Piriformis Syndrome
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| What is the definition of piriformis syndrome? | Piriformis syndrome is the compression of the sciatic nerve by the piriformis muscle.
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| Where does the sciatic nerve originate? | The lumbosacral plexus.
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| Where is the pain of piriformis located? | Pain is down the posterior thigh - referred to by the general public as sciatica.
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| Trace the sciatic nerve. | Exits the lumbosacral plexus through the greater sciatic foramen, between the ischial tuberocity and greater trocater. Follow the adductor magnus and hamstrings. At the popliteal fossa it splits int common peroneal and tibial nerves.
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| Trace the peroneal nerve after it splits from the sciatic nerve. | It splits into superficial and deep. It innervates the tibialis anterior and peroneals.
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| What are the functions of the piriformis? | -rapid or vigourous internal rotator (running).- externally rotate the femur- Horizontally abduct when hip is at 90ยบ- Internal rotate the femur when hip is flexed.
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| What are causes of piriformis? | - anomoly in the course of the nerve- direct or indirect trauma to the piriformis- inflammation- overuse- postural or positional occurances.
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| What is an aha moment for piriformis? | History: (Aha) sits on wallet, nerve sensation or pain down whole leg, sits a lot
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| What is the observation for piriformis? | Lateral rotation of foot, affected hip elevated, hyperlordosis, shoulders forward
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| Do you test gait? If so what do you find? | Atalgic Gait
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| What would you find during your palpation? | Low back, hips, glutes, whole leg. Ischemia, TPs along sacrum, in glutes and piriformis. H/T in quads, QLs if hyperlordosis. Tenderness in glutes.
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| What is the ROM findings? | AF & PR reveal decreased extension, decreased internal rotation, pain in piriformis AR reveals weakness in abduction, flexion and internal rotation
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| What is the treatment focus for piriformis? | Decrease pressure on the sciatic nerve.
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| What is the treatment plan for piriformis? | decrease compression of sciatic nerve. Treat low back, glutes, quads and hamstrings, adhesions and tps. Use heat unless trauma related or sciatic nerve inflammation.
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| What is a good self care stretch for the pirformis? | Using a rope or belt, lay supine and flex the hip and medially rotate to comfort.
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| What is a good test for proving piriformis? | Piriformis length test.
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| Good test for disproving? | Kemps for neurological or facet joint damage.
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