How To Tell What Exercises You Should Or Should NOT Be Doing For Piriformis Syndrome

hey everyone dr charlie johnson physical therapist uh in this video i want to talk about the 80 20 rule as it pertains to uh solving your pain problem so i treat a lot of people with piriformis syndrome hip issues sciatic type issues basically a pain in the butt uh and they're you know they're going to physical therapy they're going to chiropractor they're going massage therapists they're doing all this stuff and then they're confused and they don't know what's working and they lack clarity and then my job as a coach and therapist is to kind of uh you know weed through the the junk and find what's working versus what isn't working so that being said in this video i want to talk about the 80 20 rule and if you don't know what that is i can't remember the exact principle pareto's principle something like that or whatever but it's this idea that look there's probably like 20 of what you're doing is giving you 80 of the results so look if you're going to pt and you're getting a whole sheet of exercises or you're going to the chiropractor and they're treating the whole body they treat your neck and your back or whatever uh they you go to the massage therapist and they work you head to toe right they work out all your knots you know that sounds cool and it sounds really holistic but they really have no idea what they're doing and i mean this in the best of the ways because look i'm a physical therapist so i believe in physical therapy because the cool thing about what we do is that we actually give you some tools to go home with such you can treat yourself now massage therapist might sometimes the chiropractor or whatever but at the end of the day right we are giving you something that you can go home with tools knowledge and understanding uh such that you are more in control so look are 10 exercises better than you know one or two exercises or better than well okay i'll say are 10 exercises better than nothing i don't know actually but let's just say yes all right but i think we could do better so if you're going to pt right now and or anywhere else and you're dealing with a pain in the butt and you're looking to get to the root of the issue and i don't even like that word but you're looking to get some more clarity let's just say that then i want you to try this so 80 20. it's this idea that look i have people every day that reach out to me just the other day actually and they say hey i'm doing um you know i'm doing the bridge you're not gonna be able to read this by the way i'm doing the cat cow whichever one's the cat whichever one's the cow i'm doing the um you know i'm doing nerve flossing i'm doing press-ups right by the way you know if you're doing press-ups and somebody thinks probably you have maybe a back issue let's just say that all right if you're doing nerve flossing they think that maybe you have a nerve issue uh if you're doing cat cow well who really knows what that is if you're doing a bridge then you have a glute stability problem uh if you're doing uh oh you know you're doing planks because you also have a core problem can you see how nobody really knows what's going on so look i'm not saying that it's easier that i have all the answers what i'm saying though is that you've got to start to gain some clarity about what could be going on so that being said if you're doing all of these things which by the way yeah are operating off of like five different hypotheses then not only are you know is the person that you're seeing probably pretty lost uh but you are lost for sure like you're way out in left field okay so now what do you do to bring some clarity to potentially what is working versus what is not working i'm not asking you to call me and work with me per se although you could if you want all right but that being said uh if you're going somewhere and you're doing say you know let's just say five exercises or maybe we make this even longer probably more realistic you get that whole packet of papers 10 exercises with the stick figures and the reps and things like that let's just say that you're doing that and you want to use kind of what you have to problem solve through this on your own and look to help maybe the pt or the provider out so uh it's not a one-way street you've got to kind of connect with whoever you're working with such that you can get to the root again hate that word uh you can gain more clarity about your problem okay so that being said let's just say you're doing 10 things you've got that whole stack of paper in front of you and you're doing all these exercises so what do you do okay so the first thing you need to do is you need to get a baseline so you need to know sort of where you're at so many people have been trying things for so long they've sort of you know lost themselves not like mentally maybe but maybe that too but physically or whatever okay they're kind of confused about what's working versus what's not working and maybe you've lost some hope so that's completely normal there's nothing wrong with that all right but there is something wrong with that in that if you're trying everything you haven't really tried anything you're just confused now i'm getting confused so that being said the first thing you need to do is you know i would say stop everything okay well if you're going to pt currently maybe that's not an option but maybe it is an option but really in an ideal world what i would say is stop everything so right now you know if you're sitting on a chair somewhere and um here's my drawing right you're sitting on a chair somewhere and this is the water the water is very choppy in this scenario you're probably not going to be out there boating or something or swimming around right so you've got choppy water and maybe there's some storms coming in all right that's probably what it looks like for you right now if you're dealing with this issue you're trying everything you're not getting anywhere so first step in that scenario is like uh well we can't really see what's going on in the water and we can't really get out there to do anything fun or exciting because there's just too much going on so let the skies clear and let the water just chill and now you know you would want to sit out there in a nice morning you would want to like listen to the birds or like you know you'd be able to see like a little fish pop up over here or whatever it may be okay because there's not so much going on so the first things you know first things first calm muddy water so uh you know the the there's an old saying i forget who said it but the quickest way or the easiest way to calm muddy waters is to do nothing is basically leave it alone all right so if you have the choice so look if you're going to pt right now and that's not an option you need to keep going or you know the chiropractor has you convinced that you need to go there for the rest of your life and you feel guilty for some silly reason that you have to keep going then you know okay keep going but i would say if you can just stop and maybe just stop for a week so it doesn't need to be for forever just stop for a week and do nothing everything that you're adding all the rocks that you're throwing in the water okay to try to solve this problem just stop doing that and just chill so the first step is just chill chill and do nothing now maybe you're already doing that and if you are then bypass this step fast forward okay but that's that all right and you want to see where am i at my baseline and then what you want to do okay is you know if you already have