Sciatica Pain Relief For Piriformis Syndrome - Stretches and Exercises

what's up guys hey jared beckstrand here doctor of physical therapy tonintiten.com do you have a tight hip with pain that shoots down your leg you might have what we call a piriformis syndrome today i wanted to talk to you all about piriformis syndrome what it is why you get it and specifically most importantly about eight things that you can do right now at home to eliminate yours let's get into it right now all right so what exactly is sciatica now sciatica is an umbrella term that we typically use for irritation to the sciatic nerve your your nerves come down your spinal cord they come down your back and they exit out at each of various levels now those lowest nerves in your back they come out of your lower back and they kind of come together to form three major nerves that are then wrapped in a big old sheath and then that's what travels down your leg so it's those collection is that collection of those three nerves wrapped in that common sheath that travels down your leg that we refer to as the sciatic nerve now sciatica is a symptom not a diagnosis and so if you go to the doctor and the doctor says well yeah you have sciatica that is simply describing that nerve pain that you're experiencing down your leg why is it there that's the diagnosis that's the thing that we want to really get to the bottom of why do you have that sciatic nerve pain or that sciatica now the three main causes that i see probably the most common cause that i see is going to be a bulge disc or a herniated disc or just disc irritation things like that are what i hear a lot of in my physical therapy clinic if that's the case if that's your case i actually shot a video on some great things that you can do for a herniated disc or a bulge disc i'm going to leave a link to that in the description below also click on this one right up here that's the link to get to that video if you have a herniated disc that's the best treatment for those second most common cause that i see of sciatica would be disc deterioration or disc degeneration or also termed as ddd for degenerative disc disease sometimes also referred to as stenosis can be another cause of or another symptom of that disc degeneration if you know that you have those things i'm going to leave the links to another video again check the description out check this link right here if you have that disc degeneration those are going to be the best treatment for you but now okay here we go what if you actually have this piriformis tightness or this piriformis syndrome let's talk first of all about exactly what that is and so if i grab my spine model here um your pelvis is made up of three bones and so you've got basically two on either side and one in the middle right here you have a muscle so the piriformis muscle attaches to the inside part of your tailbone kind of right in this area it goes across the hip bone across the hip joint and it attaches you've kind of got you know your hip ball and socket sits out here and that muscle attaches into that outside of that bone on that side and so it kind of takes this oblique course across the across the lower back and so again here's my here's my tailbone right here and so from that inside border of that sacrum out to you can feel that bone on the side of your hip it comes right through that course right there now the anatomy is important because again those lowest nerves in your back there we go those lowest nerves in your back that come together to form that sciatic nerve they actually exit right in that area some of them actually go under that piriformis so if here's my piriformis muscle that sciatic nerve goes right underneath it in some rare cases that sciatic nerve even bifurcates or even goes through that piriformis muscle and so any tightness in that piriformis can actually cause sciatic nerve symptoms because of that irritation and so specifically that's what we refer to when we talk about piriformis syndrome tightness in the piriformis that impinges on your sciatic nerve that causes those radiating pains down into your leg now what causes some of this piriformis syndrome i'd say the most common causes that i see are people who spend a lot of time seated and so the more we sit the more constant and prolonged pressure is going to be in that area that can pinch upon that nerve if you sit all day especially on a wallet and so if i had a wallet underneath here and i spent all day sitting on that oftentimes that can be a cause of this piriformis syndrome just that prolonged pressure from that people who sit a lot with their legs crossed so if i sat all day long like this all of a sudden my hip is in this externally rotated position there's some tension on that on there's an increased pull through that piriformis muscle increased pressure on that sciatic nerve that's another common symptom that i see um pregnancy you ladies who may have some of these radiating symptoms down your leg if it's not coming from a disc or your sciatic or your sacroiliac joint or your si joint a lot of times it can be from this piriformis muscle i'm going to bring my wife in here in just a second she can tell you all about pregnancy and this and this piriformis syndrome and then um weakness is another thing if you've got weak glutes if you've got weak glute max glute mead glute man if you've got weak piriformis those can all be actually causes of this piriformis syndrome too okay enough of this chit chat so now you guys have a good understanding of what it is i hope you have a good understanding of why you get it what i want to run through now are some of my most commonly recommended fixes for it actually the best thing to do i i recommend to people all the time in my physical therapy clinic is to take a three-fold approach to this and so we've got to alleviate the tension and so