Imagine this, You are sitting at your desk working all day, Suddenly, you feel a sharp and intense pain in your buttocks, Making it impossible for you to sit comfortably, This pain often radiates to your lower back or the back of your legs, Causing you to limp when walking, And even preventing you from sleeping properly, I once had a case Where the pain was so severe that they couldn't go upstairs, So they had to move their bed downstairs, And had to take painkillers and sleeping pills just to get some rest, If you have experienced a similar situation, Then you may be dealing with a troublesome issue, Piriformis Syndrome, Piriformis Syndrome, You can also refer to it as Deep Gluteal Syndrome, Because this condition, Does not only affect the piriformis muscle, Any of the deep gluteal muscles can be affected, And it can result in a tingling sensation, This tingling sensation follows the sciatic nerve, Extending all the way from the buttocks to the back of the thigh, It can even reach the heel, Occasionally, it may radiate to the lower back, Making patients with Deep Gluteal Syndrome uncomfortable in both sitting and standing positions, So why do the deep gluteal muscles get injured? Before answering that question, Let me introduce you to what the deep gluteal muscles are. The deep gluteal muscle group consists of six muscles in total, From top to bottom, they are the piriformis, Superior gemellus, obturator internus, Inferior gemellus, obturator externus, And quadratus femoris. If you can't remember their names, it's okay, You just need to know That these muscles originate near the sacrum and the ischium, And their insertion point is near the greater trochanter, So their movement directions are very close. And because these muscles Are located in deeper layers, They are collectively referred to as the deep gluteal muscle group. Knowing the anatomy of these muscles Can be very helpful for muscle maintenance And injury prevention. What do I mean by that? Because the main causes of muscle injuries Besides accidents, Often revolve around overuse. If it's not due to overtraining, The reasons for muscles being overused Are usually compensation And prolonged fixed postures. So when we are looking for solutions We typically explore what causes These muscles to be overused, To find answers. Simply understanding the muscles' direction and function is key. It can easily be deduced Which movements are causing the muscles to be overused First, Let's take a look at who the deep gluteal muscles compensate for, The deep gluteal muscles are relatively small muscles responsible for stability, So who is responsible for movement? It's the gluteus maximus, gluteus medius, And gluteus minimus, If these gluteal muscles lack strength, Your center of gravity will wobble, This makes the deep gluteal muscles need to exert more force To help stabilize, In other words, the deep gluteal muscles compensate for the gluteal muscles, This is one of the reasons for their overuse. Although the deep gluteal muscles primarily focus on stability, They also participate in external rotation And abduction movements, Such as walking, Running, hiking, cycling, weightlifting, You can see that hip rotation and abduction are involved in these activities. So when performing these activities, The deep gluteal muscles are actually constantly activated, If they also have to compensate for the gluteal muscles, Then the deep gluteal muscles are very likely To get injured due to overuse, So training the strength of the gluteal muscles Is extremely, extremely important For preventing Piriformis Syndrome. Another reason that can lead to injuries in the deep gluteal muscles Is prolonged sitting, Nowadays, people sit for an average of 8 - 10 hours a day, Pay attention, This "sitting," Doesn't just refer to sitting in a chair, As long as you are in a semi-sitting or semi-reclining position, These all fall under the category of sitting, If you have an office job Or a job like professional driving, The chances of developing Piriformis Syndrome are even higher, Because your buttocks are constantly compressed And remain immobile, The muscles in the deep gluteal area become ischemic Fascia can become adherent, And blood circulation is impaired, Muscles in this condition tend to stiffen Stiff muscles are more prone to tears Than they are during normal activity Many small tears can accumulate Leading to inflammation It can be said that a sedentary lifestyle Is really, really unfriendly to the deep gluteal muscles Piriformis Syndrome can range from mild to severe And presents a series of symptoms You can use these symptoms To make an initial assessment of whether you have Piriformis Syndrome If you notice suspicious symptoms, Seek rehabilitation treatment early. You can reduce a lot of suffering The initial symptoms of Piriformis Syndrome After sitting for 20 - 30 