Rehabilitating Piriformis m.:Learn Integral Anatomy with Gil Hedley

www.gilhedley.com In this video I offer some of the detailed and lesser known features of the anatomical structures surrounding the piriformis muscle tissue, including the sciatic nerve, the inferior and superior gluteal arteries, veins and nerves. By learning these details, you can expand your ideas about pain and function in this area and blame the piriformis a bit less for your butt woes :) Explorer members of my site can watch detailed dissections of the gluteal region and lateral rotators in Day 3 of the Jerry dissection, as well as in Courses 4 and 9 of Anatomy from A to Z Courses 4 and 9, and also in Vol. 2, pt. 2 of The Integral Anatomy Series, Enjoy!
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[@zkampyman]

Like a lot of people, I would like to think that I am smart. When I watch Gil Hedley, I am reminded that there is always someone smarter than myself. He is absolutely brilliant in his ability to render complex concepts in a way that is understandable to the rest of us. I was on the edge of my seat during his summary hoping that he would mention core flexibility in its relationship to the psoas with special attention to the QL, Rectus Femoris and Psoas muscles.

[@somanaut]

I'm going to need to do a whole other video to hit on "the core," I realized it the moment I mentioned it, thank you for your interest!

[@vallou18]

Can't wait to see that one as well!

[@cinmac3]

and how it connects to the back of the shoulder.

[@movewithmike]

Wow, thanks for sharing such a great lesson and perspective. You're always giving me an opportunity to step back and see the body as a more cohesive whole. Always a joy to watch your videos!

[@somanaut]

Thank you kindly Mike, I grateful to know that the holistic view serves you well, it works for me too :)

[@MeganMacCarthy]

As always, you are genius. This is the best use of clay I've seen since my daughter replicated my chicken coop and al lthe chickens. And your aunt's table leg to demonstrate the importance of core stability...don't blame the toy poodle!

[@somanaut]

Yes! Don't blame the toy poodle, and don't beat it with the old table leg haha~ I want to see that chicken coop model, sounds amazing! My daughter loved clay too, runs in the family!

[@somaticat]

Yes Yes Yes. As a massage therapist, I stretched and kneaded my piriformis diligently and it didn't work for my butt and hip pain. I'm now working to stabilize my core. And I can see your cray modeling skill is evolving to next level since the nerve project.

[@somanaut]

Thank you my dear, yes the nerve project has boosted my nerve modeling skills considerably!! Is the core stabilization helping your hip and butt pain?

[@movementandrest]

Your modeling work is superb! I especially appreciated seeing the anterior view of the nerve plexus. And now I'll always think of a toy poodle when considering the piriformis :). 🙏

[@somanaut]

I am grateful for your appreciations! I recently dissected all of those nerves very clearly so it was extra fun to make the model with the strong visuals of recent experience in mind :)

[@StephanieSwafford]

Many thanks to you, your great aunt and that vicious toy poodle! This makes so much sense. I'd call this a very successful rehab of the much maligned piriformis.

[@somanaut]

Thanks Stephanie, mission accomplished!

[@MsCathyyo]

This was almost Shakespearean…until you got to the 'poodle'! Loved the sculpture that you developed; almost as beautiful as the pars intimate necklace you have created. Thank you for the 'effort heuristic'…you definitely are getting the message across-'don't blame the piriformis'! That could be a t-shirt logo!

[@somanaut]

Haha yer hysterical... Gotta develop the merch, we'll start there!

[@MsCathyyo]

@@somanaut Your course is so in depth and maybe the biggest hurdle for me is that I have to stop thinking that there is a right way or a wrong way in movement function…but, you explain from your multitude of 'teachers' to show that we have to think out of the box. Yay to core strength…BUT, I understand that 'looks' may develop to interfere with the 'ideal model'. Uh oh…so, maybe the 'ideal model' has to be challenged. Amen!

[@shoko5633]

Wow that is sooo helpful to understand the task of piriformis! Thank you 🙏🏼

[@somanaut]

You're most welcome, thank you for watching Shoko!

[@Fit-mit-Jenny]

Thank you so much, Gil, for ALL your Great videos. I love them all and I love the way they make me feel. 😁 I always get excited and amused by your excitement and your unique way to „meet“ tissues or nerves and to „rehabilitate“ the bad guys 😅 Thank you for your being !!!

