Dear Tamsin,
below 60deg flexion piriformis is an external rotator and above 60
deg it is an internal rotator. thus technically speaking below
60 deg of flexion you can apply compression down through the
femur to hold the sacrum on the bed (as one other person suggested
needs to happen), adduct the hip and pull the heel laterally which
remember is actually internal rotation. Above 60 flexion you can
do the opposite. In saying this though, I wonder whether in full
flexion it really matters because you would probably be moving
the insertion all that much before you feel a stretch in glut med
(as one of your other answerers elluded to), so are you really
even stretching piriformis? I say this despite using that stretch
myself! Worth thinking about.
Scott Epsley
physiotherapist,Brisbane Australia.
--
On Fri, 29 Oct 1999 12:28:31 Tremmens wrote:
>Hi
>Can anyone help me solve this dilemma?
>I have read lots of conflicting evidence in how to stretch the piriformis
>muscle.
>Here are 2 different stretches one that uses medial rotation and the other
>uses lateral rotation.
>Stretching to RIGHT piriformis
>
>1. Lie on your back. Bend your knees and cross your right leg over so your
>right ankle rests on your left knee. Now, bring your left leg towards your
>chest by bending at the hip. Reach through and grab your left thigh and help
>pull towards your chest.
>
>2. Lie on your back, and flex the right hip and the right knee. Now, while
>grasping the right knee with your left hand, pull the knee towards your left
>shoulder. This flexes and adducts the hip. In this position, grasp above
>the right ankle with the right hand, and rotate the ankle outwards. This
>applies medial rotation.
>
>Theoretically you would think it's the medially rotated one, as piriformis is
>a lateral rotator of the hip. But all my colleagues use the lateral rotation
>one, and I myself have better results when using the lateral rotation stretch.
>
>Does anyone have an explanation for this? Are different structures being
>stretched in lat rot. or is it due to the direction of the fibres??
>
>Thanks
>
>Tamsin Emmens
>Physiotherapist
>London
>
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