Awesome info. Thanks so much for posting. I haven't seen a more detailed piriformis treatment video yet (and as somebody with piriformis syndrome causing severe sciatic pain at the moment, I've watched a tonne)!
Happy to help Marci, we work hard on creating a comprehensive, clear and practical lesson for each video. Hope you will check out BrentBrookbush.com for all that we have to offer. Dr. B2
Great 😊 I’m starting my sport massage course and your videos very helpful for my studying… thanks 😊 and all the assessment as a pt grad in Nasm really helpful for refreshment. So many things I learned watching all your videos more power to your yt channel and please keep posting informative stuff specially in manipulation techniques 🙏💪😊
I lay on a mat on my floor and use a small hard rubber ball. I can get it into the really ropey spots and lay on it, relaxed, with knee up, foot on floor, for about 10 seconds. Then move the ball a little and do it again. Feels intense and kind of good. I think it does some good but you have to do it regularly. Sometimes it's good to ice the area afterwards.
I like the new recommendations on scope of practice B2. Far too many personal trainers 'trying out' super aggressive techniques on their clients with irritable & painful symptoms. Not bashing personal trainers, but I know first hand how little is necessary to gain a personal trainer qual.
Hey Karl, I just want everyone to be safe and effective. There is a lot more to know once you start putting your hands on people, and personal trainers are not responsible for this information (nerves, fascial structures, arteries, the response of tissues to compression, abrasion, traction, etc.). We all need to do what we can to help people, without intentionally or unintentionally putting ourselves or our clients in harms way. Dr. B2
He has actually had some imaging done and disk pathology has been ruled out. So his PCP has suggested massage to see if that can alleviate. Thanks for responding!
I need you in my life!!!!!!!After self diagnosing piriformis and IT band issues and doing piriformis stretches and exercise, I am finally able to get a good night of sleep, have less pain and increase my mobility but the glute and hip painand siconfort still there stoping from being the active person i one was, even after many many chiropractor, physical therapist and massage therapist visits, 7 months to be exact after my lumbar back surgery. Where is your office? I really think you can help my to get rid of this pain in the butt for real!
I got my first session today of physiotherapy and the therapist made what you are showing. However, I got severe pain after the session. I do not why??!!!
Hey ClayClayGirl I am sure you have been doing a ton of soft tissue work well. The truth is there are very few standardized protocols when it comes to soft tissue work. I am simply trying to put out videos that explain a simple, effective method that can be supported by evidence. I am by no means saying this is the only right way, just a good way ;-) Dr. B2
+Brent Brookbush completely understand. Let me rephrase: This is the method I prefer and have used with success in the past. Glad to know I'm not the only one doing it this way :)
Hey Brent, a great presentation! Have you ever applied a neurological element to this soft-tissue release with the classic "contract-relax" application to potentially address a neurological facet of this syndrome??
Aloha Brent, I so love your tutorials! I've been a MAT and instructor for 20+ years and your teachings are, bar none, some of the very best. You invite me to see things from very different and interesting perspectives. I do have a question, and perhaps it stems from limited visibility of your technique on the piriformis, but it appears that you are working superior to the piriformis, more in the glute max and medius range. Are you suggesting the piriformis extends to or originates from the very superior portion of the sacrum? Thanks...my question comes from true intention and wanting to sincerely understand. All my best and malama pono...
Hey Leslie, Aloha. Thank you for the kudos, I do hope at some point you will check out all we have to offer at BrentBrookbush.com. As far as the piriformis... yes... it is very high, higher than most individuals think it is. I think if you carefully trace the lateral border of the sacrum (starting at the sacral base), palpate the top of the greater trochanter and draw a line between the two, you will see how high on the posterior hip it is. Please don't take my word for it... grab an anatomy book (or better yet, a cadaver dissection photo), and trace the landmarks on a partner while looking at the image. Dr. B2
Hi. I have been suffering from immense pain in my left hip/buttox for 3 and a half years. The pain travels down my left leg and I have reduced strength in it and often suffer from pins and needles in the foot. The pain started about a week after I gave birth. I have had many scans and 2 MRI's and although that showed partial scoliois of the lower spine as well as a fued spinal bone, it showed nothing of importance in that hip, so my back specialist said that she thinks it is piriformis muscle pinching my nerve. Do you think she could be right? The pain is so bad that I can hardly walk now on the left leg, and I am in constant pain in the hip/buttox area. A friend of mine recently performed a deep tissue massage in the left buttox and there was a spot where I couldnt handle being touched hard there. Everything i am now resarching leads to the pinching of the nerve by the piriformis muscle, but wanted to get some feedback. Ifso, can I be cured of this, ie the nerve being unpinched? The constant pain is severely getting to me, and I cannot live like this anymore! I cry every day in agony, and my quality of life is diminished by it. I even have dreams about me asking surgeons to amputate my leg so I dont feel the pain any more :'(
Also, when I perform simple stretching exercises, I can barely make the slightest of movements due to pain and lack of strength, and if i lay down on my back with my knees bent and slowly move them from side to side, I get a crunching feeling and noise from my lower spine (With immense pain)
Kimmi, You need to find a new doctor. This sounds like either nerve root irritation, piriformis syndrome, or SIJ instability causing sciatica. This is a very treatable condition that usually resolves with one or all of physical therapy, anti-inflamatories and/or injections. The fact that no one has recommended any of these to you makes me think that your physician is not being particularly attentive. Start with a new physician, get in to see a physical therapist and let's see if things don't start trending in the right direction. Dr. B2
I have the same problem for 4 years now. It hurts a lot with the cold. I noticed the it helps by doing weight and going to the gym but it only relieves the pain for a couple of days and then the pain comes back. 😢. It all started after a car accident.