minutes, You'll start to feel a dull ache in your buttocks And it will get worse the longer you sit The pain is often located in the area where you keep your wallet in your back pocket Some patients also experience referred pain around the coccyx On the outer side of the buttocks or the back of the thigh There may be muscle-related pain As it progresses to the next stage, It turns into hip joint pain Apart from limping while walking, When taking big strides, The moment the front heel touches the ground is the most painful Finally, if the sciatic nerve is compressed, It will result in numbness and pain in the entire leg At this point, you can try lying down Bend your thigh, adduct and internally rotate it Move your leg toward the midline See if this movement reproduces the usual pain If it does, And sitting exacerbates it, Then you really need to see a doctor as soon as possible Once Piriformis Syndrome is diagnosed, Recovery usually takes 3 - 6 months to gradually occur This recovery time is not short at all If it progresses to compressing the sciatic nerve, Dealing with it becomes even more troublesome. So, let's try not to let Piriformis Syndrome Progress to that stage, alright? Now that you know What the initial symptoms of Piriformis Syndrome are, How can we maintain and prevent Piriformis Syndrome? It's very simple. Let me teach you three steps. First, after exercising, be sure to relax And stretch your muscles. The last time I went rock climbing, Because I did some jumping exercises, I used too much buttock strength. The next day, I had unusual swelling and pain. For those who experience this feeling after exercising, When the symptoms slightly improve, You must use a foam roller and massage ball to massage Or stretch the muscles in your buttocks. Otherwise, scar tissue from the injury Will accumulate on the muscles, Triggering the next injury. Secondly, you must break up long periods of sitting And get up and move around every 30 minutes. Thirdly, train your basic gluteal strength To prevent gluteal amnesia. Nowadays, most people work sitting down, And the most direct result of prolonged sitting Is weak and atrophied gluteal muscles. You have to know, The glutes are the largest muscles in the body. Keeping the glutes strong Is not just good for the Piriformis muscle, But also benefits the surrounding areas, Such as the health of the lower back or knee joints. The gluteal muscle training I'm about to show you Not only focuses on shortening with concentric contractions, But also strengthens lengthening with eccentric contractions. So that the muscles have enough strength To stabilize the body whether they are shortening or lengthening. In addition to the training, Of course, I will also guide you through Some stretching exercises for the Piriformis muscle To help you maintain your Piriformis muscle. The first exercise is a comprehensive gluteal relaxation. First, let's relax the Piriformis muscle. Prepare a ball Wrap it in a sock. The Piriformis muscle is located at the sacrum 1/2, Connected to the greater trochanter of the femur, Below the Piriformis muscle, You will sequentially find the superior gemellus, obturator internus, Lower limb muscles, and quadratus femoris. You can press down in sequence All the way to the position of the ischium. First, find the sore point And slowly increase the pressure at this point To let the massage ball sink into the muscle. Then, rotate the thigh inward or outward. Remember, the slower the rolling, the better. Count one repetition for both inward and outward rotations. Repeat this rotation 12 times. Do 3 sets a day. The second exercise is Sciatic Nerve Flossing. Start by lying on the ground. Your thighs should be at a 90-degree angle to the ground. Then, flex your feet. Slowly extend your lower leg towards the ceiling. When you feel tension in your buttocks, behind the knee, lower leg, or the sole of your foot, maintain this position. This position is typically where the sciatic nerve is being stretched. Keep your thighs fixed and slowly move your ankles up and down. You will feel your entire leg being gently stretched and then relaxed. Repeat this movement 15 times. Do 2 sets a day. This exercise can help increase blood circulation to the sciatic nerve and achieve nerve decompression. Pay attention to the slow movement of the ankles and avoid moving too fast or staying still for too long. After decompression, let's work on sliding the sciatic nerve between the muscle fascial tissues. First, find a wall. Lift one leg and place it against the wall so that your thigh is at a 90-degree angle to the ground. With your foot flexed downward, gently straighten your knee with your hand until you feel tension in the back of your thigh and calf. When you reach the end range, do not hold the position. Bend your knee while simultaneously pointing your ankle upward. Extend