Winning Hands Massage
Piriformis Syndrome – Runners Hip
Piriformis Syndrome is a frequent culprit in causing sciatic nerve pain
(discussed in more detail under Sciatica). Since a contracted muscle is
involved, I generally treat using OIDE. The difference is that in addition
to working the actual origin-insertion points of the Piriformis itself, I
also check, and treat if necessary, the Gluteal origin points along the
iliac spine. Assessment is simple palpation for tender points. The reason I
check the Gluteal muscles is that I am finding that contracted Glutes can
apply their own pressure onto the Piriformis and through it, to the Sciatic
nerve.
Condition where the piriformis is chronically contracted
After use is tender to palpation
May involve sciatic nerve due to
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Underdeveloped piriformis
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Under-exercised piriformis
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Under-stretched piriformis
Piriformis contracts when heel touches the ground and helps with
lift-off during running and walking
When contracted, does not allow internal rotation of femur, changing
the gait (main action is external rotation)
Factors that increase the stress
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Impact force on hip, knees, and ankles from running is up to four
times the impact from walking and the entire weight is on one leg
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Hard surfaces increase the impact
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Changes of surface increase the stress
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Lax of flexibility – stresses not evenly distributed
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Incorrect stride is made worse
Signs and symptoms
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Local pain with possible radiation to the leg if sciatic nerve is
involved; pain increases with activity
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Tender to palpation
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Muscle tension (hip, low back, thighs)
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Changes in posture and gait
Onset – trauma, gradual
Treatment goals
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Decrease tension and contracture of piriformis
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Decrease pain
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Free up sciatic nerve
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Change posture and gait
Important: stretch before and after activities
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