hey in this video i'm going to show you the top three self treatments that you can do
at home to treat your piriformis syndrome my name is dr david middoff and i'm a specialist
physical therapist at el paso manual physical therapy and this channel is dedicated to helping
people stay healthy active and mobile while avoiding unnecessary surgery injections and
pain medications please consider subscribing to this channel so that you don't miss out
on any of the helpful videos we post every week hey before we get into the treatment
i'm going to show you three things that really help to calm down the piriformis i just want
to let you know that i made another video that goes deep into why piriformis syndrome
happens what the causes are and how it's really a secondary problem more like a sign and symptom
of some deeper problem that video is a link in the description below it's called piriformis
syndrome everything that you need to know about it to get better go check that video
out if you want to learn the details behind piriformis syndrome so now that that's out
of the way let me show you what to do on the table here so that you can get some relief
from the piriformis syndrome right now the first thing you want to start out with is
a massage of some sort chances are if you've got piriformis syndrome you've got a tight
little muscle back there that piriformis muscle runs from the tailbone area out to the side
of the hip so it spans this distance between my fingers right there so right in the glute
that's where you need to massage that muscle and you can do this a few different ways the
easiest way to do it is to just use your fingers and get back in there you can use your knuckles
as well but i recommend starting out with your fingers and it would look simply just
like this you just reach in and feel around in the muscle and find where it's stiffest
and then you just gently dig in so i'm just kind of doing this kind of motion i am wiggling
my fingers kind of combing them in just a bit just like this as i'm moving my whole
arm almost like you're scratching yourself but you're digging in the tissue to move the
tissue just like this i'm moving my skin but i'm not sliding my hand over my skin i'm grabbing
the skin and moving the tissues under it just in that spot once you find a deep muscle that's
kind of a hard and tender then you would gently want to just work your way all the way through
it now if you're having trouble getting in there with your fingers you want to use a
tool i've got a few things that i can show you here so i like using these massage balls
and i've linked these in the description below in case you want to get some we've got this
pokey one in here not going to use that one right now i'm going to use this black one
now this is a pretty stiff ball and just to show you what else is in here these are two
that are connected together you could use this but i i prefer this because you can get
a lot more mobility um and motion out of this the way that you would use this to massage
your piriformis and you just have to be careful because um you you're going to put a lot of
body pressure on this potentially and it can be painful when you massage a piriformis you
don't want to be aggressive to give you a number rating system just so that you know
what intensity to use on a scale of zero to ten zero meaning it doesn't feel like anything's
happening at all and 10 meaning i'm about to cry because it's so painful you want to
be at like a two or a three you don't need to be very intense at all and if you just
give it its due diligence a couple of minutes is all you need at a two or three intensity
that muscle will start to melt down and it'll free up it won't be so hard and it'll give
you some relief so what you would do is sit on this thing so let's say it's my right side
affecting me i would just put that on my chair you could get on the floor if you wanted to
and you need some hand support so this does take some strength and you just get over it
and find the spot that's a little tender and then you just rub your bottom over that area
just remember not to be too aggressive so let me just show you from this angle here
there's the ball and i'm just putting my bottom on it right where the piriformis is and you
don't have to be a hundred percent certain that you're on the piriformis it's unless
you're in the medical field and even if you are in the medical field it's still kind of
hard to tell that you're on the right spot just find a tender spot and rub on it i need
to warn you though the piriformis is right by the sciatic nerve so if you're rubbing
this ball back there and you feel something shooting down your leg or up into your back
you're probably rubbing the nerve and that's not a good idea you're going too aggressively
and you need to back off a little bit even if you think you're at a two or three out
of ten like i said back down to a one and if you're still getting that shooting down
the leg down the back of your thigh back of the knee maybe all the way down into your
ankle or foot then this may not be for you right now you might have some sciatica that's
flaring up and this is going to potentially make it worse so this treatment right now
that i'm talking about is just for a flared up piriformis muscle now another option that
you have aside from one of these balls is a percussion massage gun let me show you mine
here
i got the to loco one here this has been my my favorite one currently and i've got it
linked in the description below if you want to get one of these you can find it on amazon
i think they only offer these on amazon i love this one for the power the weights all
the features of it i've got a review video about it you can go check it out if you want
um but you would power this thing on and i just have the ball the the softer ball it's
got a bunch of other ones i'll show you how to use that here in a second but i would just
put that right where you feel that tender muscle and go to town and again zero to ten
scale just stick at about a two or three you don't need to be very aggressive at all and
just hang out there in those spots if you have that sciatic nerve problem the pain going
down the leg then you don't want to be doing this again because vibration is known to aggravate
nerve problems so you want to be gentle and just be monitoring that nothing else is happening
besides the muscle freeing up and you would do this for just a minute or two whether you're
using the gun this percussion massage gun or you're going to be using the um massage
ball or massaging with your own hand usually about a minute or two is enough now because
there's a lot of muscle back there you might use the adapter that's more pinpointed and
this one comes with two different ones this one's more like a thumb shape so it's kind
of like your thumb going back like that and this one's more like you know just without
the the curvature on it i i found both of them to be about the same turn it on
In this video, I'm going to show you the top three self-treatments that you can do at home
to treat your piriformis syndrome. My name is Dr. David Middaugh Finn, I'm a specialist
physical therapist at El Paso manual physical therapy. And this channel is dedicated to
helping people stay healthy, active and mobile, while avoiding unnecessary surgery, injections
and pain medications. Please consider subscribing to this channel so that you don't miss out
on any of the helpful videos we post every week.