Piriformis syndrome, or at least a nerve irritation is one possible issue that could be contributing to your pain, but I would need to see you in person to assess. Complex, chronic issues like yours, that are causing some level of disability is not something I am real comfortable giving advise for via a comment box on RU-vid. If you live in NYC maybe we should make an appointment, if you do not live in NYC I would recommend finding a really good PT in your area. Dr. B2
This is good but the problem is that the attachment of the piriformis on the sacrum is very anterior,making it inaccessible and difficult to palpate from a posterior angle
Hi Brent, I had a Chiropractor do this for me, he was pressing so hard that I was sore for a week after! And now the pain in my legs has intensified and actually hurts so much it even keeps me up at night. Do you think maybe he did something wrong? This pain is horrible! The pain runs all the way down my leg to my ankle. I'm not sure how to get rid of the pain. Is stretching exercises the only way to control it? Thank You (:
Hey Vivi, I would say that if that Chiro did the technique again given your reaction the 1st time, they are doing something wrong. However, based of a single session it is hard for me to tell or critique another professional. Stretching is probably not a good idea, as it sounds like you are complaining of nerve pain. I would consider seeing another professional, perhaps a physical therapist or orthopedic physician. Dr. B2
How are you now? Did it get better?Did you find out what was going on and why the nerve became more inflamed after the treatment? That sounded scary.I hope you figured it out and found a solution and relief from pain.Let us know♡
black on black background doesn’t show your movement, client should wear a white pant or legging for demonstration, good work 👍 thank you for sharing🙏🙏🙏
Good video.. I've been suffering from piriformis syndrome from 4 months till this day it's strict my activities as a physiotherapist I tried alot of home stretching exercises for about month and I'm started to see a little progression but pain mostly come back again once I'm getting back to my workout schedule which is including" kickboxing boxing workout & jumping rope"..I wonder how long it's gonna take to relive again.cuz all I can do now just Stretching exercises at home?? And sth else if there's any possibility for it to return over again after a while?.. thanks alot appreciate ur efforts in this channel ..
well i think its a very good technique. what is your opinion on putting the patient on a side position neutral spine.... and internal rotation of the hip a bit...? i found that position very effective thanks a lot for this video.
I think it is important to keep in mind that once you know the basics (where to palpate, how to "pin" the tender point, good body mechanics, etc), you can use a variety of body positions. The technique you are describing, I have never tried, but it seems reasonable.
Sure... you do not have to flex the knee, or internally rotate the leg for that matter. It's more important that you do the technique well and get the results you can. This goes for all manual techniques, don't let "perfect be the enemy of the good". Dr. B2
Hey. "Assymetrical weight shift"... just to be sure, when piriformis is tight, that hip tends to be forward than the other? To have less weight than the other as well? Thanks
I have not found it helpful to think in those terms.. During an Overhead Squat Assessment in the posterior view, which way does the person shift. If the hip is relatively more elevated (hip hike) that may also be considered the side they shift too. It's not that it is "wrong" to notice the things you have noticed, but I find them to be less consistent and direct when it comes to implying a set of corrective interventions. Hope that makes sense, Dr. B2
Got it, master. Thanks! :) But in the case of hip hike, you would approach the QL first rather than the piriformis, right? Is there any direct relationship between the QL and Piriformis?
Not necessarily, It is just as likely that the hip is causing the "hip hike" as a muscle of the lumbar spine. The only direct link that I know of between the piriformis and QL is that they both cross the sacroiliac joint. Dr. B2
Hey PearlCrystal, We are an education platform for professionals in rehab, fitness and sports performance. This was not intended to be a coaching site for individuals. Dr. B2
@@pearlcrystal7802 No problem, it happens all the time. I would love to create an online physical therapy coaching product for the layman at some point... but that really would be a very different business, and it would deserve my full effort. Right now, our education company for professionals is more than enough ;-) Dr. B2
Recently got diagnosed with pitiformos syndrome. Haven’t been able to walk more than half way around the block recently and have been having chronic pain for over 8 months. Had to quit my job. I’ve seen different chiropractors but always have more pain after the adjustments. Would so appreciate some advice/help! Thanks
I am interested to see if this will help a client of mine coming in for sciatic pain. I have a feeling he has some trigger points in his piraformis. I have been looking for something different than I was taught in school (I am an LMT) Thanks for posting.
Always start with assessment, ensure that you have a hypothesis for why the piriformis may be involved. Although, it is often the case that the piriformis is over-active and impinging on the sciatic nerve as it exits between the piriformis and gemellus superior, it is not always the case. You may also need to refer out to a physical therapist... sciatica is not always a soft tissue issue. Dr. B2
What do you mean "uncomfortable"? Would you have preferred that I told the client I felt "an abnormal amount of tissue density and hypertonic fascicles"? I appreciate where you are coming from, but you also have to consider that communication is the science of speaking to your audience in a way that they will understand. Using the term "jacked up" with a former sprinter, former cross-fitter, certified personal trainer, athletic woman who loves to lift is hardly inappropriate. Dr. B2
Really? If that was what you took away from the video, was that Dr. B. said "Jacked up" then you are not much of a "Fitness Professional" lol. As an LMT I speak my clients language and then educate them so the will be able to speak mine when and if I need to refer them out to another professional.