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Piriformis Self-administered Dynamic Release a.k.a. Pin & Stretch

Piriformis Self-administered Dynamic Release, also known as Pin & Stretch, is a form of active release therapy designed to release the tight muscles of the buttocks, hip and low back. This technique involves pinching and stretching the piriformis muscle and its surrounding soft tissue, restoring functional muscle length and improving mobility and range of motion in the hip and low back. The procedure is easy to perform: simply apply pressure with your fingers to the area of restriction and then gently move and

Transcript

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This is Brent of the Brookbush Instititue and in this video we're bringing you advanced
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self-administered release techniques. In this particular video, we're going to go
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over piriformis dynamic release, or pin and stretch technique. Now, the piriformis
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created a little bit of a logistics problem for self-administered dynamic
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release. Two reasons. Number one, it's a fairly thin band-like muscle and it's
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deep to the gluteus maximus, which is a fairly thick muscle, so I had to find
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something that was going to have a small enough surface area so that I can get
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the pressure per square inch to get deep to the glute max while still maintaining
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my perpendicular width, so that I could block the adhesive tissue as I pull
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the muscle fibers through. That's when I happened to come across these massage
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therapy balls from Trigger Point. This is a 5 inch multi-density foam ball. They
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work quite well. I will warn you guys, once again, these dynamic release, or pin
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and stretch techniques are a progression from static release techniques. One of
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the reasons being is for this particular video, this is not nice.
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This is going to be fairly firm and cause a fairly large amount of
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discomfort. I wouldn't start with this. I would want to progress up to this if
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somebody's already started to desensitize and started to release some
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of those very active trigger points that they started with. I'm going to have my friend,
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Melissa, come out. She's going to help me demonstrate this technique. Now, your
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piriformis, once again, is a horizontal band of tissue that goes from
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tailbone to greater trochanter. So this is like a horizontal line across the top
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of your backside, but it's deep to your glutes.
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So, you're going to go ahead and sit on that foam ball. We're going to start on her
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right cheek. Notice that she's down on her elbows so that she's a little bit more
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stable.
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And then we're going to take this leg and we're going to have her put her
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ankle up on her knee. Now, what that does is it lengthens the glute max, so that if
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that muscle's lengthened, it's also a little bit thinner. It also gets me ready to put
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my piriformis on stretch.
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Now, I'm going to have you find the most tender spot horizontally across the top
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of your backside. She can go from from her tailbone all the way out almost to
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the side of her hip, just posterior to her greater trochanter. Got it?
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Alright, so once she finds that most tender spot, just like all of our other
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dynamic release or pin and stretch techniques, I'm going to have her go just
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distal to that spot. This means just closer to the greater trochanter so that
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she just rolls to the lateral side of that adhesion. You there?
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You're now going to take this hand and you're going to grab this knee.
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How you feeling? And she's going to pull with her arm, get a good
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stretch on that piriformis, hold for 2 to 5 seconds, and relax.
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Make sure she's still got the spot, she's still got the adhesion. Once again, pull
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through. So all we're doing, guys, is using that massage ball to block the
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adhesive tissue as she then stretches her piriformis and pulls the muscle
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fibers through that adhesive tissue, hopefully increasing our functional
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extensibility.
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She's going to do ten to fifteen reps. As you can see, you guys, this is, once again,
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not nice.
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This is going to cause a fair amount of discomfort, so you need to start with
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those static release techniques using something like a Trigger Point Roll, or a
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softer medicine ball. Make sure that you tone down some of those active trigger
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points, desensitize the area a little bit first, and then you can work on some more
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of these fascially based techniques increasing functional extensibility. I
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might have somebody on a foam roll for four to six weeks before I even
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introduce this technique. You ready for the other side?
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Good. Of course, after I did this technique, I would want to see some sort
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of improvement in my movement patterns. To give you guys an idea, if I was doing
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an overhead squat assessment, I might release the piraformis if I saw
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somebody who had knees bow out. If I was doing goniometric assessment, I can
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actually make a good argument for a decrease in internal rotation or
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decrease in external rotation in goniometry, so I would want to retest those. I
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make sure that if I'm going to subject my client or patient to this technique,
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which is a little uncomfortable, that I am getting good results from it. I hope
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you guys enjoy using the new massage therapy balls. I think you guys will find they're
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wonderful for all sorts of techniques. I hope you find good results from dynamic,
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or pin and stretch technique for the piriformis. I look forward to hearing