Hey, before we get into the treatments, I'm going to show you three things that really
helped to calm down that piriformis I just want to let you know that I made another video
that goes deep into why piriformis syndrome happens, what the causes are and how it's
really a secondary problem more like a sign and symptom of some deeper problem.
That videos linked in the description below. It's called piriformis syndrome, everything
that you need to know about it to get better, go check that video out if you want to learn
the details behind piriformis syndrome. So now that that's out of the way, let me
show you what to do on the table here so that you can get some relief from the piriformis
syndrome right now, the first thing you want to start out with is a massage of some sorts,
chances are if you've got piriformis syndrome, you've got a tight little muscle back there,
that piriformis muscle runs from the tailbone area out to the side of the hip.
So it spans this distance from between my fingers right there. So right in the glute,
that's where you need to massage that muscle. And you can do this a few different ways,
the easiest way to do it is to just use your fingers and get back in there can use your
knuckles as well. But I recommend starting out with your fingers. And it would look simply
just like this, you just reach in and feel around in the muscle and find where it's stiffest
and then you just gently dig in. So I'm just kind of doing this kind of motion,
I am wiggling my fingers, kind of combing them in just a bit just like this. As I'm
moving my whole arm, almost like you're scratching yourself, but you're digging in the tissue.
To move the tissue just like this, I'm moving my skin. But I'm not sliding my hand over
my skin, I'm grabbing the skin and moving the tissues under it just in that spot.
Once you find a deep muscle that's kind of hard and tender, then you would gently want
to just work your way all the way through it. Now, if you're having trouble getting
in there with your fingers, you want to use a tool, I've got a few things that I can show
you here. So I like using these massage balls. And I've linked these in the description below
in case you want to get some we got this pokey one in here, not going to use that one right
now I'm going to use this black one. Now this is a pretty stiff ball. And just
to show you what else is in here, these are two that are connected together. We you could
use this, but I prefer this because you can get a lot more mobility, emotion out of this,
the way that you would use this to massage your piriformis. And you just have to be careful
because you're going to put a lot of body pressure on this potentially in it can be
painful, when you massage your piriformis. You don't want to be aggressive to give you
a number rating system just so that you know what intensity to use, on a scale of zero
to 10 zero, meaning it doesn't feel like anything's happening at all, and 10. Meaning I'm about
to cry, because it's so painful, you want to be at like a two or three, you don't need
to be very intense at all, if you just give it its due diligence, a couple of minutes
is all you need at a two or three intensity, that muscles start to melt down and it'll
free up it won't be so hard. And to give you some relief.
So what you would do is sit on this thing. So let's say it's my right side affecting
me, I would just put that on my chair, you could get on the floor if you wanted to. And
you need some hand supports, this does take some strength, and you just get over it and
find the spot that's a little tender. And then you just rub your bottom over that area,
just remember not to be too aggressive. So let me just show you.
From this angle here. There's the ball. And I'm just putting my bottom on it right where
the piriformis is. And you don't have to be 100% certain that you're on the piriformis.