your knee and flex your foot downward. Point your toes downward Bend your knee Point your ankle upward Repeat 15 times Do two sets a day This exercise can improve the sliding ability of the sciatic nerve When the deep gluteal muscles become inflamed or tense, it can lead to adhesions between nerves and muscle fascia When the tension of the sciatic nerve increases, you may feel numbness from your thigh to your foot. These two exercises are nerve flossing techniques that can help improve blood circulation to the sciatic nerve and relieve symptoms of foot numbness caused by the sciatic nerve. The third exercise is a deep gluteal muscle stretch. Start by lying flat on your back. Lift the painful leg up and grasp it just below the knee with one hand. Gently pull your knee toward the opposite shoulder Place the other hand just below the ankle and pull the ankle upward. During this process, the thigh performs external rotation, adduction, and flexion. Be aware to keep the stretching hip as close to the floor as possible avoid lifting it. When you feel a deep stretch in the buttocks, hold for 30 seconds. Switch sides after 30 seconds. One set includes both sides. Do three sets a day. When the piriformis muscle is stretched beyond 90 degrees of hip flexion, it becomes an internal rotator and extensor. This stretch can help counteract that motion. A special note for individuals over 60: It's recommended to extend the stretching time to 60 seconds. The fourth exercise is a comprehensive gluteal eccentric training. Start with one foot in front of the other, placing the painful foot in front. The back foot's toes should be on a towel. Keep your weight on the front foot, you can hold onto a wall or a chair for support. Slide the back foot to the side and behind while bending the knee, forming a lunge position. Try to extend to the side and behind as far as possible When your knee is almost touching the floor. Then slowly come back up. You should be able to feel soreness in the front of your hip on the front leg. This indicates that your glutes are being trained. This exercise mimics the lunge position, training all the gluteal fibers that you don't normally train, through hip joint rotation. The fifth exercise is eccentric and concentric deep squats. Stand with your feet shoulder-width apart, squeeze a pillow, or use a small yoga ball or yoga block. Interlock your hands in front of your chest, squeeze your knees together, and squat down. Hold for 10 seconds at the bottom. Then slowly stand up. Repeat this movement 10 times. Do 3 sets a day. This exercise targets the external rotator muscles and focuses on eccentric contraction, which is suitable for the external rotator muscles that may become overly shortened and tense. especially in cases of injury. Next, attach a resistance band to the outside of your knee. You can also attach it to your lower leg or arch of your foot. While externally rotating your thigh, perform deep squats. Hold for 10 seconds at the bottom, then slowly stand up. During the process, you can imagine your feet turning screws into the floor. but do not let your big toes leave the ground and curl up. Repeat 10 times Do 3 sets a day This exercise helps the external rotator muscles around the hips perform concentric contractions Suitable for use in External rotator muscles that have been lengthened and injured If you want me to give you Three Tips for Dealing with Deep Gluteal Syndrome I would say don't sit for long periods Don't sit for long periods Don't sit for long periods Sitting for extended periods has far more health risks than you imagine. Apart from causing your glutes to weaken, it's also closely linked to various cardiovascular diseases. Deep gluteal syndrome is just one of the many risks of prolonged sitting, and once it occurs, In practice, it can be challenging to give the deep gluteal muscles complete rest. So it's also challenging to recover from. If it compresses the sciatic nerve, it can be so painful that you can't even walk properly. And the kind of pain that originates directly from the nerve can really leave a lasting impact on a person. Those who have experienced it will definitely know what I'm talking about. But perhaps it's not entirely a bad thing because once you've experienced that pain, usually, that person will become very proactive in taking care of their body. But I hope that none of you ever have to experience that kind of pain. Getting up and moving around every now and then can keep you away from deep gluteal syndrome. Consider it an investment in your future physical health, and it's well worth it. A healthy body is the soul's living room, while a diseased body is the soul's prison. So, that's all for this video. If it has been helpful to you, please share it with your friends. It would be a great help to me. We'll see you in the next video. Goodbye!