we're going to do that via massage i'm going to show you some self-massage techniques some stretches and so again i'm just going to show you about four or five stretches that you can do to stretch out that tight piriformis and then finally we've got to strengthen that if it is a muscle weakness issue so i've got a couple of home exercises you can do to also strengthen that piriformis that piriformis muscle up so let's get into those right now all right so once again i brought in my lovely assistant to help demonstrate some of these exercises to you guys we're going to start first with the massage techniques to that piriformis now massage is a great way i mean with any muscle if you're tight and if you have knots in that muscle massage is a great way to alleviate those and so i wanted to show you a couple of my favorite massage techniques but keep in mind the cause of this pain is that piriformis is tight on that sciatic nerve in order to massage that piriformis we have to actually kind of increase pressure on it and so it's not uncommon for this to increase some of your symptoms if it's unbearable she's already got the we tried the tennis ball just barely we'll get there if it's unbearable you guys not important spend some time stretching it out instead however if you can tolerate it some of these piriformis release techniques are going to be great a great way to help alleviate some of that tension okay so to get into this foam roller i like a foam roller because it's bigger it kind of disperses the force a little more evenly if you guys don't have a foam roller we're on ours all the time we're just all the time we're just talking about how she was just on it this morning and so i'm going to leave another link in the description to this video if you do need a foam roller check out that link that's my favorite one and so what camille is going to do if it were her left piriformis she's going to sit on the foam roller she's going to cross her left leg other way left leg over her right to roll out that left side right hand is on her ankle left hand goes down on the floor back behind her and now we've got that left piriformis on stretch in this externally rotated position and then what she can proceed to do is kind of roll forward and backward she can roll her pelvis this way and that way kind of find and identify those areas that you're super tight and then that's where we want to spend a little bit of time foam rolling what i recommend here is about 60 seconds worth you can even kind of find that trigger point and just leave it there for a 60 seconds until that trigger point kind of melts away again if there's any pain or reproduction of symptoms down your legs that's indicative that you're actually aggravating that sciatic nerve we might want to back off this for now that's number one so the foam roller i like now again talking about surface area foam roller is a lot bigger there's a much bigger surface area for that if you want something a little more aggressive a tennis ball or a lacrosse ball can also do the trick what she can do is just sneak that under her butt again right on that piriformis muscle and a lot of times even that is going to be pretty intense and so again she's kind of just supporting herself with her hands and with her feet you roll around on that piriformis you find those areas of knots and those areas of tightness and again that's where i want you to stay if you can you knew it was coming you can also cross that left leg over that right leg again put that muscle on stretch and then roll it around and find areas of tension that way again about 60 seconds of these massage techniques are what i recommend all right so we've been through some of those self massage techniques to hopefully loosen up some of those some of those knots that you may be experiencing in that muscle let's show you now some good ideas or some good options on how to stretch it out i'm going to show you four stretches they're going to go kind of easiest to hardest or kind of least intense to most intense again depending on how bad yours is irritated depending on your hip mobility hopefully i show you something that's going to help you out and so camille we've got her laying down up here what she's going to do in order to stretch out this left piriformis muscle i'm going to have her straighten out her right leg and then all she's going to do is give this left knee a big hug she's going to pull it up towards her chest now if she takes her left knee and actually pulls it over towards her right shoulder we introduce a little bit of what we call horizontal abduction and that's going to help to just increase that distance or put a little more stretch on that muscle so that's your first version of your piriformis stretch take your knee whichever leg is affected and pull it over to your opposite shoulder now if that's pretty easy if you don't get too much of a stretch with that the next level would be she's going to come out of that bend both of your knees now she's going to cross her left leg over her right her hands come down right around the back of her leg now what she's doing is she's pulling this right knee straight up into her right shoulder but we're not stretching that right side again it's this one right over here so now we just increase the degree of that external rotation until she gets more of a stretch through that piriformis muscle that's number two now if that's still pretty easy or if you have even more hip mobility than that she's going to get up into what we call a pigeon pose in yoga and so again just a deep hip rotator stretch to get into it so again we're going to stretch out her left leg she's going to bring her left leg in front of her into kind of this 90 degree position so she's got about a 90 degree bend at her knee and then her right leg is going to go straight back behind her so now all of