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Trigger Point Release - Piriformis Muscle
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- čas přidán 12. 08. 2024
- Trigger Point Therapy Tutorial: Trigger points in the piriformis are a common cause or contributing factor in low back pain, hip pain, hip dysfunction and sciatica or sciatic type pain.
In this video we cover the anatomy of the piriformis, locating trigger points and treatment including ischemic compression for trigger point release.
00:00 - Introduction to Piriformis Muscle
00:11 - Anatomy Overview
01:00 - Greater Trochanter Identification
01:50 - Piriformis Muscle Attachment
02:50 - Piriformis Functions
03:40 - Sciatic Nerve Relationship
04:50 - Trigger Points and Pain
06:00 - Identifying Trigger Points
07:20 - Ischemic Pressure Technique
08:50 - Cold and Hot Treatment
09:50 - Ice Pack Application
10:20 - Stretching the Piriformis Muscle
11:10 - Heat Pack Application
11:40 - Final Stretching and Conclusion
The full NAT online certification course covers treatment techniques and considerations for all common forms of chronic back pain including step-by-step trigger point therapy protocols.
The course is suitable for all levels of Manual Therapists, Massage Therapists, Trigger Point Therapists, Physical Therapists, Body Workers, Athletic Trainers, Exercise and Fitness Professionals.
About the Presenter
Jonathan Kuttner is a medical doctor and physical therapist. He is a qualified sports physician, and chronic pain specialist.
Dr. Kuttner is a leading advocate for research into Mind Body Healing and a regular contributor to journals and international conferences.
In 2014, Dr. Kuttner received a lifetime achievement award from the NAMTPT (National Association of Myofascial Trigger Point Therapists).
Unlimited access membership education packages available from $19.95/monthly. For more information please visit:
Trigger Point Therapy Course (Presented by Dr. Jonathan Kuttner M.D.):
nielasher.com/collections/nat...
nielasher.com/pages/education...
![Your Piriformis Isn't Tight, it's WEAK! [4 Exercises to Get it Strong]](/img/n.gif)
I’ve been trying to explain this pain to Doctors forever and a day but no one seems to understand what I was saying 😱😭… I’m saving your video for my Doctor… thank You so much ♥️🙏🙏
You nailed exellen explanation i can wait to see more thank you.
Same with me too. Sadly I live in Germany an my Doctor wont understand this video and they only have a few min. with each patient 😢
I know that frustration 🤕✌
me too, and they even make me do an MRI, and still cant find out whats the problem
@@jolujo5842 Me tooo 😭😭
I have sciatica almost from 3 years.
Excellent explanation! I wish more PTs were trained in these techniques. I suffered for a couple of years with a tight pirformis and illiacus muscle. There wasn't anyone who knew what it was or how to treat me. after much self study, not to mention PT, acupuncture, chiropractor, MRIs and NSAIDs, I finally came across releasing trigger points as a solution. Life changing! I wish I had seen this video earlier!
Same here I wish I could divorce my right leg. It's the worst!
It's not part of PT training. A good PT would suggest you see a physical therapist. Yoga can help. I've worked with lots of students with this issue but if it's really bad I would always refer to the club therapist.
Sounds like what I have been through! I have been to everyone of those practioners that you mentioned, but never got any relief.I am in pain everyday and I have it in both side my left side and leg is the worst. I get so sad and depressed because of this pain.
I had a pointed elbow there. For 15 minutes. I cried like a baby. But omg did it feel good
@@joannegreenhalgh8239 a good physical therapist would suggest you see a physical therapist?
My sincere thoughts to anyone who suffers with sciatica. I used to suffer terribly. A compassionate and brilliant physio and ongoing Yoga have been my saving grace.
Thank you so much. Instent relief from pain.
Thx
I've been going thru every shot, nerve block, and other stuff done and nothing stops the pain.
The pain is exactly where you're drawing.
I'm taking this video to my next appointment so my doctor can see it.
Very grateful for this video.
I had the same issue for years until I got a "tight hip, twisted core" ball and learned how to use it from CZcams. Best $20 I ever spent! No more pain, no more numbness. But doctors couldn't figure it out!
