How to Fix that Pain In The Butt


Pain in the BUTT whilst doing a SQUAT?

A common complaint I encounter with patients of mine can be described as a dull nagging pain that starts at the buttocks and at times, shoots down the leg. Sciatica is what it is most commonly diagnosed as, but there is another condition also common amongst athletes, known as Piriformis Syndrome. This literally is a “pain in the butt!”


The table below identifies how they may both differ. Both conditions would best be treated by physical therapy and chiropractic pelvic adjustments to help restore better mechanics, balance and function again.



Piriformis is a deep rotational muscle that externally rotates the leg when the hip is extended. In a lying relaxed position, external rotation of the leg as picture above is indicative of a tight piriformis. Stretching and foam rolling may relieve the symptoms, but doesn’t fix the cause of the problem. You need to address and fix the imbalances that are causing the tightening of the piriformis in order to see sustainable results and correction.

So, what typically causes Piriformis Syndrome? Repetitive motion is usually the cause of Piriformis Syndrome. A lot of the movements performed by athletes can predispose them to getting this condition if they have any of the following:

1. poor pelvic alignment and muscular imbalances

2. improper technique

3. decreased mobility i.e. poor hip rotation

4. weak core stability

Here are a few self-managing techniques for effective relief . These should allow you to see some relief, however, when combined with chiropractic treatment, you can be ensured of a faster and better recovery.

1. Strengthening the gluts
Weak gluts make the TFL (Tensor Fascia Latae muscle alongside the leg) overly tight and over-activated, causing the piriformis to tighten up.

TIP: use the foam roller on your TFL before any sort of exercises that engage the gluts. This will help to allow more glut activation rather than the TFL, thus taking stress off the piriformis.


Strengthening the gluts will help to take stress off the piriformis, however if other muscles have tightened, they must also likewise be addressed simultaneously.
2. Stretching to reduce hip restrictions
Stretching helps to increase internal and external rotation of the hip.

TIP: The piriformis has dual function when the hip is extended (external rotation) and when the hip is flexed (internal rotation). Stretching both is beneficial for the piriformis particularly internal rotation.


Ref. Pic a): Internal: Lie with the leg bent and at 45 degrees open. Bring the knee down to meet the opposite knee and hold for 10-15 seconds. Repeat 3 times

Ref. Pic b): External: Sit on a chair with the affected buttock leg resting on the opposite leg knee as above. Lean forward and hold for 10-15 seconds. Repeat 3 times

3. Improving core strength

Excessive pelvic tilt in squat indicates a weak core. You need to tense the abdominals whilst going down in a squat and activate the core in the transverse plane

TIP: Ref. Pic a): Slow knee raises 3 second count 10 reps, ref. pic b): Plank for 1-2 min, ref. pic c): lunge with rotation holding a weight/without weight 5x on each side.


4. Chiropractic spinal adjustment

Anterior pelvic tilt can indicate a misaligned pelvis on one side and weak core.

TIP: getting a spinal pelvic adjustment after a thorough check up can reduce the pelvic tilt thus allowing normal function and balance again. If the structure is not right, the piriformis muscle and other surrounding muscles will tighten as a result of poor mechanics.


The above are some proactive methods one can do to prevent or relieve the symptoms of Piriformis Syndrome.
Ultimately, treating the root cause of the problem will achieve faster recovery of symptoms, therefore better lifts, balanced pelvis and a happier pain-free body!

Get yourself checked today and don’t let it be a pain in the butt!

-Chiropractor and CrossFitter, Mark Enriquez

Visit his clinic at room 1604, Centuria Medical Center, Makati City or contact him for box visits. For appointments, call 09957894498. For more information visit!