♪ Bob and Brad ♪ ♪ The two most famous
physical therapists ♪ ♪ On the internet ♪ - Hi, folks. I'm Bob Schrupp, physical therapist. - Brad Heineck, physical therapist. - Together we are the most
famous physical therapist on the internet. - In our opinion, of course, Bob. - Today we're gonna show
you the number one thing to help heal your piriformis syndrome and that's pain that you're
getting down the leg. Brad will describe it in just a minute. Plus, we're doing a giveaway, Brad. - That's right, Bob. - If you are new to our channel please take a second to subscribe to us. We provide videos how to
stay healthy, fit, pain-free and we upload every day. How come Sam's facing this way? - Well, we will find out, it's a secret. - Go to bobandbrad.com,
go to the giveaway section and we are giving away
a handheld massager. - It's a nice one too. - Yeah and it's inexpensive. These work really well. - Especially if you win the giveaway. - Yeah, you go to Facebook. The contest will be
pinned to the top page, go to Twitter, Instagram, or TikToK, if you want a 60 second
version of our program. - There you go. - We have Sam out here for a reason. We want to show where
the piriformis muscle is. - You're right. - Interestingly enough what happens is this is
a short little muscle that could actually put pressure over the spinal cord or the sciatic nerve. There we go. So the sciatic nerve comes down there and it's a little muscle that it attaches over here on the sacrum. And it comes over here and attaches on the greater trochanter. So from here down to here. Kind of triangle shape if
I remember, right, Brad? - Yup, it's a little hip muscle. - And it go right over
to the sciatic nerve or the sciatic nerve might
even puncture the muscle. But what they're finding now, Brad, is, and we're trying to always
keep up to date on things. - Sure. They're finding that there may be other muscles involved, and the gemelli, and so they call it deep
gluteal syndrome now. - As far as the average person, this probably not that important what other muscles are in there. - 'Cause you're going
to do the same treatment - But they're really
getting into the details. - Now the other thing is
there's actually that muscle could be tight, but it
could also be stretched out and it would still give you problems. - Too loose. - The number one thing you need to know is which one you have? Is it short or is it long?
- Yeah. - 'Cause if it's short,
you're going to stretch it. If it's long, you don't
want to stretch it. It's already stretched out. - Right? You want to strengthen it, shorten it. - So we're gonna show you one quick test. You may need somebody to help you do this. But that'll help tell you whether or not it's long or short. Now, long before we even
showed the test, Brad, I'm going to show you how long can occur. You can move that.
- Oh, Sam's done? - Yup, Sam's done.
- Sorry, big guy. - He's going into retirement. I'm going to put this down here. And this is from Sahrmann,
Shirley Sahrmann. You wanna lie on your side, Brad. - Right here, Like this? - We're going to do this one first. - Okay, yup. - Lie on your side. - Oh yeah, that's right. - Yeah, now you're remembering. - Yes. Let's say you have somewhat wide hips. You're a female or even as a male and you sleep like this
position on a regular basis, you are stretching that muscle out. This is exactly the
position that does that. You do that night after night,
I had this problem, Brad, I started having hip pain
just because I was sleeping, kind of like this. And I actually, you know,
you sleep with a pillow between your legs and that
takes care of the problem. But something like this
will stretch it out. You can also stretch out the muscle if you're a younger athlete and you do squats and your knees, when you're doing the squat,
actually turn in like this. You're putting stress on that muscle, undue stress on that muscle. And you're stretching
it out a little bit too. So those are the ways to stretch it out. Now, why is it short? Well, one, if you sit a
lot it's gonna shorten up, which is very common
nowadays, unfortunately. - Sure. - And also if you fall or have trauma or a sporting event that that actually tore the muscle. - Sure, scars up and tightens down. - And that seemed to be the
case with a lot of people I had that it seemed like it was actually torn and scarred up and tightened. - Sure.
- So, all right. Let's show the test, Brad. Let's pull you this way. - We're just doing this
'cause it's easier to see. - You'll be able to tell
better what we're doing here. - So you need a second person
to actually kind of do this. I'm the one being tested. We're gonna check my left. - It's interesting. Brad has loose hips in one direction. So it'd be interesting to compare the two. But what you do is you have
the knees are probably bent to, what is that, Brad? About 45 degrees.
- Right. - Not way up there. You gotta be down a little bit
because interestingly enough this muscle does different
things depending on where your hips are at. So some of this may not make sense to you but just follow us. We'll give you the truth. - [Brad] We'll guide you. - So what you're gonna do is I'm gonna grab under the knee and I'm going to bring
the foot out like this. And this is internal rotation. And if the muscle is tight,
it's gonna be tight this way. If it's really loose, the foot
is going to go all further. Now you thought this
one was a little loose? - [Brad] Yeah, my right side. I think you'll see that. - [Bob] Oh yeah. So now this, by the way, is probably just getting close to normal. So what you'd see is you're
gonna look for the differences between the two sides. Let's say this is the painful side and we check it and yeah, it's tight. Let's say this is the painful side again. And we check it and it goes way out here. That means it's long. So you wanna compare it to the side. Like Brad I said is lacking, and this is probably close to normal but it's still lacking a
little bit, I would say. - [Brad] Yeah That's my natural tendency. - So of you find out it's short, we're gonna stretch it and let's show you how to
do that right now, Brad. - [Brad] Sure. We're gonna do the figure four? - Yup, figure four.
