Sitting Piriformis Muscle Stretch
Piriformis Syndrome Diagnostic Test
; Piriformis-Sciatiaic Nerve Anatomy Graphic;
Beginner Splits Stretch; A
dductor Muscles Longus, Brevis, Magnus; iliacus muscles

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DrBackman.com Chiropractic & Massage; lawrence dieter, d.c.
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sitting piriformis muscle stretch pictured.Stretching the Left Piriformis Muscle,  A New Way and the  Traditional Piriformis Muscle Stretch Are Pictured.  
Traditional Supine Piriformis Stretch. Sitting Piriformis Stretch, if you want to find this deep hip muscle in the buttocks: 

1. Sit Up Straight
2. Cross your legs and lean forward. 
(While sitting at a seminar and had crossed my legs in a figure 4 then leaned forward feeling a stretch, looked down to see what appeared to be a new Piriformis stretch.)

To Do A Quick Check To See How Tight Your Hip Muscles / Joints Are, Just Sit Up & Cross Your Legs As In The Picture On The Left. If Your Knee/Lower Leg Is at a Similar Height/Level, This Is Good; The Higher Your Knee, The Tighter Your Hip Joint.  Also Compare Your Left and Right knees As You Relax In This Position.  (The Nice Thing About The Stretch On The Left Is, You Can Be In A Meeting, Cross Your Legs, Lean Into the Conversation and Everybody Assumes That You Are Engrossed, But You Are Just Doing Your Stretches.)   Remember, if there is any pain, BACK OFF or stop.         Hip Mobilization Exercise Here

 

for an in depth discussion of this stretch please read on:


here is dieter's response to julie s.' question on what muscles this stretch actually addresses:
hello julie,
getting back to you on your piriformis question on drbackman.com/it-band-stretch or the rice.edu/~jenky/images/glut.hip.jpg
you sent me, does stretch the piriformis muscle, the tfl-tensor fascia lata or i.t. band and the gluteus max. and some smaller external rotator muscles (internal, external obturator & superior, inferior gemellus).
and after further thought on what i have posted as a piriformis stretch: i would have to say that it is not a primary piriformis stretch, if it gets stretched, it is from the last motion (forward flexion) because the external rotation and abduction will initially approximate the piriformis muscle.

but for sure this "figure 4" stretch causes:
1. external rotation,
2. abduction,
3. flexion of the hip joint.

with this stretch, one will be working on all the internal rotators of the thigh,the adductor muscles longus, brevis, magnus. www.latrobe.edu.au/podiatry/hipjoint.html (maybe a little of the iliacus but not so much the psoas muscle [has its' secondary function as a internal rotator]... because of the flexion of the hip in this stretch),

the muscles of hip extension (of which, the piriformis muscle is listed as a secondary function. www.pt.ntu.edu.tw/hmchai/Kines04/KINlower/Hip.htm#Joint

and all the ligaments surrounding the head/neck of the femur.


julie,
i use this seated stretch as one screen for hip dysfunction and or asymmetry. some, middle age and older and or younger athletes with a history of injury below the waist either cannot sit in a fig. 4 or you will see one knee at a different height ( the higher the knee the tighter the hip joint). the second screen is for the g. medius strength test www.drbackman.com/gluteus-medius-strength-test.htm

i trust that this will clarify what this stretch actually does and does not do.
another very good site with graphics: www.rad.washington.edu/atlas2/piriformis.html
take care,
dieter

Piriformis & Sciatic Nerve Relationship Anatomy Graphic (posterior cut away view of left buttocks)
piriformis muscle - sciatic nerve relationship graphic & link to research.
(This graphic is from Australian research and was traced to this now broken link: www.australia.vh.org/Providers/Textbooks/AnatomicVariants/NervousSystem/Images/70.html)
FOR THE RUNNERS IN THE CROWD: You Can Do the Standing Piriformis Muscle Stretch while Balancing on one leg much like an one legged squat, as shared by dr. steven smith d.c. pasadena, ca


Additional Evaluation of the biomechanics of the Piriformis Muscle stretch by Dr James Mally N.D.

----- Original Message -----
From: "James Mally" <>
To: <drbackman.com>
Sent: Monday, October 23, 2006 10:32 PM
Subject: Piriformis Stretch

Dear Dr. Dieter,

I like the piriformis stretch you show on your website. www.drbackman.com/piriformis-muscle-stretch.htm

I wanted to comment on your explanation of the stretch. I believe it actually does stretch the piriformis because the piriformis does internal rotation of the femur when the hip is flexed. The insertion of the piriformis is high up on the greater trochanter, so it does external rotation from anatomical position, but when the hip is flexed the piriformis becomes an internal rotator. Since the hip is flexed in the stretch, the external rotation is actually helping to stretch the piriformis. Its true that the hip abduction does shorten the piriformis some, but then the further flexion of the hip will help to stretch it.

Muscle actions are taught from anatomical position, but some muscles such as the piriformis can have a very different action when in another position.

I show this stretch at my school and I put a link to your stretches on my links page.

Thanks for creating such a great resource.
Sincerely,
James Mally
--
"The permanent temptation of life is to confuse dreams with reality.
The permanent defeat of life comes when dreams are surrendered to reality."

James Mally, N.D.
Director
Healing Arts Institute
7525 Auburn Blvd. #9
Citrus Heights, CA 95610

1- 800-71 TOUCH (800-718-6824) or 916-725-3999
www.healingartsinstitute.com


The piriformis muscle syndrome: a simple diagnostic maneuver
Original Source

Comment in:
Neurosurgery. 1994 Sep;35(3):545.
1. Journal: Neurosurgery. 1994 Mar;34(3):512-4; discussion 514. Related Articles, Links
The piriformis muscle syndrome: a simple diagnostic maneuver.
Beatty RA.  Department of Neurosurgery, University of Illinois, College of Medicine, Chicago.

Current maneuvers to diagnose the piriformis syndrome are less than ideal. Freiberg's maneuver of forceful internal rotation of the extended thigh elicits buttock pain by stretching the piriformis muscle, and Pace's maneuver elicits pain by having the patient abduct the legs in the seated position, which causes a contraction of the piriformis muscle.
This report describes a maneuver performed by:
1. The patient lying with the painful side up.
2. The painful leg flexed.
3. And the knee resting on the table.
4. (This Test is Positive When) Buttock pain is produced when the patient lifts and holds the knee several inches off the table.

The maneuver produced deep buttock pain in three patients with piriformis syndrome. In 100 consecutive patients with surgically documented herniated lumbar discs, the maneuver often produced lumbar and leg pain but not deep buttock pain. In 27 patients with primary hip abnormalities, pain was often produced in the trochanteric area but not in the buttock. The maneuver described in this report was helpful in diagnosing the piriformis syndrome. It relies on contraction of the muscle, rather than stretching, which the author believes better reproduces the actual syndrome.

Publication Types: Case Reports PMID: 8190228 [PubMed - indexed for MEDLINE]

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