an exercise routine 80 20 i promise i'll come back to that and let's just say to make it simple eight plus two is ten so let's just say you're doing ten things we wanna find the two things the one or the two things that are working and we want to eliminate the eight things that aren't working so maybe in your brain so you've got this list of ten things one two ten maybe in your brain you already have an exercise that you really love and you think is really helping you and you know when you do it at the pt office or at home whatever it just you just love it maybe just start there but you could start anywhere so look people in pain get so caught up and they think there's a right way to do something or a wrong way to do it the only wrong way to do it the only bad posture is one that makes you feel worse the only good posture is not necessarily sitting up tall or you know sleeping in a certain position or uh sleeping on your belly is bad no throw all that stuff out the only good position or good thing for you is something that makes you feel good so that being said take any one of these 10 things ah back up back up hold on you can decide you can decide on any one of those ten things okay but before you do that one thing or you start with the one thing is you need to not only have a baseline but then let's insert it right here between these steps between i guess step zero and step one my numbers are all screwed up okay is that you need to uh you would need to kind of scan or test the body meaning you've got your baseline you stopped doing all this stuff and you're like hey where am i am i feeling good am i feeling the same i'm feeling worse because you might find that just dropping out all that crap makes you feel better just like taking all the waves away makes you feel better sitting on the shoreline but at the end of the day right you need to have some type of motion or position or activity that clearly reproduces your problem so you know if you've had the problem for a while you probably know what that is it can't be like hey after i walk for three hours because well this will take you a long time to figure out but ideally you twist your hip a certain way you straighten your leg a certain way you bend a certain way you move a certain way you do something that in the moment can uh you know kind of bring on some sense of discomfort or yuckiness so you need to find a yucky motion or a yucky position boom then now we're back at this then what you want to do is you want to pick one of the things on that exercise sheet again if you can't figure it out you don't know up front because you're like oh should i do this one just eeny meeny miny moe boom pick one or if you have an idea if something is already working do that so you're going to do is you're going to do that one thing do it for the amount of reps the amount of sets that your pt or whoever told you okay so you're gonna do that thing so you're gonna scan test then you're gonna treat yourself using just the one motion the one thing remember we're trying to find the one or two things and we're trying to get rid of this junk throw away the garbage okay and then what you're gonna do is you're gonna say hmm now i'm gonna go re-test that yucky thing or that yucky motion that i had or did or whatever that could reproduce my problem and i want to then follow some basic rules i don't know how many steps this is now but if you feel better then cool that's one of the 10 things on your exercise sheet that you're going to want to do and by the way if you have one thing if it makes you feel better why would you do the nine other things just do that one thing just double down on it all right so keep doing it if it feels the same then what i'd say is you need to tweak it it doesn't mean that you know if you chose the cat cow that that was the thing that uh or and that didn't change anything that that doesn't work for you maybe do more cat whatever that is or maybe try more cow so maybe try to break it down and pick one mo one kind of end of the motion or exercise versus the other maybe do it for a little bit more uh a little bit longer a little bit more reps okay so you're going to tweak it you're going to modify it change it in some way retry it retreat and then you're going to retest and then if it makes you better keep doing it and you figured it out all right if it makes you feel worse if any of these while you're doing it make you feel worse then please don't do that a lot of times what i find is that if you're doing 10 motions two of them are helping you and eight of them might be hurting you i've treated people all the time there's nothing fancy about what we do here all right or when i work with people we're just using motion it's just that there's a scientific way and sort of process through which you can discover what's working or what's not working or what's wasting your time so a lot of times i might do the same motion that somebody did before in pt that didn't work but really it didn't work in the context of the whole bunch of stuff that they were doing but you pluck that thing out and you do it then it works okay and this is the process so you could go one by one through every exercise and determine hey i scanned my body oh this motion's yucky i do the bridge or whatever was over here before and then i retest well i yeah i treat myself and then i retest and that one doesn't work get rid of the bridge i go i do the next thing the cat cow i do it doesn't work i go i do the next thing the plank doesn't work i go i do the negative thing i do the press up whatever is listed over here oh that makes me feel good that makes me that makes things feel you know better you gonna do that stop doing the other things that are counteracting uh you know what you're doing so that being said hopefully that's helpful that's how you can find the you know the two out of ten things so the 20 20 versus 80 okay of things that are working versus not working and you know a lot of times and i think it makes sense so imagine you have like eight pounds of something over here and two pounds over here that make you feel good all right um the eight pounds of junk that you're doing uh could be outweighing the two pounds or twenty percent of things that are making you feel good so the things are making feel good don't have any opportunity or ability to actually make you feel good because you're doing so much crap that's not making you feel good so hopefully that's helpful you want to cut out this and you want to reduce those 10 exercises to just the two that work so that's your homework if you're working with somebody you're doing all this stuff right work with them and you know start to experiment on your own using this simple test the body do nothing get a baseline you know scan or test the body find a motion that's yucky treat yourself one motion at a time and then retest same better or worse and just go through that feedback loop to determine of those 10 things what's working versus what's not working

Channel: Dr. Charlie Johnson, PT

Views: 5,940

Keywords: piriformis syndrome, Piriformis Stretch, Piriformis test, piriformis syndrome exercises, piriformis syndrome treatment, piriformis treatment, piriformis treatment exercises, piriformis release, piriformis massage, piriformis tennis ball release, sciatica stretches, sciatica exercises, sciatica treatment, sciatica tennis ball, herniated disc, herniated disc treatment, herniated disc exercises, lower back pain, back pain, physical therapy, phoenixville, royersford, collegeville

Id: 5VLXLEOKBeg

Length: 13min 59sec (839 seconds)

Published: Mon Oct 26 2020