- Should we turn it? - Yeah. Probably turn again. - Yeah. It's a little easier to
demonstrate your viewing pleasure. Oh my gosh. All right, here we go. So you can do this on a bed or carpeted floor might
work a little better but we're gonna do what we
call a figure four like this. Put your ankle just above your knee. Don't go way up too high. Try and get on your thigh a little bit. And then we can push here. - [Bob] Actually gonna bring it up. Yeah, that's gonna give it the stretch. You may need a towel or a belt or something to go around the leg if you have trouble reaching that but we're gonna show you
another way to do it in a chair. - Sure. - [Bob] So if you can't get this position you can certainly do it in a chair. - Sure, all right. - [Bob] You want to do it on here, Brad? - I'll do this leg then we can. That's the same thing
just the opposite leg. The view helps a little bit. - I can show on the chair.
- Okay. - Mike, am I too close? No restraining order against me? - This should feel good. It shouldn't be a painful
stretch and actually right now I can tell I'm loosened up a little bit. - Sure. So do the same thing. Put my ankle right above the
knee on the opposite side. I'm stretching the right side and you're gonna actually push down and then you're gonna lean forward. Now when you lean forward,
don't round out your back. We always want good posture. So good posture, lean forward. And that's going to give
that baby a good stretch. Now some of you might be thinking, well, I thought this
was an external rotator? I'm getting into the weeds a little bit. Right?
- Yeah. - Actually the piriformis, when it gets way up to
the top here, beyond 90, it's actually an internal rotator. So we got to stretch the external rotator. I'm sorry. I just want to make sure. - Just in case there's
a few PhDs out there. - So the other thing that is
very helpful and I have found that this really makes
a difference right away. Any patients I've had is to
actually massage the area too. So massage the muscle, again, there could be some scar tissue. And what I have found it's hard to do yourself with your hands. I mean, you can do it. You can find a tender spot and massage it. But that's where our
actually giveaway this week works out really nice. So it's a handheld massager. And what this'll do, there we go. I'm sorry. I was supposed to let go. - Yeah, it's a little
different than our other one. - Yeah, our other massager actually you gotta hold it for three seconds. So this one, you gotta just hit it once. So the handle makes it nice
because you can get in there easily, more comfortable than with a massage gun. - Yeah, he's talking about, you know, versus this type of a gun. - Right, right. And it's got different speeds. Picking up more and more. As you can see, that
allows you to get in there without wearing your hands out. - Right. - I would actually go
on the highest speed. - Yeah, that's kind of a personal thing. You'll learn very quickly what works best. - Yeah and you can massage
that for, that's the beauty of having a massager is
that you can actually do it for a long time without fatiguing. - Right, without getting
your fingers all wore out. - All right. That's what you're gonna
do for a short muscle. You're going to stretch it. You're gonna massage it. Let's say you have a
long piriformis muscle. You're gonna strengthen it. So the first one is clamshells. Brad's going to demonstrate those. - To start out with, you'll
just lie on your side like this. It's nice to have a pillow. You don't have to, but
it's a lot more comfortable and you simply work it like this. So this is working in my right piriformis take it up and down. Good control. We're just not flopping around here. And you'll be amazed
that 10 to 15 of these with good control is going to
start to fatigue that muscle. If you do want more resistance
you can get the bands. Like I have a loop band
here that goes around. - [Bob] But don't start off with that. That'll be way too much. Just start off with against gravity. - Wow, that is ah. - [Bob] Yeah, that starts to feel it. - And you can vary the resistance if you get a little closer to your hips, it's a little easier. So you can vary the
resistance by the location of where you put it, but you know, 10 to 15 reps of those is typically good. Are we gonna go right to this standing? - Yeah, the standing. What's nice about this, Brad, is this is kind of functional. So if you are that
person that was squatting and your legs are going in this'll teach you to squat
and keep your legs out. - So I'm going to practice squats with the band around here. But I'm not going to let
this happen, you know 'cause the band is pulling it in. So we're going to actually resist the band push it out and hold. And boy, I can feel it.
- Can you feel it? - You get a real nice indication of where those muscles are
and where that piriformis is. - Again, that's a progression. That's probably one that
you're going to do later on after you've done the
clamshells without weight. - Probably more for that
athletic type person. You know, if you're just,
you know, maybe older senior. - You might not ever get to a band. - You may not need them. - By the way, Brad and I
can fix just about anything. - Except for...
- A broken heart. - The piriformis is a
long ways from there now. (laughing)