I have the EXACT thing going on with my spine. SAME location. Already had 2 steroid injections. First was way too high (L3-L4) the second was in the my SI joint. The first did absolutely nothing to help. The second only a week ago made it feel better for a couple of days. Right back where I was. I've been having this pain for about 6 years now. In 2015, I had a lamenectomy done on L3-L4. Helped for about a year. Ever since then I've had increased pain mainly in this exact area.
Botox injection worked for me.
I'm thinking of having the nerve stimulator put in, anyone watching have you had one
Yall need to have a glute massage from a professional massage therapist !!!!!
I think this explains a lot about what my hip, butt pain may be. Thank you.
Incredible video. I just went through nearly a week without being able to walk without excruciating pain, getting enough quality sleep, shower, etc. I had the worst sciatic pain. I’m just getting better, but it took a lot of work to get to this point. I injured myself at the gym, and now I’ve realized I’m no spring chicken anymore so I need to rethink my routine. Anyone out there dealing with this, my heart is with you. The woman who gives me allergy injections told me she’s dealt with it and she told me it’s worse than childbirth. I know it’s floored me before where I couldn’t move and paramedics had to take me to the hospital. It was that bad.
Thank you for your feedback and wishing you well 🙏
I totally agree with the lady comparing it to childbirth 😔that's exactly what l've been sayn when l describe how painful it is!!!! Im going into 5months straight with both piriformis and sciatic 😭
You got that right. My goodness!
Worse than childbirth yes
@@truenative5251 hope your better since you posted. Currently having back problems with wrong diagnosis that made pain worse. Now got the proper treatment exercises to,do. Whew!
So simple, and easy on the thumbs and hands for the therapist. Most importantly, gentile on a person in pain. Thank you Dr. Jonathan Kuttner.
You picked a really good model for this tutorial because of his muscle definition.
I have lived with this pain for 2 years. Thank you. This video goes with me to a doctor.
Oh my gosh! Thanks so much for giving me the answer to my pain I've been fighting with for so long. Very Helpful!!!
Hi Glenda, that's close to my mom's name, Glenna. Haha, so anyway, this is called piriformis syndrome, it took over 4 years for my many Dr's to figure out. I still have severe pain I'm my legs, but not this anymore. What help dramaticly was my Dr giving me cortisone shots in my hip, back and piriformis muscle to help release the muscle that was tightening around my sciatic nerve and causing severe pain and my whole leg would go numb. So I got shots every 3 weeks for a year and a half and that part of my pain is pretty much gone now. So ask your Dr about cortisone shots, if he says no, get another one, because it's life changing, believe me!!
@@bell2thesy thanks so much!! I have had dry needling and it has helped me as well
one of the best video...8 years with no stop pain,30 doctors and no one knows... last 6 months one doctor found this..after 7,5 years and 50.000 euros..
Thank you for your feedback 🙏
What was the problem that you had. Sciatica?
@@dissau2115 non stop pain 24 hours a day,for 8 years in the piriformis and sciatica...
I Teresa had surgery piriformis syndrome for some reason it did not work for me. The way I went in I came back out. My right leg what's the problem still has not fix the problem and still suffer not able to walk properly. I feel like something's growing and my buttock on the right side it's swallowing like it's growing. Knee problem very hard to struggle to walk. The doctor did not give me any explanation when I came out of surgery. All he said everything was stuck together. I cry was going to happen to me now. I'm back with a cane. Now my left leg did not have a problem at first. It's numb also. I feel something on my right buttocks moving up and down nerves like water. I gave everything I could to get well and nothing work. Someone can help me and reach me.
This truly explain exactly what we go through thank you for sharing
I HAVE SUFFERED FOR ONE AND A HALF YEAR.... ONLY THE TRIGGER POINTS HELP ME. THANK YOU SIR FOR HELPING PEOPLE...
Lovely voice, Dr Kuttner. Very calming and soothing.
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Dr. Kuttner and NeilAsher is always a point of relief! So nice to watch, so nice to apply.
Thank you very much for your feedback 🙌🏻 😊
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Oh how I wish I had found this channel sooner! I suffered horribly for years and found it impossible to get help from doctors. I had to search and study and learn to release my own trigger points with a candy cane shaped tool. Almost every trigger point in my body had become involved and were very painful and sensitive. It took very intense and repeated self treatment over a long period of time to totally and completely release them all and eventually get relief. It seemed like there was little information on the subject and I couldn’t find anyone to do it for me. I pray that you will be a help to those who are suffering and I thank you for sharing your knowledge and explaining things so clearly and freely!
