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Pain radiating along the path of the sciatic nerve. Decreased internal rotation of femur.
Use this technique with caution if you client has knee problems! This puts stress on the medial side of the knee.
If the client has knee problems I will use the variation that starts at 1 minute 10 seconds into the video.
Have client prone with knee flexed.
Stroke piriformis with heel of hand going from greater trochanter to sacrum while stretching the piriformis by pulling ankle laterally (internal rotation).
You can also work on the piriformis with the client’s leg abducted so that their knee is off the edge of the table. Press against their knee with your thigh so that their leg doesn’t move. Have the drape tucked under their leg so that they are securely draped, then work with the heels of your hands moving upwards from the gluteal crease to the crest of the ilium then laterally around the crest, working hand over hand.
A variation is to work into the piriformis using your elbow.nside elbow or flat part of your ulna slowly moving proximally up the anterior surface of the forearm. Go lightly over the elbow then work up the upper arm and into the axilla, pressing into the axillary border of the scapula with your elbow. Hold the clients hand with your outside hand to prevent the shoulder from moving superiorally.
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