- Hi, I'm Bob Schrupp, physical therapist.
- And I'm Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Brad, today, we're gonna do the top three self-treatments
for piriformis syndrome.
At the end of the video, we're gonna explain a little more
about what piriformis is.
But right now, let's go right into it Brad.
- Piriformis.
- Yep, it's a muscle.
- Okay, it's a muscle, right there.
- The fact that people are on this channel,
I think they know what it is. - Okay, all right.
- All right, what we're gonna do with first is--
you want to--
the three self-treatments are stretching, massage,
and strengthening.
So first, you're gonna wanna stretch it.
So I'm gonna pretend that it's my left side
that bothers me.
So you're gonna sit or lay on a bed.
You're gonna cross over your legs like this,
your ankle is gonna go past the bone here.
So it's comfortable.
And then with this, in this position,
you're gonna pull this knee to the opposite shoulder.
- Sure.
- And you'll feel a stretch here.
- Yeah, right, right here.
That's gonna stretch that out,
and it's probably gonna be a little sore.
It's gonna be tender when you do that.
- Exactly, so just bump into the pain.
Don't go crazy on it.
Don't make the pain so bad
that you're getting symptoms down your legs.
- [Brad] Right, you don't wanna tear it.
- Right, and 30 seconds times three.
Okay, say no more.
All right, if you wanna go a little more advanced,
you can take a belt
or you can actually take your arms and hands
and lift up like this and stretch it a little more.
I actually do that one every morning.
But you can also use a belt to do it.
You pull up like that.
- [Brad] Gives me something to hold on.
Can you see that Lonnie in the, get the, the--
- It's a real pretzel.
This is called the figure four position.
This makes a four, put that over.
Pull up. - [Brad] Right.
- Brad's gonna show a real advanced one though.
- [Brad] Right, and again, three times, 30 seconds.
- Yeah, three times, 30 seconds.
Okay, Mr. (indistinct) and pokey here.
- Yeah, if you're, you know, pretty able bodied and whatnot,
you want a more aggressive stretch,
you get up to a pretty high table about like this.
Yeah, get Amos out of the way there.
We're gonna go (indistinct) and you're gonna take the leg
and cross it like this.
Again, it's another form of the figure four.
And you're just gonna lean forward.
And I, with the other leg, I'm gonna drop down.
And you'll feel it stretch when you get to it.
You may have to move your body around a little bit.
Ah, there it is.
You can feel it stretch.
You're gonna hang out there and relax and breathe,
30 seconds.
And you get up and give it a break.
And you can repeat that three times.
- [Bob] Good, all right.
That's the first thing you're gonna do is the stretching.
Second thing you're gonna do is massage.
A lot of times, Brad, in my opinion,
sometimes that piriformis has a slight tear in it.
And that's why it doesn't heal or it's giving you problems.
It's spazzing up on you.
So, so we'll do some massage.
Brad's gonna show you how to massage.
Do you wanna show where it is first?
- Sure.
Let's look on, what do we, what's his name?
- Napoleon bone-aparte.
- Bone-aparte.
- All right, if you don't mind Brad,
I'll describe where it comes from.
This is your tailbone, basically your sacrum,
and it comes from the front part
of that and it attaches over onto the hip.
So it's a thin little muscle here.
And the reason it becomes a problem is because your spinal,
your sciatic nerve goes right below it
and this can press right on it.
Sometimes the spinal or the sciatic nerve goes
in between it or it actually dissects
or goes right into it.
- Oops, I tore the piriformis.
Okay, so those landmarks is exactly
what I use is to self find it.
So if you're standing there and you do like this
like you're squishing a cigarette out,
then you put your finger right there.
You're gonna find that greater trochanter,
that hip bone right there it sticks out
like a sore thumb when you move your leg.
- [Bob] That's where muscle attaches.
- That's where it attaches.
And the sacrum is that big bony part right below your belt.
