During pregnancy, a condition labelled “piriformis syndrome” is more likely to occur and it is one I see a lot of as a pregnancy massage therapist. I have ladies come in for a massage and when I get to the hips and glutes they are surprised at how tight this area can be.
Piriformis syndrome refers to a deep gluteal/low back pain that is accompanied by a prickling or burning sensation down the posterior of the lower limb, reaching into the back of the thigh and possibly into the back of the calf and sole of the foot.
A true piriformis syndrome would also be accompanied by numbness or tingling of the lower limb, as the aggravated piriformis muscle begins to compress the sciatic nerve. These neurological symptoms down the leg are often referred to as “sciatica”.
During pregnancy massage, the client is usually treated on their side, especially during the third trimester. Pillows will be used to support the body so that it rests comfortably on the table, leaving the client feeling secured. Massage techniques will aim to lengthen muscles without compressing the sciatic nerve further.
Certain STR (soft-tissue releases) may also be used as good ways to lengthen without compression. The low back region will also be worked on as well to help lessen the tension in the lumbar spine. Trigger points (hyper-irritable areas in taut bands of muscle fibre that cause muscles to shorten and refer pain to other regions of the body) may be found during treatment. These will be treated using compressions and release techniques to alleviate other causes of contributing pain.
After a massage I will give self-care information to the client. Following self-care guidelines post-massage is vital for maintaining the changes made to the body by the treatment for as long as possible, as well as maintaining general good tissue health to avoid any painful conditions from resurfacing. I recommend a weekly treatment for 3 weeks to treat a painful, chronic condition, and then spanning them out further to a 4-6 week maintenance routine to keep your tissues in good health.
Here are my top 3 tips for managing this condition:
- Follow the video below.
2) Check your feet. Are they everted like the picture below? If they are, then over time this can lead to piriformis pain and mobility restrictions especially when performing functional movements like squats, lunges and deadlifts. The external rotation of the foot leads up to internal rotation of the femur. The attachments for the piriformis are the greater trochanter of the femur and the interior surface of the sacrum. So eversion of the foot leads to a shortening and restriction of the piriformis. Every time you look down and see your feet like this then turn them back in. Small changes and bringing awareness to it can really help you start to be more mindful as to how you hold yourself.
3) If you’re looking for relief of piriformis syndrome, contact me to book your massage.