Candy cane tool? So did you use this tool by yourself? I feel so much pain
And does your pain affect more one side than the other?
@@tamiressaint5277 yes it is for reaching the places that you cannot reach for yourself and it has a “T” across it and all of the ends have a ball on them. I wish I knew the name of it but it allows you to put a lot of pressure without a lot of strength being put into it because of the leverage you get. I looked up the trigger point locations and they were all extremely tender. I just learned to hold it on them until they released but they tend to cluster and when one would release it would often move to the next nearest one. But eventually I was able to get them all to release and it changed my life. I hope you can find it and figure out how to get the relief you need! 🥰
@@tamiressaint5277 so imagine a cross with the top extending into the candy cane crook on top
@@tamiressaint5277 yes my right side was worse than the left but I had a lot of pain in my lower back, hips, and down my legs to my calves. But years of this caused tension and pain in all parts of the back and neck and even in my arms. I literally had pain and sensitivity in EVERY trigger point on my body from decades of pain. Today I have very little and it has gone from a 8-9 on the pain scale to a 2-3. 😊
Great explanation.. I am having this problem from 15months with severe pain where I literally limp while and I visited multiple doctors, PTs and got MRIs, Acupuncture, medicines, massage and many more but no progress. This video is giving me idea on trigger point of pain, I will start with this exercise and see the result. Thanks a lot for sharing this detailed video
the best information i have seen on the internet. Very easy to understand! Thank you very much!
Hello Troy … thank you for your feedback 🙏
This is the condition I have been in....thank you so much for sharing this brilliant video. How I wish many more doctors share brilliant explanations of many more problems we normally don't understand.
🙏🙏🙏
Your presentations are excellent. Showing a real person, drawing on the relevant muscles and your calm delivery.
I've had this pain for years and its now extended to the whole hip. I cannot walk, climb stairs or get in/out of the car without severe pain. The resulting lopsidedness and misalignment has repercussions throughout the body, leading to osteoarthritis and other complications.
Despite seeing countless drs and physios, only one said it was piriformis syndrome. Everyone else said its just a bit of everything. Sad why they choose not to tell patients what must be fundamental in their training.
Thank you for your comment and kind feedback. For more information please visit the blogs and articles section of our website www.nielasher.com where you can find loads more free information and videos regarding your symptoms. 🙏 Good luck to you xx
Thank you so much. This has been more helpful/informative than years of chiropractic and physical therapy….. only one person knew about the trigger point release which gave me more relief than all else immediately
Thank you for your feedback 🙏
Thank you for the most helpful information. This is the best information I have ever seen
You were seeing the wrong chiropractor. This is such a commonly treated condition and technique in chiropractic.
Just one? I live in Brazil and it seems nobody knows about them and piriformis syndrome
Brilliant video best I have seen explaining it
U have explained everything so clearly thank you so much for your time I do appreciate it, I have never heard anyone else did it this way thanks
Hello Joy … thank you for your feedback 🙏
Good stuff. I’ve been diagnosed with sciatic nerve issues that are caused by the piriformis muscle. It hasn’t really given me sciatic leg “pain” (only very infrequently) but I’ve had a lot of tingling and numbness. The piriformis muscle itself doesn’t typically hurt but when I go after the pressure points, as per this video, it is very tender. This video has certainly given me a better understanding of the components and dynamics of my condition. Thank You.
Thank you for your feedback. Wishing you good health 🙏
I've found that "good mornings" help with my sciatic pain. Non weighted. Just, a simple exercise done a few times. It sort of strengthens the hamstrings ever so slightly and awakens those inner muscles or something
Thank you so much this has been most helpful.
Thanks Niel. Great information.
Excellent demonstration
Wonderful explanation and anatomical review. Learned this first while in massage training. Also helped my nursing practice. Thanks so much for this, a refresher for some and new information for many!
Best video ive see on the topic yet!!! Thanks
Great explanation. Wonderful teacher!
