Ejercicios Estiramientos Músculo Piramidal compendio

Compendio ejercicios estiramientos.
l síndrome del piramidal es una entidad poco conocida, pero representa una causa significativa y tratable de dolor lumbar, que es más frecuente en la tercera y cuarta décadas de la vida y en mujeres.
Se debe a una compresión del nervio ciático debido a la contractura del piramidal, que puede producirse entre este y el reborde del agujero ciático mayor o por el atrapamiento nervioso dentro del propio músculo.
En la mayoría de los pacientes (hasta un 50%) existe un antecedente traumático o contusión directa sobre
el glúteo.

8. Rehabilitation protocol
Piriformis muscle syndrome

This is a gluteus sciatica pain, often fluctuating and positional for which the piriformis
muscle is strongly involved, with compression of the sciatic nerve likely at the infra-
piriformis channel.
The objective of this rehabilitation is to obtain a recovery of flexibility to the periphery of
the pelvis and secondarily for spinal mobility.
To achieve this goal, we offer physiotherapy based on several axes:

1. Stretches for the pelvic muscles with a particular emphasis on the piriformis muscle

Teach and monitor the various types of stretching mentioned in the self-rehabilitation
sheet, so that the patient may continue these at home.



2. Massage the gluteal muscles including the gluteus
medius muscle and in combination with deep transverse
friction massages (DTFM) of the piriformis muscle.



3. Myotensive workout of the piriformis muscle through
a contract-relax technique.




4. Analgesic work on the basis of TENS, on the sciatic nerve pathway.



5. We recommend working on the abdominal muscles
and resuming varied and progressive activity.



6. Supra-pelvic flexibility along with:

• Passive mobility exercises in the 3 planes.

• Active resistance by means of a contract/relax technique.

• Based on the McKenzie techniques either in standing
position with hands on the buttocks or laying on the
stomach on a table inclined at 30°.

• The fight against stiffness of the sacroiliac joints.




Physical Medicine and Rehabilitation Department, CHRU Hôpital Jean Minjoz, 25000 Besançon, France

9. Self-Rehabilitation for piriformis muscle syndrome


A stretching session lasts 20 to 30 minutes and must be performed on a daily basis. Various
muscle groups under the pelvis are involved. Stretching should never be painful , otherwise, it
promotes the reflex contraction. For an effective, gentle and gradual stretch of each of the
muscle groups below, we recommend a set position for 30 seconds to 2 minutes until you achieve
a feeling of well-being (muscle relaxation).
It is also possible to achieve an effective stretch for 10 seconds with release of 3 seconds,
repeating this 3 times.


1. Stretching the hip flexor muscles


2. Stretching the posterior chain 3. Stretching the adductor muscles


We recommend, along with stretching to perform
approximately twice a week a postural workout for 10
minutes (right image)
4. Stretching the pelvis trochanteric muscles (piriformis and obturator internus muscles)
in medial rotation : knee toward the opposite shoulder



in lateral rotation


Physical Medicine and Rehabilitation Department, CHRU Hôpital Jean Minjoz, 25000 Besançon, France