How to: Stretch Pirformis

Piriformis - Ottawa Massage BlogOne of the more commonly tight muscles, the piriformis, can be a real pain in your …. well, you know. But stretching it out regularly will help reduce pain and discomfort in your … well, you know. The following stretches aren’t just for the piriformis though. They also help with the gluteus minimus and other external rotators of the hip (there are five others!).

Some indications that you may need to stretch your external hip rotators are:

  • sciatic pain
  • SI joint pain
  • stiffness in the hips
  • postural imbalances such as being ‘duck-footed’ (toes pointing out) or weight bearing on one leg (hip jutting out)

Without further ado, here are some stretches and modifications for the external hip rotators. Find one that best suits your flexibility level.

Pigeon Pose: Kneeling on all 4s, bring the right knee forward to the right wrist. Let the right knee sink out toward the ground so the shin is more or less perpendicular between your two hands. Then extend the left leg straight back, with your toes resting in a straight line behind you. If you are able to, fold the torso over the front leg. If you find this pose very challenging, put a book, block, or cushion under your bent right hip to help support you at a comfortable distance from the ground. Repeat on the other side.

Pigeon Pose - Ottawa Massage Blog

Figure-4: Lying on your back, with your feet flat on the floor and your knees bent toward the ceiling, place the right foot on the left knee. Reach through the triangle made by your two thighs to grasp the back of the left thigh. Slowly draw the left thigh towards your chest, bringing the right shin and knee in close. Straighten the left knee to lessen the stretch. Repeat on the other side. If you have trouble grasping the back of the thigh, wrap a belt behind the thigh and hold the two ends in your hands.Figure 4 - Ottawa Massage Blog

Figure-4 on a chair: Similar to the Figure-4, only you’re sitting. While seated, place the right foot on the left knee. This may be far enough for you to feel a stretch in the right hip. If not, slowly bring your chest forward over your legs. Repeat on the other side.Figure 4 Seated - Ottawa Massage Blog

You will feel these stretches in your hip or buttock of the side being stretched. You may also feel them in the outside of the thigh, and in the low back. As long as you don’t have pain, enjoy whatever stretch you’re experiencing.

Remember to go only far enough so that you feel a delicious, comfortable sensation of lengthening. Pain means you’ve gone too far, and your muscles will contract and shorten, not stretch.

Hold each stretch for 30-60 seconds on each side, or longer if you like.


The Gluteals – a pain in the ……

Muscle of the month: The Gluteals

Gluteals, glutes, buttock, rear-end, hiney; these muscles have been given many names over the years, and I’m sure you can think of a few more!  But (pun intended), did you know you have three gluteal muscles on each side? The gluteals consist of the gluteus maximus, the gluteus medius, and the gluteus minimus. Each has its own specific actions and pain pattern, which helps your massage therapist differentiate which glute is the dysfunctional one.

Gluteus Maximus: The big Kahuna

Gluteus maximus - ottawa massage blog

Gluteus maximus (cut) lies over top of all hip muscles

Actions – Extends, laterally rotates, abducts and adducts the hip (moves leg away from or toward the body)

Common pain culprit – Sitting for an extended period of time (underwork), or conversely, excessive hill or stair climbing (overwork)

The gluteus maximus is the largest of the glute muscles, as you can tell by its name. It covers the whole span of one cheek and plays a big role in the appearance of the buttock. When we sit for long periods of time, the glute slowly atrophies, reducing its ability to contract properly for actions such as ascending stairs.

The fix: Get up often from seat, prevent atrophy by hypertrophy (exercising)!

Squats, lunges, and stair climbing are good examples of exercises that engage the gluteus maximus. If you are unsure whether you are performing them correctly, ask your massage therapist, who can help you make the proper adjustments.

Gluteus Medius: The deltoid of the hip

Actions – Abducts, flexes, medially and laterally rotates, and extends hip

Common pain culprit – Standing on one side more than the other, jutting the hip out

Lateral view of Glutues Medius - Ottawa massage blogThe gluteus medius is similar to the big shoulder muscle, the deltoid. This is because of its position and actions: it covers both the front and the back of the hip joint, allowing it to do every movement of the hip (except for adduction, bringing the leg toward the body). This is the same as what the deltoid does for the shoulder joint. Having the hip too far forward or too far back can put this muscle into a shortened position, compromising its ability to contract fully. This can also happen when you place all your weight onto one hip or have even a slight imbalance of weight.

The fix: Share the weight of the hips, and strengthen the gluteus medius with abduction exercises (bringing the leg away from the body)

Gluteus Minimus: Pseudo sciatica

Actions – Abducts, medially rotates, and flexes the hip

Common pain culprit – Getting in and out of car

Gluteus Minimus Trp Referral - Ottawa Massage BlogThis muscle is the deepest of the glute muscles, and can cause some of the most intense pain. The trigger point referral pattern for the gluteus minimus mimics that of sciatic pain. Many clients fear that they have developed sciatica when it is, luckily, only a flare-up of the glute min trigger point. How can you tell? The sensation you feel normally lets you differentiate between a trigger point and sciatica. Sciatica will be a very sharp, shooting, and almost burning pain. Gluteus minimus trigger point will be a dull, achy pain along the same sciatic pathway down the back of the leg. If the trigger point is activated, getting in and out of the car or other hip actions can aggravate it further.

The fix: Massage, heat and stretch.  The best stretch for glute minimus is the Figure 4 stretch, or pigeon pose (depending on your flexibility). Ask your RMT for guidance.

Stay tuned! Next week: How to stretch piriformis, one of the hip’s lateral rotators.