Piriformis SA Static Release

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Transcript

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This is Brent, President of B2C Fitness and on
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this video we're doing our static
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release techniques for our piriformis. Now, your piriformis isn't a muscle that
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everybody's going to need to release. I know a lot of people like to go ahead and
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roll that because it's a fairly easy technique to do, but we need to ensure
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that we go back to our assessment, and this muscle is actually short and
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overactive. Remember if we do flexibility techniques we want to make sure that
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we're lengthening and toning down a muscle that is overactive and short. So,
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if you are doing the overhead squad assessment, really the major sign that
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leads you to believe that the piriformis might be overactive is going to be the knees
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bow out. So, this isn't a totally common thing that we see all the time. For those
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of you guys doing goniometric assessment, the piriformis can restrict
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both internal and external rotation. So, if you've released a couple other
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structures like the TFL, you've done some adductor release, you've done some psoas release,
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and you're still having problems getting getting rotation back to normal it might
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be worth going to the piriformis, releasing and stretching to see if you can
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return normal hip rotation. If somebody complains of SI joint
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discomfort or pain, there's another reason why you might have to do some
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piriformis release before looking at the SI joint dysfunction specifically. I'm
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going to have my friend Leanne come out, help me demonstrate this exercise. First,
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just a little anatomy lesson so we know where we're releasing. Your
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piriformis runs from anterior sacrum, to greater trochanter. So, the sacrum is the
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tailbone, greater trochanter is that big bony thing we feel on the outside of our
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hips, so it creates a little bit of like a horizontal and slightly diagonal band
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across the top of our glute complex. Now, there are other deep rotators of the
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hips, our gemella and obturators, which lie a little bit lower, but we're still going
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to be on the top portion of our glute complex, so when Leanne goes ahead and
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sits down on this foam roll, that's where I want her to focus. So, Leanne, go ahead
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and have a seat here. She's going to go ahead and throw her hands back behind her so
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she's nice and comfortable. If it's this piriformis I want her to do, I'm going to
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go ahead and have her put that in a slightly stretched position by putting
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this ankle and this knee, and then leaning onto her right cheek. So the
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leg that's crossed is the side that you're doing. Now, first things first, I
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want to make sure Leanne is not muscle guarding, she's not tensing up to
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try to protect a very tender spot, so what I might have Leanne do is either
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pull her knee in and then relax, or might have her push her knee out kind of,
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contracting her glute and piriformis and then relax completely. Do you feel a bit more? -Yeah. If
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somebody goes from a contracted position and then relaxes, melts, then they feel a
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lot more, chances are they were contracting a little bit in their
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piriformis and glute complex to try to protect. So we want to make sure she's
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nice and relaxed on the most tender spot. You got the most tender spot?
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Good. Now, contraindication here, if Leanne starts feeling numbness or
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tingling there's a good chance she's on her sciatic nerve. Your sciatic nerve
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runs just underneath your piriformis. We don't want to pinch down on nerves, not that
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I've ever heard of anybody doing damage with a foam roll, but it's going to be
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uncomfortable, it's going to create a sensation that people are not going to
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want to stick with, and we're probably not going to get a good release. So, if by
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chance she starts feeling tingling or numbness, just have her move a little bit. You can
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either have them rock this way, remembering that that piriformis is a horizontal band,
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or just go up and down a little bit.
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Now, if this was so painful that she couldn't relax, I could regress this a
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little bit but just having her stick this leg out, and totally relax. We want to
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stay slightly externally rotated to make sure she stays on that piriformis and
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those deep rotators. Leanne wasn't having a problem with the other way, so we're
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going to go ahead and take her back to that original position. If I wanted to
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progress this a little bit, I could put these muscles more on stretch so that
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there's less bulk in the way of that trigger point by having her stretch, and hold
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her knee up towards her opposite shoulder. Now, release techniques aren't
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anything really all that fancy, it all comes down to putting pressure and
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squishing a muscle between some bone and some hard object. If we want to increase
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the intensity all we have to do is either decrease the surface area of the
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object we're using, or increase force. Since Leanne is using almost all of
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her body weight on the piriformis at this point, if this was not intense
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enough for her, we'd go to a smaller object, at which point I might switch to a softball.
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Now, I will warn you, this isn't quite the normal softball, this isn't a solid
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softball, there's actually a lot of give, this is one of those training
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softballs. I find these work really, really well, and also happen to be very portable
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for those of you who treat in home.
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She's going to do the same technique, she can search for the most tender spot,
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make sure there's no numbness or tingling, she can make sure she's not muscle
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guarding again by either pushing her knee out that way and then relaxing, or
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pulling her knee in and then relaxing. How is it feeling?
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-It's intense. It's intense, alright! Once she's found that spot, it's intense, we know
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she's relaxed, she's just going to hold until she gets a release. That's going to
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take about 30 seconds, all the way up to 2 minutes, so she's going to need to be
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in a nice, comfortable position. If she doesn't get a release, that's okay. It's
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not ideal, but it's okay. Remember that this is a skill that is going to take
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some practice, and it may take several sessions for somebody to learn how to
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do this. Ideally in the end, we want to get people feeling those
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releases so we know those trigger points have been reduced to next to nothing so
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that we get a huge increase in the quality of their movement patterns over
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time. I hope you enjoy this video, hope you enjoy the technique. Thank you