 reps and then repeat on the other side.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;As you&amp;amp;#39;ve likely now experienced, warm ups for intermediates are a combination of beginner stretches and variations that may add in coordination and/or strength work. But in the pages that follow, you&amp;amp;#39;ll up the ante on the stretch by assuming other, more challenging positions.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Related:&amp;lt;/strong&amp;gt; &amp;lt;a href=&amp;quot;https://www.verywell.com/great-hamstring-stretches-296849&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;7 Great Hamstring Stretches&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Sitting Piriformis Stretch&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;This next piriformis stretch takes place in sitting. \u00A0It can be done in a yoga-like fashion or simply as a stretching exercise. \u00A0(The yoga version is shown on the next slide.)&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Sit upright with both legs extended in front of you. One key to sitting upright while on the floor is to try to distribute your weight equally between the sitting bones. \u00A0(Sitting bones are the two hard knobs on the bottom of your pelvis. \u00A0You&amp;amp;#39;ll likely know them by the way they feel - with enough pressure or time in the sitting position, they can hurt.)&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Bend one knee and cross that lower extremity over the other, placing the foot on the floor next to (and on the inside edge of) the knee that&amp;amp;#39;s outstretched. \u00A0Wrap your opposite arm around the bent knee. \u00A0It&amp;amp;#39;s okay to also place your (other) hand on the floor behind you to help you maintain the position.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Check again to be sure your weight is equally distributed between your two sitting bones. \u00A0This is challenging for a lot of people because as soon the hip joint has to flex, as it does when you bring your leg over to the other side, chronic piriformis muscle tension, along with tension in one or more of the other hip muscles can make you automatically lift your hip to accommodate. \u00A0But don&amp;amp;#39;t let this happen, if possible. \u00A0The more well-aligned your are in this stretch, the better your results will likely be.&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Add Challenges to the Sitting Piriformis Stretch&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;As I mentioned earlier, the seated piriformis stretch can be done as a yoga pose. \u00A0In this case, you&amp;amp;#39;re also adding some extra challenge by letting go of the grasp on your leg and raising one arm.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;To intensify your work in this position, release the grasp on your knee, (as discussed earlier) and raise that arm straight up (but don&amp;amp;#39;t lock your elbow joint.) \u00A0Keeping your form in this position is what makes you work harder, and one of the best ways to ensure that is to (also discussed earlier) keep your weight weight equally distributed between the two sitting bones; otherwise, you&amp;amp;#39;ll likely get less stretch to the piriformis.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Related:&amp;lt;/strong&amp;gt; &amp;lt;a href=&amp;quot;https://www.verywell.com/tips-for-successful-spine-rehab-296540&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;Tips for Successful Back Healing&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Stretch Your Piriformis in the Pigeon Pose&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;And finally, we come to the doozie-most of all the piriformis muscle stretches. \u00A0This is another one that is taken from yoga (called the pigeon pose.) So again, be a yogini, or simply take it on as an exercise. \u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Starting on your hands and knees, lower yourself down so that one leg is extended to the back. \u00A0Bend your front hip and knee. \u00A0If possible, position your leg so that your knee is in line with your hip joint. \u00A0This may not be possible if you are very tight in your hip muscles and/or iliotibial band. \u00A0In that case do the best you can.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Place your hands on the floor in front of you to help support your. weight. \u00A0You can use them to modulate how much weight goes into your hips, taking more weight onto your hands when the stretch becomes too much, and less when you think you can go deeper.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Another way to modulate the stretch is lean your trunk forward towards the floor to take the pressure off, and rising your trunk up when you think you can take more.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Related:&amp;lt;/strong&amp;gt; &amp;lt;a href=&amp;quot;https://www.verywell.com/yoga-for-back-pain-p3-297348&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;Yoga for Back Pain&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Piriformis Muscle Stretch Cool Down - Both Knees to the Side&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;For this intermediate level piriformis flexibility routine, you not only stretched the muscle, but you added in ab work, balance challenges and challenges to your coordination. \u00A0Congratulations!.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Now it&amp;amp;#39;s time to cool down. \u00A0Do so by resuming a supine position again (on your back with your knees bent and your feet flat on the floor.) \u00A0Stretch your arms out straight (but don&amp;amp;#39;t lock your elbows.) \u00A0Ideally, your arms will be at shoulder level, but they certainly don&amp;amp;#39;t have to be if this causes you pain or strain.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Take both knees over to one side, but this time, keep your knees at hip level, and not lower. \u00A0Also, keep both sides of your upper back and both arms equally contacting the floor. \u00A0In other words, when dropping your knees over, don&amp;amp;#39;t allow the arms or shoulders on the opposite side (to where your knees are pointing( to ride up when you drop your knees.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Stay in this position between 5 and 30 seconds, then gently return your legs to the original &amp;amp;#34;standing&amp;amp;#34; position. Repeat on the other side. \u00A0Repeat the entire sequence 2-3 times.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Related: &amp;lt;/strong&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/workout-routine-strategy-296857&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;The 7 Best Workout Routine Hacks for People with Back Pain&amp;lt;/a&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;sub&amp;gt;&amp;lt;strong&amp;gt;Source:&amp;lt;/strong&amp;gt;&amp;lt;/sub&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;sub&amp;gt;Boyajian-O&amp;amp;#39;Neill, L., D.O., Mclain, R., D.O., Coleman, M., D.O. thomas, PhD. Diagnosis and Management of Piriformis syndrome: An Osteopathic Approach. The Journal of the American Osteopathic Association. Nov 2008. Accessed April 2016. &amp;lt;a href=&amp;quot;http://jaoa.org/article.aspx?articleid&amp;amp;#61;2093614&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;externalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot; rel=&amp;quot;nofollow&amp;quot;&amp;gt;http://jaoa.org/article.aspx?articleid&amp;amp;#61;2093614&amp;lt;/a&amp;gt;&amp;lt;/sub&amp;gt;&amp;lt;/p&amp;gt;"^^<http://www.w3.org/2001/XMLSchema#string>
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