It's unless you're in the medical field. And even if you are in the medical field, it's
still kind of hard to tell that you're on the right spot. Just find a tender spot and
rub on it. I need to warn you though, the piriformis is right by the sciatic nerve.
So if you're rubbing this ball back there and you feel something shooting down your
leg or up into your back, you're probably rubbing the nerve and that's not a good idea
you're going to aggressively and you need to back off a little bit. Even if you think
you're at a two or three out of 10. Like I said, back down to a one. And if you're still
getting that shooting down the leg down the back of your thigh back of the knee, maybe
all the way down into your ankle or foot then this may not be for you right now.
You might have some sciatica that's flaring up and this is going to potentially make it
worse. So this treatment right now that I'm talking about is just for flared up piriformis
muscle. And another option that you have aside from one of these balls is a percussion massage
gun. Let me show you mine here. I got the two local one here, this is been
my my favorite one currently, I've got it linked in the description below if you want
to get one of these, you can find it on Amazon, I think they only offer these on Amazon I
love this one for the power the weights, all the features of it, I've got a review video
about it, you can go check it out if you want. But you would power this thing on.
And I just had the ball the softer ball, it's got a bunch of other ones, I'll show you how
to use that here in a second. But I would just put that, right where you feel that Tinder
muscle and go to town. And again, zero to 10 scale to stick at about a two or three,
you don't need to be very aggressive at all. And just hanging out there in those spots.
If you have that sciatic nerve problem, the pain going down the leg, then you don't want
to be doing this again, because vibration is known to aggravate nerve problems.
So you want to be gentle and just be monitoring that nothing else is happening besides the
muscle freeing up. And you would do this for just a minute or two, whether using the gun,
this percussion massage gun, or you're going to be using the massage ball or massaging
with your own hand. Usually about a minute or two is enough. Now because there's a lot
of muscle back there, you might use the adapter that's more pinpointed. And this one comes
with two different ones. This one's more like a thumb shape. So it's
kind of like your thumb going back like that. And this one's more like, you know, just without
the curvature on it, I found both of them to be about the same, turn it on.
But just to show you what that looks like. So there's the pinpointed adapter, turn it
on. And again, be gentle with this. And just want to put it right on that spot. And this
one does just dig in a bit more specific to the muscle. And it's because the piriformis
muscles kind of small, this targets it a bit better in my opinion.
Now after you freed up the piriformis muscle for a couple of minutes, you can go longer
if you want but usually get diminishing returns after a couple of minutes. Next, you want
to go into a stretch. Now when I say a stretch, I don't recommend stretches very often at
all to any of my clients or anywhere on this channel, you could dig high and low there's
probably just a few times I've mentioned stretching to be a good thing.
But the way that I'm going to show you this stretch is a very strategic piriformis stretch.
So pay close attention and make sure that you're doing this right so that you don't
aggravate your piriformis problem as well as something else like a sciatica problem
for this piriformis stretch, you're going to have to lie down in your back, I'm just
going to put away my massage going in here. And I'll lie down on the table so you can
see what I'm doing. Now, a common piriformis stretch is like this,
where you cross your leg over on your back this foot this legs bent foot flat, and then
you put your ankle on your other knee. And when you push down like this, it can provide
a stretch here, you can pull across this way, we're going to focus on stretching the piriformis
muscles. So that means I'm going to have to move my
knee across this way. But I'm going to do it very carefully. Because just pinning my
ankle down right here, it already gives me a lot of leverage. So I'm going to just put
my hands right here and gently pull it over across my body. This is passive. So in other
words, I'm not using any muscles in my leg here, I'm just controlling the motion with
my hands. And once you get to about a two or three intensity
of stretch, so zero to 10, same scale that we use before, once you get to a two or three.
So for me about right there, then what you're going to do very, very lightly, is push your
knee into your hands. So as if I'm pushing that way, and you're going to hold it for
10 seconds, so stretch gets about a two or three.
Now I'm going to push my knees in my hand, and it shouldn't be aggressive, it should
be pretty light, what you want to feel is just this muscle back here engage very lightly.
And then after about 10 seconds or so let it go. And see if we can go any further. Still
staying in about a two or three on that on that zero to 10 scale. And if you get a little
bit more stretch Graham stays the same, that's fine, too.
You're not shooting for more motion necessarily. You're trying to get this muscle to relax.
