Welcome back for the conclusion of the garbage treatment of “Piriformis Syndrome”.
Ever have trouble standing up first thing in the morning? Does it get better after a few steps? Is it hard to get out of the car or chair after sitting too long? Its all about the jelly!
I had left off explaining why “piriformis stretches” in the presence of “true” piriformis problem, makes little sense as to why you would feel better immediately and in the short term. I’m talking as few and 1-10 repetitions of that “stretch”.
I had also just pointed out that there is lumbar flexion doing those exercises.
So here is the little caveat. Some people may experience worsening symptoms doing those “stretches”, and decide that it definitively confirms piriformis syndrome. Let me just explain why for most it will feel better initially and typically get worse the more you do.
So when you round your low back (bending forward, pulling knees towards your chest, sitting) it causes your spine to open in the back. The back part of the spine is where the nerves exit that feed your lower body, and the sciatic nerve is just a continuation of the spinal nerves coming out at different places in your back.
As I stated earlier nearly all sciatica is caused from a disc bulge. If you think of your disc as a jelly filled donut, when you bend or flex your back forward it compresses the front of the donut and the jelly moves out to the back. The more times and more force we use the more jelly moves out. Remember the nerves that feed you lower body are at the back of the spine. The direction the jelly is moving.
This is why you get worse if you a lot of bending, sitting, driving, hamstring and piriformis stretches. The size of the bulge will depend upon your tolerance to those motions. Some can tolerate 1 rep or 1 minute, others can tolerate 30.
OK why does it feel better initially? Well that is because you only have so much space where the nerve comes out of the back, and if you have “jelly” taking up room there is even less space, so when you flex forward (from sitting, stretches, bending), remember it opens the back and closes the front. Essentially you create more room where the nerve comes out and it takes pressure off the nerve, and symptoms get better.
However eventually because of time or repetitions in a forward motion the jelly moves out more and more and takes up more space. So you bend forward more, and more to get relief, and all of a sudden you can’t stand up anymore. What has happened is there is so much “jelly” out the back now it blocks your motion!
Here is the answer to fix it, and it works in about 95% of the cases. You need to move the “jelly” back into the donut. So if bending forwards or sitting moves it out, what do you think moves it in?
Activities such as bending backwards, repeated extension in lying, walking, laying on your stomach, and sitting with “good” posture!
There are a progression of forces, variations in positions that may need to occur, but just starting with those will help.
If you want anymore advice or have any questions please leave a comment, post it on our facebook page or give us a call.
Think Simply. Think Logically