Transcription
All right, to everyone experiencing piriformis pain that sometimes can go down the leg and act like sciatica. We're gonna give you symptoms, self-treatment plus information, how to completely understand, how you can solve this problem, long term. Hold on just a, nine seconds.
- Nine point seconds.
- 9.3, Yeah.
♪ Bob and Brad ♪
♪ The two most famous physical therapist ♪
♪ On the internet ♪
Okay, first of all we need to know the anatomy of the piriformis muscle. And if you look from the backside, it's gonna actually connect underneath the sacrum and then it comes out, and this pink tape actually represents where it is. It's a pretty good representation of it, actually. It goes over and connects to the-
- The hip.
- The hip, the greater trochanter, this just outside the ball of the hip.
Okay now, if you look, you're gonna see this yellow, this represents the sciatic nerve. Now, if this muscle tightens up, too tight, it can put pressure on that sciatic nerve. Not only does it cause pain here from the muscle being contracted and over tighten but it can put pressure on the nerve and give symptoms all the way down to the foot and into the toes.
- [Bob] So it's called fake sciatica, sometimes.
- Right, exactly right. So it's usually sciatica comes from the back. In this case, similar symptoms coming from this area. So the whole goal is to relax this muscle, take the pressure off the static nerve as well as the pain of the tight muscle, just being relaxed and relieved.
Okay, we're first gonna cover some soft tissue, working some stretches that can oftentimes help relax that muscle and work well. Bob is in what we call the 90/90 position, lying on his back. You can do this in the living room with a chair. We just have a stool here, use a stool or a chair. And oftentimes the Ottoman, oftentimes this will offer relief right away, and you'll feel that muscle relax. The next thing you can do...
Now, actually let's just talk about an option if you don't have that or simply go in what we call hook line position. Now let's say Bob has his piriformis on his right side's tight. He's gonna grab his right knee and pull it up and over across to his opposite shoulder, that stretches, you will feel this. If you had a tight piriformis you will feel it right there in the buttock. What you can do, if that's the tight one, put that down and to test it, do the other leg. Every time I had someone with a piriformis problem and you have them compare one side to the other. They say, "Oh, is there a big difference?"
- A difference?
- Yep.
So then you're gonna work on that. Sometimes a stretch will be enough to eliminate that tight muscle. Sometimes it's so tight we need to work a little bit harder.
Okay, the next stretch that can work really well. This is for someone who's pretty mobile. It can be a little challenging, but if you're mobile and more athletic, it works really well. Although we can both do it and we're old.
- Right, we're old.
- Yeah.
So you go in this position and then bring this foot across. This is the way I do it. And I just simply reach here, and I reach here, and it's the pigeon pose. I'm really not... This is a yoga stretch and I'm not, yoga people.
- (cross-talking) Wise pigeon.
- Yeah. And yoga people would say, "Eh there's a couple things you're doing wrong." But I definitely feel that piriformis being stretched right there. I'm fairly tight with this stretch. I just started working on it in the last few months. But again, do this side, say if that was my tight one, and then do the other side and you will... And actually my right side is tighter.
- It is.
- Yeah. See that? Boy that's a big difference. I don't have piriformis syndrome but obviously my right hip and piriformis is tight. So that's why I'm working on it at home. So work with that. You're gonna hold it for 10, up to 30 seconds. If you feel that muscle relax, and just melt away, and the pain go away, you know you're right on. If not, we've got another option.
Okay, now we're gonna go on to some options for some soft tissue work. We're gonna get into that muscle and relax it through being a little more aggressive. We can start out with a tennis ball. I'm gonna go down on the floor, put the tennis ball here. Right there where that piriformis is, and you'll find out when you start rolling on it, I'm supporting my weight through my arms and my feet. So I'm not getting too aggressive. And you'll find when you hit this, the tight spot, it's gonna bite a little bit. But if it feels like, "Oh, it hurts so good." And then you get off of it, and it feels better, you continue to work it. If it hurts and you stop.
- Especially if it hurts down the leg.
- Yes, exactly. You don't want it to hurt so bad that it makes pain down the leg, that's a bad thing.
- If it recreates the pain.
- Right, exactly.
- So use it gently to start out with and see how it responds. You may spend a minute or two with that.
If you have a foam roller, these can work very nicely as well. They're not as aggressive as the tennis ball. And then you're just gonna work on it here, and back and forth, and work around it, oftentimes works better. And then get onto that tight spot of the piriformis and see if that soft tissue...
If you wanna get even more aggressive and you happen to have a massage gun, they can work well with the round head. There's oftentimes five heads. All of our massage guns have five heads, the round one and you can do it in a seated position, like Bob is working here. If you wanna do it lying on your side with one leg up, like this, that can work as well. It's one of those things that whatever works best for you. Oh, I'm right on it there, Bob. Boy I'd like to get a little more aggressive with (cross-talking).
- So this is the EM-19.
- Oh yeah, that's right.
- And it's only available at select Walmarts. Well like (mumbling).
- Yep. Very good.
And we're gonna go on. We also have another exercise that is even... Actually, I think this next one is really quite the deal. Okay. This is a real nice alternative. Works best, you could do it on your bed, a carpeted floor is probably preferable. Just lie on your stomach like this. Now, if this, the left buttock, is a piriformis that's tight. We're gonna go into this position. Okay. We call it roadkill. Don't ask me why, it's really not important. But this is a position you get into, and you move around in such a way. And if you feel that pain in that piriformis decrease, then you wiggle around or noodle until you find where it's the most-
- Find the right spot.
- Yeah. It's gotta be the most comfortable position you're in. And once you find it, sometimes the knee is up, sometimes it's down a little bit, the pain drops down to like zero or a one. Then you're gonna hit the timer on your cell phone or whatever, 'cause you want to go 90 seconds in a very relaxed position, and without any people bothering you so you can just relax and breathe. At least 90 seconds, up to a minute and up to 120 seconds.
- Up to two minutes.
- It is specific like that. That would be two minutes?
- Yeah, Brad, very good.
- So at that point, you're gonna slowly go back after the 90-120 seconds and you are not gonna get up and run around or do any aggressive activity. You can do a little massage with it, afterwards. Not real aggressive. And then you're just gonna go for a walk.
- And can that be done daily, Brad?
- Yep. And then if you have good results with it you can do it two or three times a day, but what will happen, it will get better every day. And you'll just forget about your piriformis (indistinct).
- It seems simple, but it works.
- Yeah. And you gotta be careful. You gotta be specific as I was mentioning.
So all these options, now, there's one thing, Bob, about piriformis syndrome. We saw that it could be fake sciatica. If you do these, or some of them work but only temporarily, and you go sit down after a little while and they come back, it's probably fake sciatica. You know what I'm saying?
- No.
- Well, you do these for, it goes away for half hour and then you go sit and you're probably slouched.
- Oh, I see it's real sciatica.
- Yeah. Then it... Yeah, that's what I meant. The piriformis was fake but you have sciatica from lower back. In that case, you can try this exercise. Can you just slide over Bob, and do some press up like this?
- We got a whole program on-
- Yeah. Do 10 of those. And if that happens to make it feel better, then you know it's from the back.
- Right, or if it makes it worse.
- We're jumping into the weeds a little bit here but I thought we would go there. So good luck with your piriformis syndrome. Chances are, you're gonna find something that drops it down to zero pain and you'll feel better. And you'll be grateful, Bob. I think they will be grateful.
- Yeah, they will thank you.
- Wow, I'm done. I gotta take a break.
(upbeat music)