Treatment for Piriformis Pain

Tonight's session is about clips to treat

piriformis

pain

. Now first I'm going to look at the anatomy of the

piriformis

muscle and why it can cause problems if it's in spasm or irritated and then we'll look at the top five tips. What I have for people who have piriformis

pain

, how they can improve. Well, my name is Marika. I am the physiotherapist for physiocommunication of sports injuries. We could receive online physiotherapy

treatment

for your injuries. I'll put a link to my website in the comments or description of this video too, so let's jump in and take a look at the anatomy of the shapes.

There we go, what you're looking at is the back of the leg, the buttock, the main muscle. The gluteus maximus has been cut and you can see that little red muscle which is the piriformis muscle. Now it is a small muscle in the buttock. You may think what's the big deal with us, but now in the next picture on the side you can see that there's a nice yellow line that runs down his leg and that's his sciatic nerve and because his sciatic nerve runs underneath, through or above for some people, the same shape of the muscle when that muscle becomes tight and painful, it can affect the sciatic nerve and that can cause you a lot of headaches. pain in your buttock, but now the other thing I want you to notice in that Anatomy picture is how many other muscles are very close to the piriformis muscle, you have your gluteus, find the muscle, your gluteus, men, you have your gluteus maximus. at the top, you have very deep buttock muscles, your operator and you are also girls, they are their names now anyway, you are a very, very deep small, then you have the attachment of the hamstrings to the ischial tuberosity and also you have your IT band on your side, now any of those structures, if they're tight or sore, I think it's your piriformis muscle and also because the structures that run through the lower back and the sacroiliac joint go into the fascia that surrounds the piriformis muscle which can also affect your pain in that area, so it's worth keeping that in mind when we move on to tip number one.

Now let me put them in place, so the number one tip is to make sure you have the correct diagnosis because As I just showed you, there are quite a few other structures in the glutes that can cause pain in that area and what I find in practice is that Often a tight and sore piriformis is actually caused by an unhappy lower back. o secreted sacroiliac joint or injuries to some of the other muscles pure piriformis syndrome, which is a term that people like to use, is extremely rare now piriformis syndrome is where only the piriformis muscle is extremely irritated or tight and holds on to the sciatic nerve causing pain in the back of the leg, of course yes, it exists, but it's not as common as people like to diagnose, but I find that a doctor will find a tight, sore piriformis and say, "Oh, this one it's a pretty formal syndrome that causes you pain, but then it's actually the lower back or the clearly external joint itself or something else that's causing the piriformis muscle to be tight and if you don't address those other issues and you just have The piriformis muscle may not fit better because you are not really dealing with the cause, so it is very important to understand what is causing your piriformis pain and buttock pain so that you can apply the correct

treatment

.

Now let's say you have a piriformis muscle that is contributing to your pain. What can you do? Do it, so the second thing you can do is lift it up. You can definitely use piriformis stretches, but also stretches for the rest of the gluteal area. What I will say is if your piriformis muscle is really irritated and the sciatic nerve. it's quite tender because it's been crushed for a while or it goes hand in hand with a lower back injury which can be tender if you're going to do a strong stretch of the upper form muscle you can actually make it feel worse, so what I What in practice works well is that if you do stretches but to a very low degree, you just take it as if you can feel the first sensation of a stretch and hold it there for a long period of time.

Remember with these kinds of things. Now you have an increase in stones in your muscles, so the muscle tone is too much. You want to decrease it, so you want to deactivate the muscle. To deactivate the muscles, we need to hold the stretches for at least 30 seconds, but in reality it is longer than 45 seconds, so a very low big stretch held for longer periods of time is much better now if I can demonstrate one of my favorites because it's not that extreme, let me pull out my chair and I'll show you my favorite. So one of the most common examples that people know about is the pigeon stretch, but what I find with that is that you have to be in quite a contorted position to get the pigeon stretch properly and it's also quite difficult to control how much. strength you pass it so the one I prefer is you lying on your back and I just want to try to see what I'll do and you cross your one leg so that this is the leg that I'm stretching what you do You cross it completely and then you place a hand on the knee, the another on the lower leg and you pull both towards the opposite shoulder, so let me move a little bit more towards the camera so you can see it. correctly, so you cross one leg over one hand on the knee, then one on the bottom of the leg and cross the chest.

Now I'm not going up to the opposite shoulder up. I'm pretty diagonal to my chest. I wonder if I like it like this if you can see, so if you look at me from behind, ah, yeah, that'll work if I stretch this one out. Now you cross your leg for me with one hand on the knee and the other on the bottom of the leg and pull it. towards your opposite shoulder there we go so that would stretch my trainers on this side now if you're pretty tight in the other glute muscles you can feel a stretch if you lift it up for me that doesn't actually stretch much. but if your whole butt cheek is tight then it can be a useful stretch to do as well just bring it up but if you want to get the piriformis specifically then you have to cross over and also pull with this hand down and don't pull as hard as you can just bring it up to where you feel the first stretch and hold it there for 35 to 45 seconds okay that's my favorite stretch for the piriformis just because you can really control how much force Do it right so if we move forward I'm actually going to put my computer on laptop on my lap, let's see what tip number three is, mom number three is massage.

