CMT IV: Piriformis Syndrome Flashcards
Treatment Goal of Piriformis Syndrome
Decrease Hypertonicity of Piriformis Muscle
Piriformis Syndrome Treatment
1)Resting Position
2) Dry Warming
- Rocking
- Compressions
3) Fascial Work
- Open Palm/Loose Fist (45 degree angle)
4) Joint Mobilization
- Hip Pin and Stretch (ext. rot., fist pin, int. rot.)
- Sacral Compressions
5) Clearing
- Lateral Border of Sacrum
- Greater Trochanter
- Iliac Crest Border
6) Deeper Warming
- Light Effleurage
- Petrissage (loose fist)
- Heavy Effleurage (include low back and hamstrings)
7) Specific Work
- Glut Med, Glut Max
- Piriformis (Frog Leg)
8) Stretch
- Ext. Rot.
9) Close
- Heavy Effleurage
- Petrissage
- Light Petrissage
Piriformis Homework
- Chair Figure 4 w/ Forward Lean
- Sit on Tennis Ball
What is Piriformis Syndrome
An entrapment of the sciatic nerve due to hypertonic piriformis muscle
Actions of Piriformis Muscle
- Eccentric Int. Rot. (during walking)
- Int. Rot (hip flexed >90 degrees)
- Ext. Rot (hip neutral or extended)
- Horiz. ABD (hip flexed 90 degrees/seated)
Function of Sciatic Nerve
Supplies motor and sensory fibers to posterior thigh, leg, and foot
Causes of Piriformis Syndrome
- Overuse
- Postural Issues (valgus knees, hyper-lordosis, ITB contraction
- Trauma
- Arthritic Inflammation to SI/Hip Joint
- Extended Sitting
- Pregnancy
S/S of Piriformis Syndrome
- Ext. Rot. During Walking
- Limping
- Posterior Nerve Pain from Hip to Foot
= Sitting from Sitting or Running
Piriformis Trigger Points Pain Pattern
Posterior Dull and Achy Pain from Hip to Knee
Disc Herniation Test
Straight Leg Rase Test w/ Braggard’s
Location of Piriformis Trigger Points
- Lateral Border of the Sacrum
- 1/3 of the Way from Greater Trochanter
Test for Piriformis Syndrom
PACE ABD Test
Muscle that needs to be sufficiently warmed to treat piriformis
Glute Max
When not to perform deep friction techniques
Client is taking anti inflammatory medication
Piriformis Syndrome Treatment Frequency
1x Week for 4 to 6 Weeks
