Self Myofascial Release in Individuals With Piriformis Syndrome
Condition: Piriformis Muscle Syndrome
MeSH terms: Piriformis Muscle Syndrome; Syndrome
Study type: Interventional

Summary: 
      Piriformis syndrome is pain that extends from the hip to the knee, caused by the pressure of
      the piriformis muscle in the hip on the sciatic nerve. There is no valid protocol for the
      treatment of this syndrome. Physiotherapists generally use hip strengthening exercises and
      modalities for pain. In this study, in addition to the classical treatment, we will give two
      different programs consisting of self-myofascial relaxation and stretching exercises to two
      different groups for 4 weeks as home exercise. We will question the level of pain that people
      felt in the hip before starting the exercises and at the 4th week after starting the
      exercises and measured the hip joint range of motion.
    

Detailed description: 
      Piriformis syndrome (PS) is a condition caused by compression of the sciatic nerve, causing
      pain, tingling, and numbness. Although conservative treatment includes hip muscle
      strengthening and stretching, there is no proven treatment method in the literature.

      This study will be conducted to investigate the effect of stretching and myofascial release
      added to standard physiotherapy treatment in piriformis syndrome.

      This prospective, randomized controlled study will be planned to completed with 64
      individuals between the ages of 20-40. Participants will be randomized into the Piriformis
      Muscle Stretch Group (PiM-S) and Piriformis Muscle Self Myofascial Release Group (PiM-SMR).
      Both groups will be included in a home program of muscle strengthening exercises for 4 weeks.
      And groups will be subjected to perform stretching and self-myofascial relaxation exercises,
      respectively, in addition to the home exercise program. The primary outcome of the study is
      pain intensity, and the secondary outcome is determined as the range of motion (ROM) of the
      hip.
    

Intervention name(s): Muscle Stretching; Self Myofascial Release; home exercises
Intervention type(s): Other; Other; Other
Intervention description(s): Stretching based on the FAIR (flexion, adduction and internal rotation) position, which provides the most effective stretching on the piriformis muscle, was demonstrated, and a illustrated brochure containing the explanatory information of the application was given to the group participants. With the ipsilateral hip flexion, adduction and internal rotation, the foot is positioned to the lateral side of the contralateral knee, thus long-term passive stretching is targeted in this position. Individuals were asked to leave a 2-days gap between the two stretching exercise sessions by performing 10 repetitions (minimum duration of 15 s stretching, 30 s rest period between repetitions) 3 sets and 3 days of a week.; The patient was presented with the anatomically localized area of the PiM on a visual anatomy map and they were encouraged to find this area on their body. They were asked to verify the trigger points along the PiM and then sat on the trigger points with the help of a tennis ball. Individuals were taught the PiM-SMR exercise, in which they would make forward-backward, right-left, diagonal and circular movements on the ball using their body weight. There was a continuation of the application with an interval of 2 days; 3 times a day with 10 repetitions (the application was for 1 min and 30s rest period between repetitions).; The exercise brochure consists of 5 different exercises that include isometric and isotonic strengthening of the hip and surrounding muscles. Isometric contraction of gluteus maximus, hip march, external/internal rotation of hips with theraband, 4 sided straight leg raises were the exercises and prescribed 5 days a week, 10 repetitions, 3 sets. All participants were advised to use analgesics determined by the physician in case of unbearable pain and to apply a hot pack for 10-20 minutes before sessions.
Other intervention name(s): Piriformis Muscle Stretching
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel group study
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Piriformis syndrome; Pain; hip; range of motion; sciatica