Iimbangela zePiriformis Syndrome kunye neSciatica

Imisipha ye-piriformis iyaziwa ngokubanzi phakathi kwezemidlalo kunye nabaqeqeshi bezempilo njengesihlunu esibalulekileyo kwi-hip post. Le mi sebenzi isebenze ukulawula ukujikeleza kwe-hip kunye nokutshatyalaliswa kwayo kwaye nayo iyimisipha engachazwanga ngenxa yokuguquka kwayo kwezenzo ngokujikeleza. Umzimba we-piriformis uphakamisa nokuqonda njengemibangela eyahlukahlukeneyo piriformis syndrome, imeko ekhunjulwa ukuba yinto enokubangela intlungu kunye nokungasebenzi, kungekhona kuphela kubadlali, kodwa nakubantu bonke ngokubanzi.

Inatomy of the Piriformis Muscle

 

 

Umsila we-piriformis uvela kummandla wangaphakathi we-sacrum kwaye ugcinwe ngokukhuselekileyo ngamaqhosha amathathu atholakala phakathi kweyokuqala, yesibini, yesithathu neyesine yangaphambili ye-sacral foramina. Ngamanye amaxesha, imvelaphi yayo inokuba yinto ebanzi kangangokuba ijoyine i-capsule ye-sacroiliac kunye ne-sacrotuberous kunye / okanye i-ligrospinous ligament. Imisipha ye-piriformis iyisisu esomeleleyo nesomeleleyo esivela kwi-pelvis ngokusebenzisa i-foramen enkulu kakhulu, ukwahlula i-foramen kwi-suprapiriform kunye ne-infra-piriform foramina. Njengoko iqhubela phambili kwi-foramen enkulu, i-muscle iyancipha ukuya kwinqanaba apho lenza i-tendon edibanisa nomgangatho ophezulu-mpahla we-trochanter omkhulu, ngokuqhelekileyo ukudibanisa ne-tendon ye-obturator internus ne-gemelli muscle.

Imithambo yegazi kunye nemithambo yegazi efumaneka ngaphakathi kwe-suprapiriform foramen yaziwa ngokuba yimithambo yeglasi kunye nemithambo ephezulu, kwaye ezo zifunyenwe kwi-infra-piriforma fossa zaziwa ngokuba zii-neruteal nerves and nerves, kubandakanya ne-sciatic nerve. Ngenxa yobukhulu bayo obubanzi kwi-sciatic foramen enkulu, kukho umngcipheko kwiinqanawa ezininzi kunye neentsholongwane eziphuma kwi-pelvis zinokucinezeleka.

Umsila we-piriformis uhambelana ngokuthe ngqo kunye nezinye iifutshane ze-hip rotator ngokunjalo, njenge-gemellus ephezulu, i-obturator internus, i-gemellus engaphantsi kunye ne-obturator ngaphandle. Ukwahlula okuphambili phakathi kwesi sihlunu kunye nezinye ii-rotator ezimfutshane ukuxhamla kwayo kwi-nerve ye-sciatic. Umsila we-piriformis udlula emva kwesibindi ngelixa abanye abajikelezileyo badlula phambi kwawo.

 

 

