Tip:
Highlight text to annotate it
X
I want us to take a couple of minutes talking about an exercise that is frequently done
in the gym setting, and often, unfortunately, done in the physical therapy setting that
would be very difficult on a back patient who's having acute or subacute pain, and that
is the piriformis muscle stretching. The piriformis muscle is a small, pear-shaped muscle in our
buttock, and it helps with the stability of our hip. Unfortunately, due to its location
and where it's innervated from, the nerve roots in your lumbar and sacrum, the muscle
is often in spasm and often aching during an acute or subacute injury.
OK, so you're going to bend your knees. Alright. We're going to fold one leg over the other,
and we're going to draw this up towards the chest. Now, I think a lot of people are familiar
with this kind of a stretch and usually in this position, in this case on the left hip
and buttock, there should be a stretch feeling. If we were to switch and do the other side
we would feel it on the other side as well. Alright.
So, it looks like a very safe stretch, and usually patients will describe it as feeling
really good in their hip or buttock area. But, unfortunately, the spine is placed in
a very provocative position where it's being flexed up, often stimulating the stresses
that are bringing the patient into the clinic in the first place due to too much sitting,
or bending, or carrying and lifting. So, although they're being reinforced by the stretch feeling
in the buttock, unfortunately they're actually putting the spine in a flex posture and potentially
harming the injury.
Again, during the moment it feels pretty good, but later on into the next day it's often
felt worse in the back or in that area. The patient will constantly stretch it, and stretch
it, and stretch it three, four, or five times per day and really not make a dent in their
symptoms. That's why, because they're putting the spine in the wrong position despite the
positive enforcement on the tissue.
So that is the piriformis muscle stretch.