Now massage can be a really useful tool if you have one. kind of pain in the buttocks, but the same principle applies to this, if you are really going to hit the piriformis muscle and it is already irritable and if you hold on to the sciatic nerve, it is very possible that it will get worse, so it will be a firm massage, but it should be comfortably uncomfortable, it shouldn't cause tingling or sharp pain in your leg when you do it and that counts, if a massage therapist does it too it may be uncomfortable, but otherwise it will be comfortably uncomfortable.

I've seen people get worse with the massage because of it so if you want to apply it yourself all you need is a nice firm ball so I tend to use the thinner ball because it doesn't really mark my walls as much and again you can Do it on the floor, but I'll also do it standing against the wall, now let me get this bit out of the way so you can see well what I'm leaving, so what you want to do is not get lost anymore. I want to massage that part of the buttock, okay, so you're pretty focused on the muscles that are in that area, but you're going to go according to where you feel the discomfort against the wall, so what you do is you place the ball.

At that point just relax and go through the wall. Now I want to take this camera a little further so you can see what I'm doing with my legs further down and let's see what you can see there, okay? That's better, so what I'm doing is literally using my leg that's away from the wall to push against the wall, but for this leg that's being massaged where I have the ball against the wall, I'm actually just leaning over. my body weight against it and I'm trying to relax it so I can really get into that muscle now, if you put it back in the painful spot, it's going to be comfortably uncomfortable and you just hold it there for a while again.

You can hold it for about thirty seconds to forty-five seconds, but you will feel the pain decrease. Hold it there and then you can move on to the next one. You can do the same on the ground by simply leaning on the ground. but sometimes I find it quite uncomfortable and it's hard to control how much pressure you put on it, but it would be in this position and you lean into it and there you can feel the discomfort coming and just hold the position again before moving on to the next one, but remember that acting can get irritated easily, so take your time and relax and feel the pain go away instead of getting worse, okay, so let's see how to close everything again, okay, so if we look at tip number four and that is strength training, so when it comes to strength training people often like to use exercises like the glam or lateral leg raises.

Now I find out if the piriformis is really irritated and make a plan when it gets shorter. position at the top often just goes into spasm, which is why my patients react very well to simple glute bridges at first and in fact, what research has shown, if you do a glute bridge and especially a glute bridge glutes with one leg, you get a lot of activation. in the piriformis muscle, so I usually find it's a nice easy way to start getting some blood supply through the piriformis. I also include like a call to the spine in the bridge position to start mobilizing the lower back and if I think the main cause of the pain is actually coming from the lower back, which is a really nice combination in which we can start to address the lower back but also circulate and things through the piriformis, so to show you what I mean by that typical so-called glute or spine bridge. in the glute bridge, what I would do would be like this, it would be just simple, where you do a pelvic tilt and you go up and then you get to the top and you just squeeze your butt and hold the position, but I'm not arching. my back I'm just squeezing my buttocks squeezing my stomach and counting to 10 and then you go back down, okay, so it's pelvic tilt, go up, hold, squeeze and go back down, and our patients actually find that much more tolerable than trying to make plans or something great so tip number four was strength training and lastly be careful with hamstring stretches now when we move and especially when you extend your legs forward it also moves the nerve sciatic now.

The sciatic nerve is meant to slide freely as you move. Imagine that short form holding on to it so it can't slide, so if you do a hamstring stretch, you'll stretch the nerve and what happens then is you get even more irritated, especially if your leg hurts a little bit. be careful with hamstring stretches don't do them in the first instance make sure you loosen your glutes and stuff first and then very gently start stretching them now when you stretch your hamstrings in these cases it should feel better or the same after you stop doing it , if you feel really uncomfortable after doing it then it is not the right exercise at the moment because the nerve cannot glide freely, so work on the other parts first, but that is why it is useful to consult the physio or someone similar to see what is your specific case why your butt hurts and then also when is the right time to implement all these things, so the five points to remember are There are many reasons why the piriformis muscle can be angry.

Piriformis syndrome with muscle-only failure is not very common. Generally it's from a direct hit, something like that that gets irritated. It's more likely the yak's lower back or sacred joint or something else. That you have been injured and that contributes to this second is massage, which can be very useful, as can stretching, but not too strong. You have to do it very carefully. Strength training is also helpful. The glute bridge is a great place to start with that and then be careful not to necessarily do hamstring stretches at first because it can be worse. I'd rather go see someone before adding that.

Excellent, let me know if you have any questions. I sincerely hope you watch it. This says there was sound in this video, but yeah, have a good night, take care.