Iimpawu ezahlukileyo zeAnatomical

Ukutshintshwa kwamanani amaninzi kuye kwafunyaniswa ngaphambili kwi-piriformis muscle. Okokuqala, kunokuncediswa okunye okudibeneyo kwi-vertibrae yokuqala ye-sacral kunye ne-coccyx. Okwesibini, i-tendon inokudibanisa ne-gluteus medius okanye minimus okanye ne-gemellus. Kwakhona, malunga namaphesenti angaphantsi kwe-20 yamatyala, isisundu se-piriformis sinokuhlulwa ngamacandelo amabini ahlukeneyo, ngaluphi na inxalenye okanye zonke iimbindi ze-sciatic ezinokuhamba. Emva koko, i-muscle ingadibanisa kunye ne-capsule ehlangeneyo ye-hip njenge-tendon edibeneyo kunye ne-obturator internus. Ukongeza, isalathisi sokuhlukanisa imisipha ye-piriformis iboniswe ukuba ihluke ngokulinganisela kunye nesimo kwi-supero-surface surface ye-trochanter enkulu. Iyakwelula kwi-25 ukuya kwi-64 ipesenti yobude obungemva kwesithuba esingaphandle kwe-trochanter enkulu, kunye neepesenti ze-57 zayo ezixubile ngaphezulu kwaye i-43 ipesenti ngaphezulu ngaphezulu. Ekugqibeleni kodwa, abaphandi bafunda ingongoma yayo yokufaka ngokubanzi kwaye bafumanisa ukuba kukho iintlobo ezine zokufakelwa kwaye ezi zibonakaliswe ngokuxhomekeke kubudlelwane nomngqingili ngaphakathi. Utshintsho lokubekwa kunye nobubanzi boqhagamshelwano lwe-distal ye-muscle ye-piriformis lunokuchaphazela ukuphumelela kwimiba eyaziwa ngokuba yi-inversion yezenzo.

Ngapha koko, unxibelelwano phakathi kwemisipha ye-piriformis kunye ne-nerve ye-sciatic ibe yingxaki exoxwa kakhulu. Sele kugqityiwe ukuba kukho umahluko phakathi kwe-piriformis muscle kunye nokunxibelelana kwayo ne-nerve ye-sciatic. Iindidi ezingaphantsi kolu luhlu lubandakanya: uhlobo lwe-1-A, apho umsipha ubunjwe ngophawu olusebenza ngaphakathi nangaphantsi koku, kufumaneka kuma-70 ukuya kuma-85 epesenti yamatyala; Uhlobo lwe-2-B, apho i-piriformis muscle ihlukaniswe ngamacandelo amabini kunye ne-peroneal nererve eqhelekileyo ehamba phakathi kwamacandelo amabini kunye ne-tibial nerve ehamba ngaphambili nangaphantsi, efumaneka kwi-10 ukuya kuma-20 ekhulwini amatyala; Chwetheza i-3-C, apho isahlulo se-peroneal sishiya ngaphezulu kwesisipha kunye nenxalenye ye-tibial ifunyenwe ngezantsi, ifunyenwe kwipesenti ezi-2 ukuya kwezi-3 zamatyala; kwaye uthayiphe i-4-D, apho i-nerve engavumelaniyo idlula kwi-piriformis muscle, efunyenwe malunga neepesenti ezi-2 zamatyala.

 

 

Ngaphezu koko, kucatshangelwa ukuba ezinye ezimbini, ukungafani okungaqhelekanga, kunokubonakaliswa ngetekisi E no-F kwimzobo. Uhlobo lwe-1-A luyintlukwano eqhelekileyo, ibonisa i-nerve ye-sciatic njengoko idlula ngaphantsi kwesisundu se-piriformis.

Umsebenzi we-Piriformis Muscle

Imisebenzi ebalulekileyo yemisipha ye-piriformis kukubonelela ukujikeleza kwangaphandle kunye nokuvumela ukuthatha i-90 degrees ye-hip flexion. Ngethuba lokuthwala ubunzima, umsila we-piriformis uvimbela ukujikeleza kwangaphakathi kwezezifo kwisigaba sokuma sokuhamba nokusebenza. Kwakhona, kunceda abajikelezileyo abancinci be-hip ekunciphiseni i-hip kunye nokuzinzisa. Ngenxa yokuba unokusebenzisa amandla oblique kwi-sacrum, kunokuvelisa amandla okugqoka okujikelezayo kwi-sacroiliac. Ngaphandle koko, oku kuya kutshaya isiseko esisezantsi se-sacrum ngaphambili kunye nesigxina se sacrum ngasemva.

