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Diana Remaley, LMT
Diana@RemaleyMassage.com
(203)292-5362
19 Compo Road South
Westport, CT

Piriformis Stretch / The Posterior Hip

Many clients come in to my office complaining of "glute pain." Now, it is completely valid that one or more of your three gluteal group muscles could be causing a muscular problem. But they're big, powerful muscles which we can usually get under control fairly quickly. Typically, the underhanded culprits are of the "Deep Lateral Rotator Group", which are a group of six small muscles underneath the gluteal group. Since they're physically smaller, therefore weaker, closer to the nerves and more difficult to stretch, they're hard to keep relaxed and healthy. The most (in)famous of this group is the Piriformis muscle.

the nerve, so when it’s hypertonic (“tight”), it can press down on the nerve like a rolling pin pushing down a piece of cotton. This nerve compression (referred to as “Piriformis Syndrome”) can lead to numbness and tingling down the leg and is often mistaken for sciatica, which has similar symptoms. While true sciatica requires surgical intervention, Piriformis Syndrome is a soft tissue dysfunction that responds quite well to massage therapy. and stretching. If you’ve been experiencing any of these symptoms, give this stretch a try!

The Piriformis is one of six muscles in the "Deep Lateral Rotator Group". We call them that, because, you guessed it, they're deeper than the other muscles in the area, and they rotate the leg laterally. Anatomists are typically very literal.

They attach, roughly, from the sacrum and pelvis to the head of the femur. If you imagine holding a string from your sacrum to the very top of your thigh, that's about the direction these muscles take. If you keep your leg stationary and move your toes in and out, it's this muscle group that's doing most of the moving.

Since these muscles are between the pelvis and the femur, to stretch them, we want to move those bones apart. But we also need to rotate the leg laterally to keep the head of the femur in the correct position. It's this rotation of the femur that makes the stretch correct or not – and it translates into the position of the lower leg.

Beginning standing next to a hard flat surface that’s about the height of your pelvis. Rotate and place one leg up, with your knee pointing out. It’s critical here that your lower leg is perpendicular to your body; if it’s turned in, your femur isn’t rotated enough and there isn't enough space between your pelvis and femur. If it’s turned out, your femur is rotated too far and there’s going to be too much stress on your knee.

Gently bend the knee of your standing leg, lowering yourself further in to the surface your leg is on. Get used to the feeling of your weight on the leg that's stretching, using the stability of the surface. Keeping your abs pulled in, pivot your body forward, aiming to rest your chest on your leg. When you get as far as you comfortably can drop your body, hold the stretch for a good 30-60 seconds, or until it feels like the muscles have relaxed. You can even drop your head down to relax your shoulders and feel the stretch affect your entire spine. This is my favorite part of this stretch!

Keep in mind that some people can’t come close to the full movement here, and that’s perfectly fine. The idea of the stretch is to try to move your body in to this position, and whatever range of motion you’ve got on a particular day is to be respected. Especially when dealing with the hips and lower back, you never want to bounce or force a stretch. There are days when this movement is effortless for me, and others when it’s incredibly difficult to move in to the proper position. On those more difficult days, I don’t try to force myself in to any position, but I do spend extra time letting myself “fall” in to it. The idea is that the longer you let your mind and muscles relax, the more fully you’ll stretch. 

 

The deep lateral rotators, and especially the Piriformis, are prone to dysfunction, unfortunately. So stretching them regularly is crucial if you’ve experienced any kind of hip pain or numbness and tingling in the legs. And massage therapy can really help! Book your session today and we can begin to move you out of pain and toward proper movement and function again. I’ll see you in my Westport office!

Stretching the Trap, revisited

This muscle group is likely tight right now!

This is a re-post of one of my oldest blog entries, from 2015.  The stretch itself is still one that I show 80% of my new clients, so I wanted to revamp this entry. It's worth it to get this move correct!

If you're feeling tension in your neck and shoulders, give this one a try.

Anatomy Lesson:

 The Trapezius (“Trap”) muscle attaches from roughly the base of the head, goes out to form what we refer to as “shoulders”, attaches to the top of the arm, moves in toward the shoulder blades, then down the spine. In this stretch, we take advantage of the attachment on the arm.

