J Life | Jan-March 2019 jan-mar-19-jlife-USE | Page 4

WHAT ABOUT THAT
PAIN IN THE BUTT?
Written by: Jaimie Perkunas DPT, e-RYT, C-IAYT | Tucson J Specialty Yoga Instructor
We hear it all the time, “that was a pain in the butt”, not literally but more
figuratively speaking. However, there are a fair amount of people walking
around with pain in the back of the hip and leg that comes from a muscle
deep inside the buttocks, often times referred to as, the glute. This small
seemingly incidental muscle called the piriformis is located underneath the
gluteus maximus and connects the sacrum, a triangular shaped bone at the
bottom of the spine, to the femur, also known as thigh bone.
The piriformis muscle helps the leg move in three directions: turn/rotate
outward, move out to the side away from the body, and back behind you.
When this muscle becomes too tight it can cause a pain deep in the butt,
and at times, sciatica symptoms resulting in pain down the back of the leg.
This is called piriformis syndrome and is the result of the close relationship
between the sciatic nerve and the piriformis muscle.
HIP INWARD ROTATION
Rest on your back with both feet on the ground. Walk one foot off the mat
and lower the inside of your knee towards the ground (keep other foot
on the ground, knee pointing up towards the ceiling). Have your thigh
parallel with the long edge of the mat, and your shin parallel with the
short edge of your mat. Flex your foot towards your knee.
**if you have pain in your knee, place a blanket or block underneath the
inside of the knee and do not try to touch your knee to the ground.
Reach your knee toward the bottom edge of your mat. Imagine the whole
thigh rotating inward.
Sustain for 5-10 breaths.
HIP OUTWARD ROTATION
The sciatic nerve usually exits underneath the piriformis muscle. However,
approximately 10% to 20% of the time, part or all of the sciatic nerve either
exits through the piriformis or above it.[1] This may result in some people
being more prone to piriformis syndrome. Additionally, females are 6
times more likely to have piriformis syndrome than males. [2] Piriformis
syndrome can be challenging to diagnose and treat. The good news is that
there are techniques to help prevent piriformis syndrome, a literal pain in
the butt.
1. Avoid putting a wallet or phone in the back pocket of your pants.
When a wallet or phone is in your back pocket while you are sitting it shifts
your pelvis in an unbalanced way. To help keep your pelvis level put your
wallet/phone in your front pocket or coat pocket.
2. Look down at your feet and see if one foot is turning outward more
than your other foot. The outward rotation of your foot suggests that your
piriformis is tighter on that side. Have your feet match. Do this by turning
your outward foot more forward.
3. Stretch your hip muscles, especially inward and outward rotation.
Most people are familiar with stretching their quads and hamstrings which
move the leg forward and back however it is also important to stretch the
hip rotators. Here are two of my favorite stretches for stretching your hip
rotators.
4 J LIFE
Rest on your back with both your feet on the wall and knees at 90 degrees.
Cross your ankle over your knee. Keep your hips on the ground and level.
Flex your crossed foot. Reach your top knee towards the wall. Feel the
stretch along the outer hip of crossed leg.If you do not feel a stretch move
closer to the wall.
Sustain for 5-10 breaths.
Please remember the stretches above are for your hips, and
if you feel pain or discomfort in your knee or low back
reach out to a professional to help you.
I hope these techniques help you avoid feeling the literal
pain in the butt in the year to come.
Sources
- Manual Therapy for the Low Back and Pelvis: A Clinical Orthopedic Approach
- https://emedicine.medscape.com/article/87545-overview#showall