Thank you Dr Jonathan Kuttner. Great explanations and certainly on the money for me. I am an amputee of 34 years. Currently I'm really feeling it in this area that you are describing. I have been off my Prosthesis for near 8 months now after a Surgical operation to my stump. I'm at the point now of of fitting into my prosthesis; weak lower back, constant stubborn pain in the area that you are describing. I really appreciate your expertise. THANK YOU DOCTOR JONATHAN KUTTNER.
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Thank you so very much,Dr.
My experience was after back surgery, I had nerve pain in both hips and nerve damage down both legs and feet. The pain was the worst pain I’ve ever had and it lasted four months.This was four years ago and I still have numbness in my legs and feet. Two weeks after the surgery I couldn’t move without awful pain. I spent six weeks inpatient physical therapy. The nerve pain started going down my leg so couldn’t make anymore progress and I was discharged. I made an appt. with a pain management doctor. I told him what all was going on. He gave me an injection. It didn’t work. I went back and he did another. In three days I noticed some change and that was the beginning of the end of the nerve pain. This was four years ago and I’m pain free as far as nerve pain goes. I still am unsteady walking from the nerve damage in my legs and feet. But no pain. Just thought I’d put this out there. I hope anyone with this pain finds a solution. When I had the pain, I couldn’t sit in an upright position. I had to recline or lie flat or the nerve pain was unbearable. And that was for four months. It’s not for sissies. Bev
I am going through this myself now with great pain if I sit. Where did you receive the injection that ultimately helped you. I want to tell my pain mgmt doctor about this.
Hello, unfortunately, no injections will help you, they only transfer the active trigger to the passive state. Painkiller injections give only a temporary effect, until, under the influence of a number of negative factors (hypothermia, overload), your trigger becomes active again. And remember the main thing. Not treated trigger point always leads to myofibrosis
Can't wait to try Thank you so much My husband found trigger point prior to seeing this video and yes ,jumped from pain lol
Best video explanation ever. Thankyou so much.
Thank you so much for your feedback!
Thank you for this informative video! I had back surgery last October and am working out the kinks. My left leg is healing at a slower pace and I suffer with rather powerful left hip/leg cramps when I get up from sitting after about 15 minutes. I really like your clear explanations and demonstration of the leg drop-down; will try that in a minute! Lol Thanks again!!
Hi
Thank you for the information, I really appreciate it, my pain is due to squash, softball and a few other sport, I however have been trying to press on these pressure points myself and it was sore, even hanging my leg down and it gave me relief but this video has been a great help in teaching me about the technique for the piriformis and it's helped with my back a great deal as well, now to follow through and do it more often to get rid of the pain hopefully completely
I watched a video saying we need to shorten the muscle... my pain is gone. I overstretched it in exercise. We more often than not try to stretch.
@@KingJesus41 yes I have spondylolethesis from a slipped vertebrae ( I think from doing the plough) trying not to have to have surgery. Anyway who could do the CORRECT surgery?
Rewelacyjny wykład. Wspaniały specjalista. Dziękuję
Hello Marzena …. Thank you for your feedback 🙏
THANK YOU for explaining to me what is happening to me and why. I understand so much more about what I can do to give myself relief.
Hi @LQOTW,
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Very helpful. Thank you!
Great video! Lumbar spondylotheliosis? from a back injury long ago resulting in two back fusions. Before the surgeries I was a runner from 1988 to 2012. The pain I experienced the most was from my hips and butt, due to hip flexor, illiacus and piriformis weakness. In-between my 1st and 2nd fusion I learned stretches for those three muscles with other stretches and 2 years after my 2nd surgery and with meds, I could finally walk long enough to start losing the 45 pounds I gained! I have lost 15 pounds since Jan 1! It is so important to adhere to a regimen of stretching those hip, back and leg muscles to minimize pain in those areas! Peace and love to all of you!
OMG!!!! I'm sorry for your suffering. I need surgery 😫 but I don't want to lose my mobility, flexibility, and everything I worked for. My spirit is broken. How are you doing now?? I almost feel like saying no to surgery reading comments all over CZcams and I see so many negative results. I'm to scared to trust any surgeon now. What can you do know activities wise? Have you ever gone ketogenic for weight management and inflammation?
Wow. Great work sir. You have done a marvelous tutorial.