[@mindfulfeet]

Your clay models are brilliant, Gil - thank you! And thank you for sharing a new approach to addressing sciatica and not blaming the piriformis! I've always said that the piriformis is overworking but never made the connection with stabilising the spinal column. I always thought that it was taking over the role of the bigger muscles like the glutes. I believe that it is best addressed by a whole-body approach based on bony alignment and interdependent movement. Can we stabilise the pelvis? Can we move the pelvis? What's its default position? Can we relax and stabilise the ribcage? Can we move the ribcage independently of the pelvis and vice versa? I look forward to checking out the content of the subscriber area of your website. Thanks again! Isabelle

[@somanaut]

Wonderful, thank you Isabelle!

[@bodyw8n8]

Loved the great aunt table leg representation, I feel lat strength also plays a part in the spine stability to relieve pressure off the piriformis, along with the core strength 😊 shows how much strength plays a part in pain relief

[@somanaut]

Yes! Thank you for adding to the conversation!

[@lovinglife2217]

Thank you for being an outstanding educator. I like your table leg analogy. I would also include the pelvic floor in assisting the piriformis to stabilize the table leg (spine). Sometimes therapists focusing on stretching or massaging a tight piriformis/pelvic floor when they really have to look from a different point of view and think why the muscle may be tight (to stabilize). Focusing on improving stabilization will resolve the muscle clenching/overuse.

[@herdmentality101]

Awesome lesson, thank you!! I love finding these videos at just the right time. I have hEDS so instability in all of my joints throughout my body. When you have so much peripheral pain it's easy to forget about the core. And all to often, a little postural correction of my neck can release tension in my upper abdomen and pelvic floor and vice versa. Thanks again!!

[@somanaut]

Ah perfect, some day before long I'll offer something on the hypermobility spectrum issues!

[@andreakennedy4080]

Thank you , thank you , thank you, I am sharing this with everyone on my email list!!!!!

[@somanaut]

Oh great Andrea, I appreciate you sharing!

[@jeffsimslmt]

Love seeing the plexus anteriorly. See you soon.

[@somanaut]

cool right? and I didn't even show the anterior vasculature, as it would have just disappeared...pelvis is a busy place! Cu soon :)

[@lisavaughan8761]

Wow: This so explains a situation from 2 years ago, after a lot of yoga I thought I was practicing correctly; tried acupuncture, massage therapy; focusing on the piriformis....Core balance; I have intuitively been employing and this has helped immensely. You just turned on the lights. Thank you, Gil!

[@somanaut]

I appreciate your real-world experience and contribution here very much Lisa, thank you for sharing that!

[@jpg3702]

Yes! core balance has helped me in so many seemingly unrelated ways like even plantar fasciitis.

[@feldenkraismethod]

Gil, thank you for your brilliant illustrious articulation - and FUN presentations!🌠

[@somanaut]

Aww thank you so much, I appreciate your interest :)

[@evecunardyoga6362]

Makes so much sense. Thank you.

[@somanaut]

Thank you Eve, I appreciate your interest!

[@jkc9615]

Excellent informational presentation. Thank you:)

[@somanaut]

Thank you JKC, I appreciate your interest :)

[@arianemccormack8111]

So relevant for physiotherapy Gill. I am treating a few pregnant women with PGP at the moment and as you eloquently eluded, there is so much more than just piriformis doing the work, or things not working affecting piriformis. I think I will use your table leg analogy ahah!! I might not bring it into clinic though ;-)

[@somanaut]

Aww go on, bring it in Ariane, they'll get it!!

[@avivadanziger7891]

Gorgeous! Mind blowing as always !! Thanks for this 🫶🏽🪷

[@somanaut]

Aww thanks Aviva!

[@estherl1383]

I love your clay models. Thanks a lot

[@somanaut]

Thank you Esther, I do love to play with clay to get the stuff in my head out in 3D!

[@angelmuscledoc]

Always learning! Thanks again Gil!!

[@somanaut]

Woot! Me too, thanks Angel!