Ekubeni umsila we-piriformis ungasemva kwe-hip zangaphandle ze-rotator ngenxa yokuncedisa kwi-surface yangaphakathi ye-sacrum, inefuthe elikhulu ekusebenziseni umphumo wokujikeleza kwi-joint hip. Ngamanye amaxesha, iingcali zonyango ziye zafumanisa imiba kunye ne-piriformis muscle apho ibonakala ibomelele kwaye i-hypertonic, ngelixa elinye i-rotator elifutshane elincinci elithotyana ne-axis of rotation lingenakuvinjelwa kunye ne-hypotonic.

Ukuguquka kwesenzo

Inkxalabo enkulu yokuphikisana enxulumene nomsebenzi we-piriformis muscle yendima yayo yokuguqulwa komsebenzi, eyona nto ibhekiswe kuyo njengento yokuguquka kwenxaxheba yendima. Abaphandi bacebise ukuba njengokuba i-hip ihamba ngeengcongolo ze-60 ukuya kwii-90 degrees kwaye zikhulu, i-tendon ye-piriformis ukutshintsha kwemizimba kwi-trochanter enkulu. Ngenxa yoko, umgca wayo wokutsala ungabonakali nje ngokuba ngumqhubi wangaphandle we-hip, nangona kunjalo, ugalelo ekujikelezeni kwangaphakathi kwe-hip. Ngenxa yoko, iguqula umsebenzi wayo wokujikeleza kwiindawo eziphakamileyo ze-hip.

Nangona kunjalo, uphando olutshanje olwenziwa ngokusasazeka kwe-anatomical lubonise ukuba ukunamathiselwa kwe-piriformis muscle kwi-trochanter enkulu kunokutshintsha kwaye, kwezinye iimeko, ingafaka kwindawo apho kungenakho ukukwazi ukuwuyeka umsebenzi wayo, umzekelo, kwi-attachment engaphezulu. Ngaloo ndlela, ukunweba umsila we-piriformis ube ngukujikeleza kwangaphandle xa umlenze uguquguquka ngaphaya kwee-degrees ze-90, ngokusekelwe ekutshintsheni kwendima yezenzo, kuya kuba yinto engasebenzi njengonyango okanye ukudukisa njengendlela yoviwo.

Indima yemisipha ye-piriformis kwii-engile ezininzi ezidibeneyo yinto ebalulekileyo yokuqwalaselwa kwabaqeqeshi bezempilo abavavanya nokunyanga oonobangela be-piriformis syndrome. Rhoqo, kuyacetyiswa ukolula i-hip kwi-flexion, ukuthambisa kunye nokujikeleza kwangaphandle ukolula umsipha we-piriformis ngaphezulu kwe-glutes ngokusebenzisa ukuguqulwa komqondo womsebenzi.

I-MSK Ukungasebenzi kunye neengxaki zePiriformis Syndrome

Kwiminyaka emininzi eyadlulayo, kwacetyiswa ukuba kwezinye iimeko, iimpawu ze-sciatica zinokuvela ngaphandle komqolo ngenxa yezihlunu zepiriformis. Le hypothesis yaxhaswa kwakamsinya nje emva kokuba iingcali zaphucula ngempumelelo iimpawu ze-sciatica ngokwahlulahlula umsipha wepiriformis. Ngokusekwe kukwahlulahlula i-cadaver anatomical dissection, abaphandi bakholelwa ukuba ukubola kwemisipha ye-piriformis kunokuba noxanduva lokucaphuka kwentliziyo ye-sciatic.

Ixesha leyeza lonyango le-piriformis syndrome laza laxhamla kwiimpawu ze-sciatica, ezikholelwa ukuba zibangelwa yinto engafanelekiyo ephazamisayo kwi-piriformis muscle ngokugxila kwizinto eziqhelekileyo ezibangelwa yi-sciatica, njenge-root impingue impingement ebangelwa i-disc. Ngokukhawuleza yaba yinguqulelo eyamkelekileyo kodwa ingavumelananga malunga neempawu zonyango kunye neemvavanyo zokuxilonga ukuze zihluke kwezinye iindawo zemithombo ye-sciatica.