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I love your explanation. It is very clear and understandable.
Hi Fazel,
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Thank god for you tube. Maybe now all these experts will understand my pain and problems.
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Thank you for detailed explanation and technique!
Hello Stephen … thank you for your feedback 🙏
Amazing info and video. So kind to share this valuable info to help people. Much gratitude.
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Super! Thank you for a great video 👌
Thanks a lot for this extensive explanation. Now I understand my sciatica pain origin & right method to treat it. 🙏
Thank you for your feedback and wishing you well 🙏
Makes sense! You are literally spot on. Thank you.
Hi Nanace,
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I am at the initial stages of this painful sciatica for which my GP has recommended frequent Tyleno and Pregamblin medication.. another chiropractor suggested spinal decompression.
However after watching your Excellent video, understanding the trigger-points,the hot and cold massage and the associated extensions I have realized a better sustainable solution for my performs Inflammations . hank you very much.
Congratulations! I'm a trigger point and myofascial release specialist. I learned to refine my technique because of my own nerve impingement issues.
I am confident these techniques will help you.
Tylenol is hepato- toxic in large quantities. I found meloxicam very helpful. I couldn't stand pregabalin because it made me tired and dopey. If you can get keterolac 10mg po it's also very effective and less damaging to the liver.
Best of luck for relief!
@@thesliverhankie I have this pain on both legs but more on the left side. My doctor prescribed meloxicam but after reading the after effects it has on the heart and liver, I decided not to take it and suffer with this pain. I have this kind of pain daily. I wish I can find someone to do it for me. I have been to countless doctors and health practioners like Chiro, Accupunterist Massage therapist etc etc.
Brilliant advice. This is almost magical.
Christopher … thank you for your feedback 🙏
Début d'année on m'a diagnostique de l arthrose au niveau du dos et j'ai des crise de douleur intense au niveau du nerf sciatique. Le médecin m'a présidés séance de kinésithérapie j'ai trouvent kinésithérapeute qui utilise les points trigger au début j'étais septique sur le fait d'utiliser les points tricher. Ça fait 3 mois que j'ai commencé les séances à 2 séance par semaine sa me soulage très bien et en continu j'ai encore de temps en temps des douleurs elle son moins forte et dure moins longtemps donc je recommande vivement se genre thérapie.
Excellent to see and I understand even more now.
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Thanks a lot. My pain starts higher in the lumbar and takes the gluteous. That exercise is perfect.
Great explanation and suggestions. Thank you for sharing 🙏
Thank you for your feedback 🙏🙏🙏
wow very clear doc. thanks for your explanation..
We are glad it was helpful! 🙌
Very good explanation
Thank you..... I've been treating myself with trigger points but didn't know about the cold/heat. Started and look forward to making greater strives in my recovering
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Very clear and precise explanation! Really useful!! Thank you very much🙏
I suffered with piriformis syndrome for over 3 months. I found a fabulous sports medicine physician who helped me tremendously. She found my trigger points then performed dry needling (not the same as accupuncture) on those trigger points. It took several sessions but, I have no more pain.
Thank you after months of pain I can clearly see that this problem could be the source of the sciatic pain!!🇬🇧👍
Hi Janet,
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Oh my. Just too watch this brings back memories of extreme pain I've gone through just the last 5 weeks or so! All the above pain. Understanding helps. But it takes time to eventually put two and two together. Rest and steriods and muscle relaxants and now anti inflam before bedtime has me moving more comfortably at least! More pain than all the labour pains of four kids. But whý? I ask. PT is the best. If you can get an appointment soon enough. And helping yourself is nòt a good idea. You may do it wrong.
What a wonderful explanation. Thank you so much!
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Thanks for the explanation. I’ve suffered with sciatica and this video has helped me understand exactly where my pain is coming from. That’s helped me get some relief and get much better.
So pleased to hear that! Wishing you well and thank you for your feedback 🙏
Excellent lesson!!!
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You are verry good with explanations. Thank you.
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Absolutely perfect explanation and execution 👍🏻
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Thankyou for this explanation especially showing a real person Ive had tightness from bottom of my rear to approximately five inches above the back of my knre for three years I cant do my yoga on the effected side' left' and it gets numb when sitting.!