a sudden we get the weight of her body gravity acting straight down that's causing this hip to rotate even more to put even more of a stretch on that piriformis muscle again this one's probably the most intense if you are limited in your hip mobility like i there's a reason i brought her into this i kind of can't get into this position because i have some tight hip rotators and so this is probably the most aggressive but if you can get into it it's also a great way to stretch out that piriformis muscle okay go ahead and get out of that and now um again i mentioned in the introduction to this video one of the most common causes of this pain or a lot of the pain that i see a lot of times in my clinic would be pregnancy and pregnant women now the three stretches that i just showed you it's kind of difficult to get into that if you do have you know a pregnant belly going on case in point you kind of have the sciatica thing going on with our last so two pregnancies at least it might have been okay so the last three we've got four kids three out of the four have she had this sciatic nerve pain with a lot of it was due to that piriformis muscle tightness so this is how we stretched it out with her this is a little easier to get into with the pregnancy and so she would take her leg again the one that's affected and all you've got to do is stand at the edge of your bed your kitchen table couches are a little bit too low hopefully your bed's high enough some type of platform that's about this high she would bring her leg up into this position and now with a nice straight back she's going to lean forward until she feels a stretch come back up out of that if she was to simply round forward she can obviously go a lot further but a lot of that motion is coming from her upper back keep in mind that it's in the hips that we want to be moving and so keep your back nice and flat and then just lean forward on this and again she's a pro at this she did this one quite a bit again with our pregnancy so again four options for stretches again the goal being to alleviate some of that tension of that piriformis muscle that's that's pushing down on your sciatic nerve okay so the last thing we want to do so if you'll get back up here again sorry on your left side she's she's working hard on this one and so the last thing we want to do is introduce some strengthening exercises to that piriformis muscle so just some muscle activation in that area promote blood flow into that spot help it to release and relax a little bit more also to promote strength in that spot to alleviate some of the tension some of the stress in there the easiest thing to do is camille's gonna roll over onto her left side let's say for example it was her right leg that was affected and then with both of her knees bent we're going to do what we call a clamshell exercise so that piriformis is a hip rotator and so how we activate it is to go through hip rotation with both knees bent she's laying on her left side and what she's going to do is keep her feet together separate her knees so her right knee is going to pull up towards me and then come back down again we call these clam shells in the physical therapy clinic because you get this opening and closing again if it's her right leg that's affected this is working that right piriformis as she's going through this external rotation motion typically what i recommend to people is three sets of ten on this and then you're going to repeat that at least once a day twice a day if you can tolerate it i don't think i mentioned anything about my stretches my stretches i'll typically hold each one for 20 seconds repeat that three times and then the stretches you can also do a couple times a day as well so about 60 seconds on each of those stretches twice a day clamshells is your strength exercise number one strength exercise number two she's going to get up here onto all fours and a little bit more aggressive as now we're kind of going a little bit harder against gravity she's going to do what we call a well we call it a quadruped hip external rotation how lame is that it's called a fire hydrant you guys and so a fire hydrant exercise again down here on all fours and then she's going to take her bent leg keeping her hip at 90 keeping her knee at 90 and then she's going to raise that right knee up towards the ceiling and then slowly lower it back down again we're promoting that external rotation motion in the hip that's causing that piriformis muscle to fire that's exercise number two again a little bit more aggressive than your first one if you can tolerate clamshells you might try this if this is too aggressive go back to your clam shells and again about three sets of ten on those exercises how you feeling great that piriformis is like completely completely healed she's cured it's america hey you guys i hope you found this beneficial again my goal here was to show you some exercises that you can do to treat piriformis syndrome at home i hope you found it again hope you found it beneficial if you did go ahead and hit that thumbs up button down below and say thank you so much for those likes that you guys give me that really means a lot 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Channel: Tone and Tighten

Views: 1,121,830

Rating: 4.947278 out of 5

Keywords: piriformis exercises, sciatica exercises, sciatica, sciatica pain relief, piriformis, piriformis syndrome, piriformis stretch, piriformis release, stretches for sciatic nerve pain, stretches for sciatica, how to treat piriformis syndrome, how to treat sciatic nerve pain, how to treat sciatica pain, how to treat sciatic pain, how to treat piriformis syndrome with massage, how to stretch piriformis muscle, how to stretch piriformis, sciatic nerve stretches, sciatic nerve pain

Id: 5ZXJEO6fc-4

Length: 16min 22sec (982 seconds)

Published: Thu Mar 21 2019