Ukuqonda izizathu zePiriformis Syndrome

I-Piriformis syndrome inokuchazwa njengentsebenziswano phakathi kwe-piriformis muscle kunye ne-nerve ye-sciatic, apho oku kunokucaphukisa iimbilini kunye nokuphuhlisa intlungu ye-hip yangasemva kunye nokudluliselwa kwe-distal phantsi kwethanga elingasemva, elifana neempawu ze-sciatica yangempela. Ukwahlula-umonakalo kulo mmandla ngokuqhelekileyo kulandela ngaphandle kwezizathu ezaziwa kakhulu ze-sciatica kunye neentlungu ze-buttock.

Ngokukodwa, iingxelo zentlungu ye-buttock kunye nokuhanjiswa kweempawu ezikude azibalulekanga kwizizathu zesifo se-piriformis. Iimpawu ezifanayo zixhaphake kakhulu xa kubonakala amayeza asezantsi eentlungu ezisecaleni kunye nokungasebenzi kakuhle kwamathambo. Ke ngoko, uvavanyo olupheleleyo lwezi ndawo kufuneka lwenziwe ukukhusela nakuphi na ukugula. Kucetyisiwe ukuba oonobangela be-piriformis syndrome banokubanjelwa uxanduva malunga ne-5 ukuya kwi-6 yepesenti yamatyala e-sciatica. Kwiimeko ezininzi, iyakhula kubantu abakuminyaka ephakathi, umndilili okanye iminyaka engama-38 kwaye ixhaphake kakhulu kwabasetyhini.

I-Pathogenesis yePiriformis Syndrome

 

 

Iimbangela ze-Piriformis syndrome zinokudibaniswa nezinto ezintathu ezibangela iziphumo: Okokuqala, intlungu ebhekiswe kuyo ingaba yimiphumo yamaphuzu e-myofascial. Okwesibini, ukufakwa kwesibindi sokulwa ne-sciatic foramen xa idlula nge-infrapiriform fossa okanye ngaphakathi kwimizimba ye-piriformis. Kwaye okwesithathu, ukungasebenzi komzimba kwe-sacroiliac kubangelwa ukuba i-piriformis muscle spasms.

Abanye abaphandi banikezela inani elongezelelweyo lezinto ezibangelwa izimbangela ze-piriformis syndrome ngolu hlobo lulandelayo: i-gluteal trauma kwi-sacroiliac okanye i-gluteal, iinguqu ze-anatomical, i-myofascial trigger points, i-hypertrophy ye-piriformis muscle okanye i-spirims of muscle ye-piriformis njenge-laminectomy, indawo ehlala kuyo izilonda ezinjenge-neoplasm, bursitis, i-abscess kunye ne-myositis, ii-injection ezinqamlekileyo kunye nokubethelwa kwabesifazane.

iimpawu

Iimpawu eziqhelekileyo ezichazwe ngoonobangela be-piriformis syndrome zibandakanya: uvakalelo oluqinileyo okanye olungqiniweyo kwi-buttock kunye / okanye i-hamstring, iintlungu eziqaqambayo ukuya kuthi ga kwiipesenti ezingama-98 zamatyala, iintlungu ze-fcalf ukuya kuthi ga kwiipesenti ezingama-59 zamatyala, ukunyuka ngokuhlala kunye Ukuqhekeka ukuba i-trunk ithambekele phambili okanye umlenze uwelele ngapha komlenze ongachaphazelekiyo kunye neempawu ezinokubakho zepheripheral ezinje ngeentlungu kunye ne-paresthesia ngasemva, ukuqaqamba, iimpundu, i-perineum kunye nomva wethanga ukuya kuthi ga kwiipesenti ezingama-82 zamatyala.