And from there to there is where that muscle goes.
I'm gonna go right in the middle
and I'm gonna start digging around in there.
And you're gonna find that tender spot very clearly.
It's not like, well, is this it?
When you get on it, you're gonna, oh boy, that hurts.
And at that point is where you're going to,
well I'm gonna go on this side so the camera can see it.
You can get up on that and you can pull that leg up
and put a little stretch on it and you can work on it here.
Now I usually use something to sit on
either a roller or a ball, but this works too.
- All right, there's a roller.
- Sure, so you get a foam roller.
This is a three inch diameter.
I think the six inch work better for most people.
- [Bob] Yeah it does, yeah.
You could do it on a bed.
- You wanna do it right now on the bed, just so you can see?
- Yeah, I like to do it on the floor.
- [Bob] I would prefer to do it on the floor.
- But because it's easier to film,
you'll see why it's squished, too squishy on a bed,
but for demonstration purposes.
And we're gonna go like this.
And boy-- - [Bob] That's intense.
- Pretty aggressive when you hit that, that tender spot.
And I'm gonna adjust intensity by lifting up with my arms.
And as it gets better, after 20 seconds,
it's starting to feel a little bit better.
That's the green light to get a little more aggressive.
- I would probably start with your own hand first
because it would be.
And you could try a tennis ball too in the same way.
- And that's even more aggressive.
- Yeah, again, these are very aggressive.
A lot of people are not gonna like it
and they don't wanna do it.
I mean, that's fine.
Some people just really like that deep.
- It's probably more for the people who are aggressive.
They're either weightlifters or, you know, running a lot.
The muscles are really toned.
- Yep, all right.
The last thing Brad we're gonna do,
do you mind taking that?
We're gonna strengthen that muscle.
And I think this is very important, Brad.
In fact, I think this is one
of the more important self-treatments that you're gonna do.
So you're gonna lay on your stomach.
You're gonna bring your leg off the edge of the bed.
And you're gonna make sure you don't fall off the bed,
cause that would be disastrous.
You're gonna cross the leg over your knee.
- You're gonna hook that foot, right there.
- Yeah, hook it, exactly.
- Right at the Popliteal Fossa, the back of the knee.
- So what I'm gonna do is bring the leg up like this,
one, two, three, four, five, relax.
One, two, three, four, five.
Well, I don't think my muscle's very strong, Brad.
This really is work.
- [Brad] Oh yeah.
- One, two, three, four, five.
We're gonna do 10 of those.
One, two, three, four, five.
- [Brad] Wow, do we have to do 10 of these?
- Three, four, five, no, I wanted to give them five
so they were ready and quite aware.
Now, so you're gonna do those three treatments,
in addition just a couple things to be aware of.
- Right.
- You don't wanna be sitting with your wallet
in the back pocket, especially Brad's wallet
which is this thick,
you know he is got all that money in there.
- Well, I like to keep other things in there too.
- Oh yeah.
- My keys, 300 credit cards.
- Yeah, that's right.
The other thing is when you're laying at night Brad,
do you mind standing up real quick?
I don't want you to have that on stretched all night long.
So just wanna make sure you have the pillow
between your legs if you're laying on your side.
- Right.
- When you're sitting,
don't be sitting with your knees crossed,
cause that can really put a lot of stress
on the piriformis right now.
- Right.
- And the last thing is if you are a runner,
I would stay running on the flats for a while.
The running on the hills is gonna put a lot of stress on it.
- Right, right.
- So that's, that's really it, Brad.
- Most people are tuned out by now.
They're all doing the stretches and the strengthening.
- But I wanna tell you, you gotta make sure you subscribe
if you haven't subscribed already.
- Well we can say anything we want now.
- Yeah, yeah.
We're gonna help you stay healthy, fit, pain free.
- Right.
- And, and we are not professional actors,
but we are a professional therapists.
- And I didn't even know that.
Thanks a lot.