piriformis syndrome

[Val]

hi i'm looking for some information on "piriformisi syndrome" what techniques, treatment, contraindications and excersise's are used and recommened. i have a potential client with this condition and wanted to get a little insight on the situation.thanks jenn

 

[janna]

piriformis syndrome

also called "false sciatica".  Piriformis Syndrome only refers pain down to knee, whereas sciatica can 'candy-cane' all the way down to the foot. I lay client prone, leg winged out to side - foot against other knee or calf (pillow under ankle). Soften the IT band/TFL & do deep compressions & pulls on glutes, inchworming in semi-circles, following the curve of the illiac crest (I do these pulls over the sheet & towel, so it is less sharp). If client can tolerate deep pressure well, secure your draping & run forearm from knee - up the IT band - & deep figure eights on glutes.Stretches:  hold onto a very strudy piece of furniture or doorjamb & cross foot over knee. Aligning knee over ankle, bend into a squat until you feel the burn! Variations can be done sitting in chair or on floor too.Longterm solutions:  strengthen inner thigh (adductors) and internal rotation groups & stretch external rotators & abduction muscles to create a better balance between these.Jill/Sagetherapist

 

[pink]

For piriformis syndrome, I usually start with the client prone.  I warm up the tissues of the lumbar area, glutes, and legs.  Once I am ready to do deeper work, I work the client in the sidelying position.  This opens up the area of the rotators nicely. You can use thumbs, fingertips, elbows.  Be careful at first to not go in too deep too fast and make sure you are not putting direct pressure on the sciatic nerve. Once I have worked out the glutes and rotators I will work the adductors also.   Homework is to stretch the area by placing both feet on the floor.  Then place one foot onto the opposite knee (ankle to knee) then lean forward towards the raised, bent knee (opposte knee).  The stretch can be done in other ways besides seated.  If the person is in a decent amount of discomfort, I have them stretch seated.  Otherwise the other versions work fine.  Be aware of clients with knee problems since this stretch can cause issues with knees due to the positioning.

 

[PROTEA]

piriformis syndrome

Here is an article by Whitney Lowe in Massage Magazine about Piriformis Syndrome:http://www.massagemag.com/2003/issue106/assess106.5.htmMiguel de Camposhttp://www.wincityinc.com

 

[beka]

piriformis syndrome

hi,thank you all for your replies, all very helpful.miguel great referance artical. jenn ;D

 

[Todd ex-atheist]

piriformis syndrome

Do you happen to know where I could find pics of some of those stretches? In NC we cannot legally prescribe stretches or exercises, but we can hand out or recommend printed material. I am considering picking out 3 or 4 common problems and putting together a booklet with information on self care for them.

 

[Chandra]

purchase : Informed Touch: A Clinician's Guide to Evaluation and Treatment of Myofascial Disorders (Hardcover)  &  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief (Paeforum.xxxack)They will help you TREMENDOUSLY!  They are wonderful references and have what you need in them.  

 

[Dazaa]

piriformis syndrome

Thanks! ;D

 

[awm_2266]

In this "piriformis syndrome" the piriformis along with the remaining deep six have become short and tight exerting pressure on the sciatic nerve.  There is a simple yet effective solution to alleviate this problem.  Find the muscles that are short and tight, and lengthen them.  Reciprocal Inhibition on the deep six seems like it would be the logical choice becasue you would be strenthening the medial rotators while inhibiting your target, and you would be able to lengthen your target afterwads.  Im sure any muscle energy technique would work just fine though!

 

[zealot144]

the Piriformis isnt going to become short while the other deep five do not.  I was simply saying that if you use a Muscle energy technique(PIR, RI, PRT, C.R.A.C.L. or pulsed muscle energy) it would be near impossible to affect the piriformis and not affect the others since they all have the same function.And yes I do agree that the piriformis is the only one that will cause sciatica symptoms, but if the piriformis is short, the rest of the lateral rotators are to and that can create dysfunction.