Foam Rolling and Dynamic Stretching in Piriformis Syndrome

NCT07278193 | Active Not Recruiting DMC

• 1 other identifier: UOL/IREB/25/09/0047
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

To compare the combined effects of foam rolling and dynamic stretching in patients with piriformis syndrome.

• Marching in Place - 30 seconds
• Pelvic Tilts - 10 reps
• Gentle Hip Circles - 10 reps each direction
• Intervention Phase (8-10 minutes) Group 1: Foam Rolling Alone (FR) (\~10 minutes)
• Piriformis Foam Rolling: 30-60 sec per side (2-3 sets)
• Glutes \& Lower Back Foam Rolling: 30 sec each (2-3 sets)
• Hamstrings \& IT Band Foam Rolling: 30 sec each (2-3 sets) Focus: Slow, controlled rolling with sustained pressure on tender spots. Group 2: Foam Rolling + Dynamic Stretching (FR+DS) (\~10-12 minutes) Step 1: Foam Rolling (\~5-6 minutes, same as Group 1) Step 2: Dynamic Stretching (\~5-6 minutes)
• Dynamic Piriformis Stretch: Standing knee-to-opposite-shoulder pull (10 reps per leg)
• Leg Swings: Forward and sideways (10 reps each leg)
• Walking Lunges with Rotation: 10 reps per leg
• Hip Circles \& Controlled Butt Kicks: 10 reps each
• Cool-Down (2-3 minutes) Objective: Reduce muscle tension and promote recovery.
• Seated Piriformis Stretch: 30 sec hold per side (2 sets)
• Hamstring Stretch: 30 sec hold per leg
• Lower Back Stretch (Child's Pose): 30 sec Progression \& Adjustments
• Gradual increase in duration or intensity as tolerated.
• Modify exercises if discomfort or pain occurs.
• After week 4, increase dynamic stretch duration if flexibility improves. Outcome Measures The effectiveness of the intervention will be assessed through the following key outcome measures:
• Pain Level - Evaluating changes in discomfort intensity during daily activities and movement.
• Range of Motion (ROM) - Measuring improvements in hip flexibility and mobility.

Conditions

Piriformis Syndrome

Keywords

foam rolling; dynamic stretching; piriformis muscle; Quality of life

Outcome Measures

Primary Outcomes (2)

• Goniometer

  Range of motion will be measured using the Goniometer. Its primary function is external rotation of the hip with a normal range of motion (ROM) of 0°- 45°additionally, the piriformis assists in hip abduction with a typical range of 0°-45°. Interestingly, the piriformis also supports internal rotation with a normal ROM of 0°-35°.

  At baseline, 4th week and 8th week

• NPRS (Numeric pain rating scale)

  Pain will be measured using the NPRS (Numeric pain rating scale) which assesses the intensity of pain on a scale ranging from 0 no pain to 10 worst imaginable pain. Participants will report their pain levels at baseline and post-intervention to determine the efficacy of foam rolling and dynamic stretching

  Each outcome variable will be measured at baseline, mid-intervention and post-intervention

Secondary Outcomes (1)

• SF-12 (Short Form Health Survey)

  At baseline, 4th week and 8th week

Study Arms (2)

Group A (Foam Rolling):

EXPERIMENTAL

Participants will use a foam roller to apply pressure to the piriformis muscle and surrounding areas, targeting tight spots and trigger points. This technique helps release muscle tension, improve blood circulation, and alleviate pain by using slow, controlled rolling motions that will last 5-10 minutes twice daily, 3 sessions per week for up to 8 weeks.

Other: Group A (Foam Rolling)

Group B (Foam rolling and Dynamic Stretching)

EXPERIMENTAL

Group B (Foam rolling and Dynamic Stretching): Group B will receive foam rolling with dynamic stretching. Hot pack will be applied 5-3 min before rolling and dynamic stretching. The rolling helps release muscle tension, improve blood circulation, and alleviate pain by using slow, controlled rolling motions will last 5-10 minutes. The stretching routine will include exercises like hip swings, seated piriformis stretches, and Dynamic Figure-Four Stretch supine stretch. Each stretching session will last 10-15 minutes and will be conducted twice daily (3 days a week) for 8 weeks. This approach ensures gradual improvement in muscle flexibility and joint mobility while maintaining participant safety and comfort throughout the intervention. Ultrasound therapy will be applied after stretching.

Other: Group B (Foam rolling and Dynamic Stretching)

Interventions

Group A (Foam Rolling) OTHER

Foam Rolling Alone (FR) (\~10 minutes) * Piriformis Foam Rolling: 30-60 sec per side (2-3 sets) * Glutes \& Lower Back Foam Rolling: 30 sec each (2-3 sets) * Hamstrings \& IT Band Foam Rolling: 30 sec each (2-3 sets) Focus: Slow, controlled rolling with sustained pressure on tender spots.

Group A (Foam Rolling):

Group B (Foam rolling and Dynamic Stretching) OTHER

Dynamic Stretching (\~5-6 minutes) * Dynamic Piriformis Stretch: Standing knee-to-opposite-shoulder pull (10 reps per leg) * Leg Swings: Forward and sideways (10 reps each leg) * Walking Lunges with Rotation: 10 reps per leg * Hip Circles \& Controlled Butt Kicks: 10 reps each 3\. Cool-Down (2-3 minutes) Objective: Reduce muscle tension and promote recovery. * Seated Piriformis Stretch: 30 sec hold per side (2 sets) * Hamstring Stretch: 30 sec hold per leg * Lower Back Stretch (Child's Pose): 30 sec

Group B (Foam rolling and Dynamic Stretching)

Eligibility Criteria

• Age: 35 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 35-50 years diagnosed with Piriformis Syndrome based on clinical findings. (Chang et al., 2024)
• Having positive FAIR test is commonly used to diagnose piriformis syndrome.
• Pain intensity of at least 4 on the numeric pain rating scale (NPRS) at baseline(A Penichet-Tomas et al., 2021).
• DIAGNOSTIC CRITERIA OF PIRIFORMIS SYNDROME
• The diagnostic criteria for piriformis syndrome include clinical history, physical examination findings. The symptoms include buttock pain radiating to the posterior thigh or leg, worsened by sitting, climbing stairs, or activities that stretch the piriformis muscle. Physical examination, tenderness over the piriformis muscle or sciatic notch and a positive FAIR test (Flexion, Adduction, and Internal Rotation) are indicative. Additional tests, such as the Pace test and Straight Leg Raise with external rotation.

You may not qualify if:

• Current use of medications such as strong analgesics or muscle relaxants. (e.g., injections, surgery) within the last three months.
• Uncontrolled medical conditions, such as active infections, cancer, or cardiovascular issues that may interfere with the study or the participant's ability to complete the protocol safely(Alfonso Penichet-Tomas et al., 2021).
• History of lumbar disc herniation, spinal stenosis, or other serious lumbar spine pathologies that may cause similar symptoms.
• Prior surgeries in the lumbar spine, hip, or pelvis that may interfere with the study's outcomes(Pişirici et al., 2020).

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

University of Lahore teaching hospital

Lahore, Punjab Province, 54000, Pakistan

Location

MeSH Terms

Conditions

Piriformis Muscle Syndrome

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Sciatic Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Neuralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pelvic Pain

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Sana Akram, MS-OMPT

  University of Lahore

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Masking Description
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PT

Model Details: Model Description

Study Record Dates

• First Submitted: November 30, 2025
• First Posted: December 11, 2025
• Study Start: October 31, 2025
• Primary Completion: December 25, 2025
• Study Completion: January 2, 2026
• Last Updated: December 11, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)