[@lindalang1091]

another excellent video! but as you skated away from teaching about "the core" and strengthening it, I thought YOU'D be The Best person to excavate & evaluate the workings of the three bandhas in yoga practice: mula bandha in the pelvis through uddiyana at the solar plexus to julandhara in the throat, which I believe most truly represent the concept of core strength(ening) and structural integration. Thank you, thank you, thank you!

[@somanaut]

Hi Linda, the moment I said the word "core" I knew I'd have to address that in another video, so, more to come!

[@sandrahargrave1638]

Awesome as always.

[@somanaut]

Thank you Sandra, I appreciate your ongoing interest!

[@EmbodiedLearningSystems]

The use of the table leg to help one conceptualize what's happening in the sacral area is fantastic. I too have questions about what is meant by "core stability", coming from my point of view as an Alexander Technique teacher. One of our maxims is "mobility = stability", and the opposite being rigidity = instability. I want to keep an open mind and wait til core stability is defined also! as it can mean so many different things. In AT teaching and practice, we have a set of relationships we encourage such that the spine is not stiff, the head is not pulled down on the spinal column (causing compression), the arms are not rigid or pulled in, and the legs are energized in such a way that the sacrum would not get locked in a rigid relationship with either leg, thus encourages a gliding environment for all the tissues. Think of a Hula dancer, with their head gliding along at the same level while their hips are flowing side to side in a wave like motion...thus, your table leg would be waving, which creates stability/balance.

[@somanaut]

Very interesting description, thank you for sharing that! There are no doubt many notions of core mobility and core stability, might have to come back to that in another vid!

[@EmbodiedLearningSystems]

Please do! I am sooo open to hearing your take on it. I'm sure it's a bit of a can of worms...but it could be fun too!@@somanaut

[@marycandullo526]

THANK YOU GIL!

[@somanaut]

You're welcome Mary!

[@anamargaridasilva5149]

Thank you very much, Gil!

[@somanaut]

You are most welcome Ana Margarida!

[@pemkri]

Thank you 😊 great as usual... Now another thought popped up, what determines why and how a "variation" would happen in the process of developing? Reminds me of Blechschmidts try to describe the Embryo as a fluid, intelligent organism (what it certainly is) ... but who has done some research in that topic? Would you mind naming some sources that would be worth reading?

[@somanaut]

Hmm good question! I am a huge fan of Erich Blechschmidt's incredible embryology work, and indeed most anatomical variations (as opposed to conscious or accidental variations that occur throughout life) are evident and occur during embryological/fetal development. As for causation, all I can offer is that literally every human being represents what I like to call "the norm of variation." Variation is the norm, and our books disguise this de facto by drawing averages and means instead of specific examples, which to me are the only actual representations of true anatomy. So there's a philosophy underlying my answer to your question: nature is variable, so actual examples make for the best starting points for understanding what human's serve up with respect to any given anatomical structure, and I just observe and report that while avoiding a judgement that the "average" is "right" or "normal" and that that which varies from the average (which is Everyone!) is somehow "off." Thank you for stimulating this little rant haha!

[@pemkri]

@somanaut thank you for taking my question that serious... I often wondered why and how something happens... I am a trainee in Osteopathy and I love the biodynamic approach and this has led me to thinking about it, because sometimes I feel things inside a body that is inexplicable but leaves me in awe... and there we are who and what determines our appearance? I don't believe in the Gene theory there must be something else pulling and pushing and turning the switches... looking forward to your next post!

[@nancysanchez160]

My Pilates client, Molly Fudge Mastrangelo did ground-breaking work in embryolocal development-yes, in sea urchins-and yes, it relates to us humanoids

[@SuziGeiger]

hahaha "Woes in our butts" love it and so true. We blame it all on the piriformis.. No more Gil

[@somanaut]

Everyone needs their champion :)

[@hazelmcloughlin7290]

Fantastic and well needed

[@somanaut]

Thank you Hazel!

[@garygammon754]

THANK_YOU!!! finally someone points out that the piriformis is not necessarily the bad guy. Spinal instability. lower appendage instability, and hip instability have much more to do with potential sciatic problem. IE beathing it up to treat sciatica is only picking on the victim!

[@somanaut]

Yah let's not blame the messenger, thank you Gary!

[@naomi_jean]

I love this and it is So helpful. Thank you❤❤❤

[@alisonmarsh5346]

You are a metaphor MASTER!!

