Piriformis / SI Joint Release

If there is a topic you would like to discuss… please post it and we can start some dialogue. Here is a video that has gotten a lot of attention on youtube, so I believe it is something that many people are interested in. Let’s get some discussion going on this often encountered issue.

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4 Responses

  1. g Says:

    Yeah man, some of my favorite stuff here!

  2. stephanie Says:

    Erik, thank you for sharing this video. My question is: is there any contraindication to this technique? I am thinking of a bulging disk @ L5/S1 type problem or instability of the sacrum due to strectched ligaments (ie postpregnancy). Also, does spondilolisthesis exist at the level of the sacrum? (sacrum sliding anteriorly of L5) if yes, I would imagine putting pressure on the sacrum would not be a good thing.

  3. erik_dalton Says:

    If you watch Teri’s lumbar spine carefully throughout this technique, you’ll notice no increase in lumbar lordosis or lumbosacral angle. Positioning the elbow at the PSIS while lifting the leg would create hyperlordosis and the possibility of excessive compressive forces through the L5-S1 and L4-5 facets and intervertebral discs so always keep this in mind when performing this technique. (I warn of this on the video).

    Your concerns of creating excessive long dorsal SI ligament hypermobility in post-pregnancy women is valid. I always assess for hyperombility on everyone who enters my office via specific ‘spring tests’ developed by Jerry Hesch, PT. These wonderful tools are presented in my new 6-DVD set from which this clip was taken.

    Per you question about spondylolisthesis; the most common areas of dysfunction (cracking of the pars interarcualis) takes place at L5-S1, followed by L4-5 followed by C4-5. Clients coming in complaining of bilateral sciatic-type pain who present with excessive lumbosacral angle and lumbar lordosis are suspect. I may do some soft tissue work with them sidelying but if the discomfort persists, I refer them out for an orthopedic workup to rule out spondylolisthesis or central disc herniation. Some therapist will work on them prone with a pillow under the belly….not me. Keep ‘em sidelying and in a tucked fetal position just to be safe.

    Recall that this technique is primarily designed as an external femoral rotator release and most of the downward pressure is on muscle, not bone.

    Thx for the thoughtful post Stephanie ~ ERIK

  4. g Says:

    Hey Erik~ I have been in many of your workshops. I’d like to talk about some of the points you make in class about muscle contraction.

    First off, you talk about gentle contractions. I think you say a 20% effort is often suffice. I always use this verbal cue, 20%, and if they still contract forcefully,I ask for 20% of that contraction. I have found this very useful. As in the case of a client who may be experiencing low back pain, the less forceful the contraction, the less likely they are to increase lordosis and increase compression into the facets, discs, etc.

    Secondly you state about gentle contractions..The smaller the movement, the more effective the new information is for the central nervous system (Weber-Fechner Law) I find it helps people get in touch with their bodies and truly allow change to happen, without blowing through all the dysfunction to the stronger units. Could this be considered part of the “spinal learning” you talk about?

    In my massage school we learned some “muscle energy techniques” such as post isometric relaxation and reciprocal inhibition, for the big muscles. Your workshops have helped me fine tune this information, and apply it to segments of the body in a more accurate manner. Thanks Erik!

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