This stretch works by letting the  leg pull down on the arm; if you tense your shoulder, it won't work. Let your shoulders drop as far to the ground as possible. Turning your head to the opposite side stretches the entire length of upper musculature – pay attention to any particularly tense spots up your neck. If you notice a tender area, you can turn your chin up toward the sky, even rotating it a bit to try to release the tension and increase range of motion.

 The stretch:

Begin by holding your ankle, as if you were going to stretch the front of your thigh.

 

 

 Rather than pulling your ankle toward the back of your hip, stretch the Trap by letting the weight of your ankle and leg pull down on your arm. Turn your neck and head to the opposite side to increase the stretch. Hold for at least 20 seconds, moving your head further if possible.  Ideally, your ear would be able to touch your shoulder. I have to admit, though, mine only comes close on my most relaxed day!

Repeat on the both sides.

 

If you're stuck in your office chair or in a car, you can still do this stretch, just by grabbing the bottom of your seat instead of your ankle.  It's not AS complete, but it works in a pinch.

Once you master this stretch, I guarantee you'll be doing it constantly! It's wonderful when you're having a stressful day, and before and after exercising.

And remember that massage therapy is fantastic for the traps in particular.  Book a session today if you're still feeling some tension.  I'll see you in my Westport office!

A Plantar Foot Stretch

Dealing with stubborn heel pain? This movement can help!

Plantar fasciitis is rampant. In fact, I'm starting to think practitioners just diagnose this to describe any pain on the bottom of the foot. While true plantar fasciitis is complicated and a little more than we can cover in one blog post stretch, strengthening the lower legs with this movement can help affect heel pain.

A few years ago, I had a nasty case of plantar fasciitis myself. In future posts, I'll explore how I alleviated it, but for now, I'll show you one of the easiest stretches to help any non-specific heel pain. You'll need an exercise band; there's really no substitute for it here. I like doing it at the end of the day while laying in bed, but you could do it seated at your desk, or even as part of your daily workouts.

Anatomy Lesson:

The two major muscles in the calf group are the "soleus" and "gastrocnemius." These attach from about the knee to the heel bone ("calcaneus") and it's this heel attachment that's critical: If the calf muscles are chronically overused, they're going to pull on the calcaneus, essentially yanking the foot toward the heel. Over time, this will irritate the connective tissue ("fascia") that holds the foot together. "Fasciitis" is simply an inflammation of this connective tissue. Managing fasciitis is therefore about reducing physical inflammation AND reducing the factors that contributed to the inflammation in the first place. Calf group tension is usually first on that list.

This movement is useful to strengthen the calf muscle group, and it's that strength built over time that will eventually help stop the heel from pulling and irritating the fascia.

The Movement

(This is kind of a half-stretch-half-strengthening exercise, so I'm calling it a "movement" because it fits in to neither category neatly.)

Barefoot, either lying down or sitting, hook the band around the ball of your foot. It should fit nicely in to the crook of your arch. Hold the other end with your hands. (The band should be long enough that you don't feel like you're going to snap it with this length.)

Bend your arms up, gently pulling the band to make your toes move up to about a 45 degree angle to your lower leg. Lower, SLOWLY, but don't intentionally point your toes, just let your foot go back to it's natural position. Repeat 5 times, as slowly as you can handle, pointing the toes and puling them back. The slow movement is key here; it you move too quickly, you're just using momentum to move the muscles. Slowly moving forward as well as backward, means you're using the muscles both concentrically and eccentrically, which is just a fancy way to say you're using them more efficiently and effectively.

When my foot was at it's worst, I'd spend about 10 minutes at the end of each day with this movement. Try to distract yourself by watching TV while you're doing it! If you notice any pain or burning in the heel, back off a bit. That usually indicates that the fascia is still irritated, and there's little point in irritating it further. Try doing the movement only once or twice instead of for a few minutes. Remember that training our muscles takes time. If it took you months, years, or even a lifetime to develop the patterns involved in plantar fasciitis, so you're not going to fix them in a week!

Massage therapy is an incredibly effective adjunct to treatment for plantar fasciitis. I've helped myself and many others through it! I'll see you in my Westport office!

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Diana Remaley, LMT
Diana@RemaleyMassage.com
(203)292-5362
19 Compo Road South
Westport, CT