[@somanaut]

Haha thank you Alison, they just come tumbling out uninvited to the party ;)

[@alisonmarsh5346]

@@somanaut That is a gift. And what makes you such a relatable, effective teacher.

[@SilaYoga]

Thanks Gil for another great video

[@somanaut]

My pleasure, thanks for watching!

[@amberlamascus7789]

Mine is more like a chihuahua! As always thank you 🙏🏽

[@artofalignmentacademy]

Wonderful, Gil ;-) Thank you! xoxo

[@somanaut]

You are most welcome my dear! xoxo

[@shubhammaurya5722]

Amazing now I focus more on core and back muscle strength..😊

[@somanaut]

It seems to help, from my own reviews of feedback, keep us posted on how that goes :)

[@shubhammaurya5722]

@@somanaut ofcourse

[@emilielovesevie688]

My four year old thinks you are so funny and loved this video and laughed at “woes in your butt” in particular

[@somanaut]

Haha that makes me so happy to hear that Emilie... I homeschooled my three kids for many years, pretty much everything I do in terms of teaching is just an extension of that adventure!

[@AngelikaFiedorowicz]

Beautiful model! 😍

[@om5335]

Wonderful, more of these 😊

[@somanaut]

Make a list, I can add it to mine haha!

[@om5335]

@@somanaut I appreciate all the materials that you uploaded so far , The last video I find educative as well as applicable for me as a bodyworker ,So anything along these lines I find very beneficial

[@hansmassage5964]

As Taya Countryman said in one of her classes it acts as an antagonist to the adductors of the femur. So the pair adjust the top of the leg to stay laterally over the foot.

[@somanaut]

That and more!

[@dawnmorris3996]

So helpful!

[@somanaut]

I'm glad to hear that Dawn, thanks for watching!

[@galaraisa]

Thanks a lot. You are great. 🙏🏾

[@somanaut]

I appreciate your interest!

[@alisonmarsh5346]

YESSSS! Thank you!!! 4:58

[@somanaut]

You're welcome Alison!! I always found it curious that this huge gaggle of neurovascular tissues rarely if ever merits an acknowledgement amidst all of the piriformis "bashing," so here we go!

[@Technesoma]

The toy poodle metaphor is great!!! I'm gonna get me a great pyrenees piriformis, to protect me from the spine wolves : ).

[@somanaut]

Haha that's it!

[@scottsiegel8067]

So, the piriformis muscle assumes the responsibility of being a postural muscle in the presence of core instability? Also, did you say nerves can be hypertonic, and can impinge upon the muscle?

[@somanaut]

Yes to both! Thanks for your interest Scott :)

[@margueriteoreilly2168]

Wow Unbelievable pirifimis muscle Belfast Ireland 🇮🇪 💪 😍

[@margueriteoreilly2168]

Super cool the nerves from back to front, understanding my body more with these cool 😎 lessons 😎 💗💚🧠🇮🇪💪💚

[@somanaut]

I just dissected this with care recently during the Nerve project, and got such a better understanding this time...and I will do it again...and again! I definitely learn by repetition haha Thank you as always for your enthusiasm Marguerite, love to Belfast!!

[@margueriteoreilly2168]

@somanaut My hip is in pain , this is 100 percent showing me what is in that area 🤔 I love the Nerve Project It has opened a hole new way of thinking Definitely a fan Thank you so much Gil Marguerite 🧠💗😎💚💪

[@victoriatatge4220]

"im just trying to lighten the blame and burden on the piriformis from all our woes...in our butts" 😂

[@cinmac3]

i hearso much about the vagus nerve to you have information, all these techniques to stimulate it,i don't feel what the say.

[@somanaut]

I am building a Vagus Nerve Playlist on my channel here, there are several videos with more to come, though I have not jumped on the trend of "vagus nerve hacks"...just yet haha~

[@dominickballard3311]

"PromoSM" 👊

[@somanaut]

Hi Dominick, tell me more! What does "PromoSM" mean?!

[@returntodogen]

How about, we were put off balance in some way and our brain sensed danger so the pirifirmis came to the rescue. All that really needs to be done is for the brain to be convinced of safety and the piriformis can relax instead of focus on aa "weak core"

[@somanaut]

If that works, I'm all for what works!