Will save this video.. Thanks Again..!!
After years and years of hip pain I went to a massage therapist and she was the first one to address this trigger and changed my life.
I’m going to have to try it!! Thank you for sharing….
@@iamjoyt If you happen to be a MT in the Bay Area (CA) please let me know!
Thank you for this explanation
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The hands are wonderful. Thank you very much.
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Thank you! This was great. And really clear 😊
Why didn't he show the groin stretch ? I wanna see everything
Incredible information! Thank you!
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That is my problem spot right there. I have been a delivery man for about 23-24 years at the Brown company. I barely have any disc at the L5 S1 location. My left leg is in terrible shape now. Im looking at permanent disability and possible forced retirement. My left foot is constantly tripping my up.
Well done!
Thank you for helping me pinpoint the area I need to focus on.
Good luck 👍
Brilliantly explained
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Wonderful explanation Dr. thank you,,can you come to New York now..
Superb explanation! Thank you so much for taking your time with this! 🥰
Fabulous...thank you...
For a very long time, I have been self massaging my piriformus for soothing/easing & pain release.
NOW, I understand the why... 😊
Hello Ros … thank you for your feedback 🙏
Thank you so much ,doctor.
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I glad I have seen this video . Thank you so much. For super explanation
🙏🙏🙏
Brilliant. Loved the explanation. I am fascinated by this subject as I have had so many problems with lower back and issues in the buttock area. Given my time again I would have loved to have gone into this field of medicine.
Few years ago, I used a heating pad for a few minutes to hopefully relax the nerves and muscles in this area. I ended up in the hospital! It increased my inflammation to the point of unbearable. I found a TENS unit was the best form of relief, and it was immediate. Also it calmed the nerves enough that the pain went away for at least a week. I stand by my TENS unit! Cold and heat were big no-nos for me.
What are TENS unit?
@@goldfinger1970 it's a machine that chiropractors tend to use to loosen up muscles. You attach pads around your muscles and it connects to a machine that sends electrical impulses to the pads.
I use a tens unit as well
As much as I want to use heat on mine I know from experience it only makes things worse :( It's annoying but when mine 'goes out' all I can do is go straight to bed for 3 or 4 days. Fighting it does no good whatsoever.
Yes! I took a hot bath and couldn't walk after.
All my best congratulations. Dr. You explain it so well and clear that all Drs. should learn!
Many years with such painful injury caused by protrusion above coxis which last time it lasted more then 3 months of strong pain making impossible even walking...ending with cortison tablets 8mgs. per day per a week.
I will defenetly follow your therapy method and I'm sure it will serve me forever.
Many thanks Dr. and my best wishes.
Thank you for your kind words and for sharing your journey with us! We're glad our therapy method has provided you with hope and clarity. We wish you a smooth path to relief and improved health. Best wishes from our team!
Dude you're awesome thank you
Thanks for bringing this very Informative video to us. Thanks.
Glad it was helpful. Thank you for following our channel. xx
Thanks so much have been going through this pain since 2019.....but now can breathe
Same ...I've been with this pain since 2019. How many times do we practice this techniques? Once a Day, I guess...thank you so much Doctor.
Thank you for the great thorough exploration. What a nasty injury yet the anatomy and complexity is amazing. To anyone also suffering from this hope you can find relief soon 💪🏾
thank for healing IFO.
Thank you
I’m suffering from exactly this but no doctor is knowledgeable about this, my chiropractor didn’t even mention this.
شكرا جزيلا
I am so grateful for your video!!
🙏🙏🙏
Thank you so much sir....
Thank thank you!
Thank you. I did fysotherapie and after that i have more pain. Have morfine now, i can use the theracane stick. Thank you.
Seems similar to using a lacrosse ball in finding trigger point release; unfortunately, some insurance companies wont cover such, so PTs simply wont do use it, though they should mention it for at home care. Laying in that ball, holding the pressure through the pain was very effective. Now it's glute brides, glute squats (no weight bearing), fig 4 stretches, etc.
Thank you. It is very helpful.
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THANK YOU!!!
Thanx sir for this great video....it was very informative!
🙏🙏🙏
That’s the spot. Laying on a nice lacrosse ball gets tight n there and relieves my pain
Thank you so much. Nice video
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