St. Lukes Elks Rehab Blog

We see so many patients presenting with lower back pain, and usually from chronic or repetitive use, combined with inner core instability.  We administer the standard inner core exercises focusing on the pelvic floor, the transversus abdominus, and the transversospinales, or multifidus muscles.  These exercises are wonderful for beginning the stabilization process.

 

Also, if indicated, we facilitate stretches; of the Piriformis, or external hip rotators, the lower thoracic spine, the hamstrings, and the quadriceps.  These work well to release the lower back, but my personal favorite would have to be stretching the piriformis.

 

And my favorite way of stretching the piriformis is by crossing one leg on top of the knee of the other, and bending over in a seated position, keeping the “down” leg in a solid 90 degree bend.  I think what is most appealing is the relative level of ease in this stretch.  It is good for people who have trouble doing the same motions while on their back, and it allows for more of the whole body to relax into the stretch, using gravity instead of lifting the crossed legs up and working against gravity.  Almost every patient I’ve coached in this stretch says “oh yeah, I feel that.”

 

One important tip:  try and imagine that while you are bending forward in the chair that your only fulcrum is at your hips, keeping your chin up as you lean forward.  Imagine your hips are a hinge and this is where you are bending.  Also, if the person can not totally cross their legs (elderly or more stiff folks) then they can cross them as far their comfort level, then lean forward.

 

This stretch, combined with thorough deep tissue massage when indicated, in the lower Lumbar region including the Quadratus Lumborum , Gluteus Maximus/Medius, and Piriformis without major contraindicated spinal pathology, are  most certainly highly beneficial therapeutic protocols.

 

Paul Greear NCTMB

Nampa North

Filed under: Common Aches & Pains, Massage Therapy