I recently read a post on Runner's World about what to do for piriformis syndrome and I felt like they had left something out. From working with piriformis and "sciatic" pain on a daily basis, I'd thought I'd share a little info on an exercise that has done wonders for my clients. Often, runners and triathletes neglect frontal and transverse plane movements, meaning that they do not perform any exercises going side to side or with a rotational component because all of their movement is in forward, backward flexion and extension. Some runners choose not to do resistance exercises at all because of the idea of carrying too much muscle mass which, I think, is a mistake. You can train to be strong and avoid the bulk while making yourself a more balanced and efficient runner. Your hip/glutes are vital in controlling rotational forces of the lower extremity and protecting the back from accessory movement. It's like driving on tires that are not balanced, they wear faster just like your joints. Your glutes are part of your "core", much more important than the 6 pack abs (they just look good). If you are already flexible, stretching the piriformis will provide you with little benefit other than temporary relief. The glutes and piriformis need strength to accept your body weight when landing on one leg while running. Strengthening the glutes may help with your knee pain as well believe it or not (We had an Ironman solve his knee pain within days of performing this exercise I'm about to describe). Your knee does not want to rotate, it wants to flex and extend. If the upper leg rotates inward because of weak glutes, it puts strain on the knee joint and IT Band. So, once again, you can try to stretch the IT all that you want, but the strength in the glutes will most likely provide the greatest benefit.
I am a huge fan of an exercise that we call resisted side step because of how effective it is in targeting your butt muscles. The only equipment you need is a theraband with good resistance. You can tie one around your ankles or purchase one in the 850HealthStore through Amazon. Blue or green would be your best bet, blue being more difficult. The continuous loop band seems to provide better resistance (12 inches). Now, walk sideways with it around your ankles while keeping your toes pointed a tad inward and avoid pointing outward because it will engage your hip flexor instead of the muscles we're going after. Also, avoid leaning sideways and keep your midsection tight. You can walk sideways for approx. 20 feet then walk back without turning around. Do 3 sets and you will feel it! Give it 2 weeks of performing most days of the week and you will be a better athlete!
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Dr. Mark Giovanini
Scott Rusin is the Director of Physical Therapy at the Sandestin Executive Health & Wellness Center in Sandestin Resort, Miramar Beach, FL. He has a degree in Physical Therapy, is a Certified Strength & Conditioning Specialist (CSCS) and Nike Golf NG360 Performance Specialist Powered by the Gray Institute.