That's the goal. So make sure that you're not that's why I don't like to call this a
stretch even because you're not trying to gain more motion that that's not the point
here. The point is to calm down your piriformis. So after you stretch a little bit more, you
can hang out there for about 2030 seconds and then you're going to repeat that process
three times. You're going to push that knee out against
your hands. You're trying to resist and not let it move but if it moves a bit, that's
okay. Hold it for about 10 seconds. Make sure the muscle back here is gently activating
not aggravating anything. And after 10 seconds, let it go and see if you can go any further.
If you can't, that's okay, if you can go a little further, no intense stretching, and
no intense muscle activation. I'm going to do one more time. When I push my knee outwards
here, get this to work. This is called the muscle energy technique.
By the way, if you look it up in, you know, for medical purposes, medical terms, after
you contract here for about 10 seconds and let it go. And you can stretch one more final
time, before you relax, that should allow that muscle to give up some freedom to stop
spasming. And the best way, in my opinion, to use that strategic stretch or that muscle
energy technique is to go back and forth with your massage. So the first treatment thing
that I said, you know, getting in there with your fingers massaging or using the ball or
the massage gun, if you go through the massage for just a couple of minutes, get that muscle
to soften up of it, then come back and do this stretch of this muscle energy technique.
And you can repeat that process until you've calmed down your piriformis muscle as much
as it's going to come down right now. Then you can repeat the same thing later on in
the day in a few hours, or tomorrow. And you should be able to continue doing this for
as long as it takes usually a few days to get your piriformis to calm down.
Now once you feel like it's calmed down enough for you to use the muscle a bit more aggressively,
then you would go into this next third treatment option that I'm going to give you and it's
a glute activation, you want to begin to fire your glute muscles because the piriformis
is technically one of the glute muscles, but there's a bunch of other glute muscles in
there. And piriformis should not be the main one firing, there's bigger muscles that are
way more important to fire. So what we're trying to do next is get them
all to fire appropriately without the piriformis dominating and wanting to spasm again. So
to do this exercise, you're going to lay down on your back again, similar to how you were
a second ago. And then you're going to pull your knee towards your chest, you might get
a little stretch in there, that's okay, that's not the point or anything related to it.
Then what you're going to do to get your glute to activate, you're going to do a 10 second
hold, you're going to push your knee away from your body, but you're going to resist
with your hands. So keep your hands here, you might just bend your elbows a bit to pull
your knee in, then you're pushing your knee away.
And on a scale of zero to 10 intensity two or three again, doesn't need to be very active
at all, what you should feel is the glutes tightening up lightly, nothing aggressive,
it should just engage a bit in there and the glutes, hold it for 10 seconds and you can
relax, let your leg fall in the direction that it wants to go. Just keep your hands
there so that you'd like doesn't flop down and repeat this three times.
So I'm going to do two more times here, I'm going to get my flute going. And I feel the
the muscle there engage lightly two or three intensity. And after about 10 seconds or so
relax again. And you shouldn't feel anything spasming. It shouldn't hurt your piriformis
it should just feel like the muscle worked a bit and then once you relax like it, it
relax and gave up. So one more time when a pull my knee up just a bit and push my knee
away activating my glutes. Hold it for about 10 seconds or so.
And your other group might want to activate too. So I'm using my right leg right here.
My left glute is tightening up too. That's fine. That's okay. After 10 seconds, relax,
and you're good. Now you've activated your glute muscles all together the way they're
supposed to fire without your piriformis dominating. Now these three exercises are just meant to
give you some short-term relief from your piriformis syndrome.
To get long term relief from piriformis syndrome, there's usually a deeper root problem that
needs to be addressed. Usually, a sciatica problem or an SI joint the sacroiliac joint
problem. I go into detail on SI joint problems and sciatica problems on other videos on our
channel. So I want to just point your attention to the videos in the description below.
We've got some links that are links to playlists for SI joint problems and sciatica problems.
So go check those out. If you think you have more of a sciatica problem or an SI joint
problem, you'll be able to get more specific help to get the long-term relief because your
piriformis syndrome is usually just a symptom of one of those other problems.
Hey, if you thought this video was helpful for you, please give us a thumbs up share
this with somebody that you think needs this somebody who's suffering from piriformis syndrome.
It needs some relief, some natural relief, and I hope to see you in the next video. Bye
friends