Ukufumana iziphumo kunye neemviwo

Kubalulekile ukugcina engqondweni ukuba i-hip flexion kunye nokujikeleza kwangaphandle okusebenzayo okanye ukujikeleza kwangaphakathi kwangaphakathi kunokunyusa iimpawu zokungasebenzi. Iziphumo ezongeziweyo zezizathu ezivavanyiweyo zesifo se-piriformis zibonakalise i-SLR elungileyo engaphantsi kweedigri ze-15 kwicala eliqhelekileyo. Olunye uvavanyo olusetyenziselwa ukuvavanya oonobangela be-piriformis syndrome lubandakanya, uphawu oluqinisekileyo lwe-Freiberg s, elisetyenziswe kuma-32 ukuya kuma-63 eepesenti zamatyala, kubandakanya ukuveliswa kwentlungu ekujikelezisweni kwangaphakathi okunyanzelekileyo kwesinqe kwindawo ephezulu, ekukholelwa ukuba kubangelwa Ukolula nje isihlunu se-piriformis kunye noxinzelelo lwe-nerve ye-sciatic kwi-ligament ye-sacrospinous. Uphawu lwePacers, olusetyenziswa kwiipesenti ezingama-30 ukuya kuma-74 zamatyala, kubandakanya ukuvelisa iintlungu kunye nobuthathaka ekuthinjweni okungafunekiyo kunye nokujikeleza kwangaphandle kwethanga kwindawo yokuhlala. Ubuhlungu kwisikhundla se-FAIR esisetyenziselwa ukuvavanya ukungasebenzi kakuhle, kubandakanya ukuveliswa kwentlungu xa umlenze ubanjwa ngokujija, ukukhutshwa kunye nokujikeleza kwangaphakathi. Ukongezelela, i-lumbar lordosis kunye ne-hip flexor tightness ibeka umntu ekunyuseni ukunyanzeliswa kwe-nerve ye-sciatic ngokubhekiselele kwi-notch ye-sciatic nge-piriformis efutshane. Uvavanyo lwe-Electro-diagnostic lunokungqineka luluncedo ekufumaneni iingxaki zemisipha ye-piriformis.

Xa i-spasm ephazamisayo ngaphakathi kwimizimba ye-piriformis ejikelezileyo ikhona kwaye kukho intlungu ye-obturator ngaphakathi kunye neentsikelelo zangaphandle kwi-notch ephezulu, efumaneka kwi-59 kwi-92 yeepesenti zamatyala, umntu kufuneka enze iSims isikhundla sokulandela uvavanyo. Umgca we-piriformis umele ube ngaphezu komda ophakamileyo wesisundu se-piriformis kwaye unwebe ngokukhawuleza ukusuka phezulu ngaphezu kwe-trochanter enkulu kumda we-cephalic we-sciatic foramen kwi-sacrum. Uviwo luya kuqhubeka apho umgca uhlulwe ube ngowesithathu. Ukushicilela ngokugqithiseleyo kwintlanzi kwi-point of maximum-tender pointness, edlalwa ngokukhawuleza kwinqanaba eliphakathi kunye neyokugqibela yesithathu yomgca.

uphando

Ukucatshulwa okuqhelekileyo, okufana ne-X-ray, i-CT scan kunye ne-MRI, badla ukungaphumeleli ekuhloleni ubukho kunye nezimbangela ze-piriformis syndrome. Nangona kunjalo, ixabiso elithile lingaba khona kwi-test-diagnostic testing. Injongo yale mvavanyo kukufumana iimpazamo eziqhutyelwayo kwi-nerve ye-sciatic. Iziphumo ezinjengeempawu ezinokuthi zide zifikeleleke, umzekelo, i-H reflex ye-nerbial nererve kunye / okanye i-neroneal nervous, ingaba yinto eqhelekileyo ekuphumleni kodwa ilibazisekile kwiindawo apho i-rotation zangaphandle ze-rotator ziqinisiwe.

