Piriformis Massage – How To Apply Deep Tissue Massage for Piriformis Muscle

Piriformis Massage – How To Apply Deep Tissue Massage for Piriformis Muscle


Rick Merriam: 00:07 So we’re going to palpate the piriformis. And the first thing we’re going to do is find
the top of the crest of the ilium. So the superior aspect of the crest. I’m going to work my way around until I get to the psis. So for her, the psis is right here, and that’s
where I’m going to start my palpation. The piriformis muscle is attaching to the
anterior surface of the sacrum. So being that that’s the case, I can’t actually palpate those attachments. So I’m going to do the next best thing, and address the sacrotuberous ligament that the piriformis attaches to. Rick Merriam: 00:56 So another way to say that is, the piriformis is deep
to the sacrotuberous ligament. So if I use that lateral edge of the sacrum
as a guide, I can compress the sacrotuberous ligament until I feel some resistance…for
lack of a better term. And then, I’m going to move my thumb, in
this case, back and forth and side to side. Okay…so I’m actually compressing the sacrotuberous ligament with the goal of palpating the piriformis muscle. As best I can, I’m addressing the piriformis as it comes off the anterior surface of the sacrum. So again, I’m going to use that lateral sacrum or the lateral edge of that sacrum as a guide. And you can see how my fingers or my thumb is angled. I’m trying to angle in this direction rather
than being straight down, which you might actually see me do too. Right now I’m actually applying force on an angle. Okay, so again, compressing…it might be
hard to see on the camera, but I’m moving my thumb back and forth and side to side. This is referred to as transverse friction. You might also see it as a circular friction…if I was using more of a circular pattern. And of course, this tends to be something
you would see in the realm of sports massage. Okay. So as I’ve been working through here, I’ve
been kind of zooming in or getting more specific. Rick Merriam: 03:07 And again, feeling for
the lateral sacrum and using that lateral sacrum as a guide. I’m trying to get as close to the sacrum as
I can to try an pick up as many of those attachments as I can. Rick Merriam: 03:25 So from here, I’m going to jump over to here because I just covered all of that territory. Rick Merriam: 03:33 By the way, that was most of the width of the piriformis as it comes off of the sacrum. Just to give you an idea, the widest portion of the piriformis goes from here to that psis. That’s about the width of the piriformis as
it comes off the sacrum. But due to the sacrotuberous ligament, I’m going to continue to follow that lateral edge of the sacrum. Because the piriformis is actually attaching to the sacrotuberous ligament. Okay, so from here I’m going to jump back
down a little bit more. Rick Merriam: 04:28 Again, finding that lateral aspect of the sacrum and then applying force at an angle. You can see I’m trying to angle more in that direction. So I’m not going towards the table. I’m compressing the tissue first. In this case, the sacrotuberous ligament. And then adding that friction. So as I’m going through this, I’m not looking for or feeling for a release. I’m looking to cover all of this ground with
the intention of working on the attachments of the piriformis. Okay, so you can see, looking at the pelvis
here…and the sacrum. You can see that I was here initially, then,
I palpated the piriformis inferior to the psis. From there, I applied force into the sacrotuberous ligament as it comes off the psis. Then I followed the lateral sacrum until I
got to right here. Rick Merriam: 05:46 And then from there we’re
going to go over to the greater trochanter. You’re looking at it from a posterior view. And so right now we’re going to work right
in here. Okay. So you’re looking from a superior view. And we’re going to look for this notch right in through here. Just in case you can’t tell from this vantage point, she is actually laterally rotated. Depending on how you learned it, uh, externally rotated. So I have the thigh turned out. And that’s going to allow me to address the attachment that’s located on the greater trochanter. Okay. So I can access that. And that’s important. Because if I can’t get to the attachment of
the piriformis, I’m not going to get the result. So what I’m doing here, I’m coming in from the head of the table and trying to get perpendicular to that. As much as I possibly can. And again, by laterally rotating or externally rotating the thigh at the hip, I can get the right angle. You’re going to feel that tendon come in to the bone. Feel for that notch. And once you feel for that tendon and/or notch, you’re trying to be as perpendicular to that bony landmark as you can.You want to compress that tissue. I’m going to compress the tendon of the piriformis right into that greater trochanter. Rick Merriam: 07:45 So again, compressing this time directly into the bone and then I’m going to get that side to side or back
and forth friction massage. As you can see, I’m using my thumb. So that’s going to cover a lot of territory. The key is, once you’re in here is to try
an get a lay of the land. And then be even more specific. Rick Merriam: 08:17 Okay. Try to visualize how that tendon comes into the trochanter. Feel for that notch. Compress that attachment from as many angles as you can, while staying as perpendicular to the bony landmark as you can. The other thing that I do that you can’t see
in the video…prior to turning the camera on, I had her slide to her left. This way, her entire thigh is supported by
the table. Then I put this small bolster that’s half
of small round bolster under the ankle. Supporting the ankle prevents the lower leg
from falling off the table. So that covers the attachments of the piriformis muscle. Thanks for watching.

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