Piriformis and Obturator Muscles Connection

I recently posted a short little tidbit of information on my Facebook Fanpage Stop Chasing Pain that said, 'If you always have a tight piriformis muscle, try activating the obturators.'  

Well this little post kicked off a firestorm of questions and comments that prompted me to expand a little more. I will be making a video of this activation protocol and posting it so you can see it in action, but this will be a quick summary of the how and why.


It all comes down to Motor Control Theory. This is based on pioneering work of Vernon Brooks 'The Neural Basis of Motor Control' and it's clinical application by David Weinstock and his NeuroKinetic Therapy. The Motor Control Center located in the cerbellum receives information from the limbic system and then the cerebral cortex before passing the information to the spine.

Your body’s Motor Control Center – the Cerebellum

The cerebellum is like central command controlling every muscle in your body. It is connected to each of your muscles via the somatic nervous system – sort of like control wires. Your cerebellum is where your body stores the information necessary to perform complex movements easily and naturally. 

Sometimes things happen to you that cause your body to protect itself – accidents, pain, and overwork etc. In response to these stimuli, your body creates a new program, or a compensation pattern. These patterns are exactly what your body needs to create in order to protect itself from that trauma. It goes into survival mode. The problem is that your body has no mechanism to let go of the compensation pattern when it is no longer needed Your nervous system has adapted to the dysfunction.

The body has no mechanism to let go of compensation patterns that you no longer need. Long after the trauma has passed, your body continues to over-use the bracing muscles that it relied on during the trauma, and continues to inhibit the muscles that were shut down. This creates a vicious cycle: The inhibited muscles actually start to weaken from lack of use, causing you to use the bracing muscles even more. Eventually, the bracing muscles simply stay tight all the time, lose their ability to fire efficiently, and they hurt. Now you start to CHASE PAIN! And we don't chase pain...we FIX PROBLEMS! 

Pain is where your problem ended up...NOT where it started!

So what we do is very similar to Muscle Activation Techniques where we test the strength of various muscles in relationship to pain. You can stretch and rub that tight muscle all day long, but until you reset the motor program it will not let go. Hence pain always returns.

So for the Piriformis we evaluate antagonistic and synergistic muscles for weakness and then reactivate them. 

Antagonist

Evaluate internal rotators of the hip

Synergist

Usual Culprits: Gluteus maximus, medius, obturator internus/externus, quadratus lumborum and hamstrings.

Once you find the weakness, you have 30-60 seconds to reset the Control Center via muscle activation. Once we reset and reactivate the obturators the MCC lets go of the piriformis so it can heal. The nervous system wins every time.

The video will show you how I test the obturators....and how I test them is how I activate them in conjunction with releasing the spasm.

You will see what I mean on the video...it all comes down to isolation and positioning. Got ya curious now don't I?? 

****Special Thanks to Jeff Elam, CBW for information referenced in this post. Visit his website for more information about his work.

JEFF ELAM

See ya soon!

Doc P.

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