The first exercise that we are going to do
is a piriformis stretch. There are 2 different variations that we use in the clinic. The
first is laying down, bend one knee up. So if you want to stretch the right piriformis,
you bend the left knee up. Cross the right leg over the left leg. Reach across with the opposite
hand, the left hand, and pull towards you. You should feel this directly in your
butt muscle, your piriformis muscle. In the clinic, we hold that for 30 seconds and we
do 3 of them. One variation to that especially for people that have hip arthritis or hip
osteoarthritis, we will do it this way: Put your hand here and press down. My personal preference
is the first method but we have had a lot of people who like this as well. And
they still get that buttock stretch. The second exercise that we are going to do
is another piriformis stretch. This is a little more advanced especially for runners. How
we do it is this: start with your leg propped up. This would be to stretch the left piriformis.
Left leg is up crossed over, then you can lean forward. So definitely more advanced
than the first one but on this we do the same thing, hold for 30 seconds and we do this
3 times in the clinic. The third exercise that we are going to do…the
first 2 were stretching. The third one is going to be one to strengthen the piriformis
muscle and this is the best one that I know of. It fires the piriformis in all 3 ways
that it moves your hip joint. The first one is to turn your leg out. The next one is to lift your
leg out. And it also extends the hip. So it does all 3 of those. We call this the prone figure
4 isometric. What you do is you lay on a mat table or on a bench or on the side of
a bed or a sofa. Lay on your stomach and position one leg off the edge, the leg that
you want to exercise. Lock your foot behind your opposite knee then raise your knee up.
You should feel this fire in your buttocks muscle pretty good. We do a 5 second hold.
We start with 10 of these in the clinic. When we are talking about piriformis syndrome,
the first thing that we want to do is define what is the piriformis? Also we want
to look at what is a syndrome? The piriformis is a muscle in your rear. It attaches
to the side of the tailbone. This would be a person standing facing that direction. This
is the tailbone. This is the right half of the pelvis. This is the left half of the pelvis.
The piriformis attaches to the front side of the tailbone and comes across and attaches over
here to the top of your thigh bone. Piriformis is a muscle syndrome which means
a cluster of signs and symptoms with no known cause. With piriformis syndrome, there
are 4 or 5 main causes. The most common is that there is an underlying pelvic
issue where the pelvis isn’t moving the way that it is supposed to. That puts extra pressure
on the piriformis and that creates sciatic nerve problems. The one thing with piriformis
syndrome the way that it is commonly used at least in our area of the Eastern United
States, is if the lumbar spine is ruled out, so there is no problem in the low back but
the person has sciatica meaning that nerve pain down the back of the leg. Many times
that is attributed to piriformis syndrome.