Kuye kwaqinisekiswa ukuba ulwahlulo lwe-tibial lwe-nerve ye-sciatic luhlala lugciniwe, i-nerve ye-gluteal engaphantsi enika i-gluteus maximus inokuchaphazeleka kwaye i-muscle ingaba ne-atrophied. Nangona kunjalo, ukuvavanywa kwe-nerve peroneal kunokubonelela ngeziphumo ezigqwesileyo njengoko kunokwenzeka ukuba zibe yinxalenye edibeneyo ye-nerve ye-sciatic. I-H-wave inokuthi ingasebenzi ngexesha lesithuba esibuhlungu sokunyanzeliswa kwe-adduction-internal rotation yomlenze ochaphazelekayo.

I-Piriformis Syndrome Myths

Abaphandi baxubushe ukuba i-piriformis syndrome ligama eliqhelekileyo elisetyenziswayo elisetyenziselwa ukuchaza nayiphi na i-tender ye-gluteal engabonakaliyo kunye nentlungu ebuhlungu yomlenze. Kwaxelwa ukuba kuphela kwiimeko ezinqabileyo imisipha ye-piriformis ebandakanyekayo ekunyanzeleni kwe-nerve ye-nerve ye-sciatic enokuthi emva koko ifaneleke ngokuchanekileyo njengenye yezizathu ze-piriformis syndrome. Kwacatshulwa ukuba kukho ubungqina obulinganiselweyo kunye neemeko apho ukuxilongwa kwezizathu ze-piriformis syndrome kunokwenziwa, ngokukodwa, apho kukho umonakalo oxinzelelekileyo kwi-nerve ye-sciatic nge-piriformis muscle. Kwizifundo ezininzi ezizimeleyo, i-nerve ye-sciatic yabonwa ukuba ixinzelelwe ngumsipha we-piriformis kwiimeko ezifana ne-hypertrophy ye-muscle, ukungaqhelekanga kwe-anatomical jikelele njenge-bifid piriformis muscle kwaye ngenxa yokunyanzeliswa ngamabhande e-fibrous.

Kwakhona, ukuxhwaleka kunye nokusilela umsila we-piriformis kunokubandakanya i-nerve ye-sciatic. Kungenzeka ukuba iziganeko ezinqabileyo ze-piriformis syndrome zibangelwa sisifo esibi ngokuthe ngqo kwi-piriformis muscle ngenxa yentlekele ephazamisayo kwisisipha. Oku kubizwa ngokuba yi-post-traumatic syndrome.

Abaphandi baxhasa le ngxabano ngokuchaza ukuba kunokwenzeka ukuba, ngenxa yobudlelwane be-anatomical ye-piriformis muscle ukuya kwiimbilini ezahlukahlukeneyo kwindawo enzulu ye-gluteal, intlungu ye-buttock-inokubangelwa ukubanjelwa kwe-gluteal nerves kunye ne-hamstring pain. ngenxa yokubanjiswa kwemithambo-luvo ye-cutaneous yangasemva yethanga, kunokuba kubanjwe i-nerve ye-sciatic yodwa. Oku kubonisa imeko ehlalutywe ngokwezonyango ngokungabikho kweempawu ze-distal sciatic neurological. Ingaba i-piriformis muscle yimbangela yokunyanzeliswa ayizange isungulwe ngokucacileyo. Kunokwenzeka ukuba i-obturator internus/gemelli complex yenye imbangela yoxinzelelo lwe-neural. Abaphandi bacebise ukusebenzisa igama elithi deep gluteal syndrome kune-piriformis syndrome.

impatho

Xa esinye sezizathu ezininzi ze-piriformis syndrome zifunyenwe kwaye ingcali yezempilo ivakalelwa kukuba ukuxilongwa okufanelekileyo kwenziwe, unyango luya kuxhomekeka ngokubanzi kwisizathu esibangela ukungasebenzi. Ukuba i-piriformis muscle iqinile kwaye i-spasms, ngoko okokuqala unyango olulondolozayo luya kugxininisa ekwandiseni nasekuphululeni umsipha oqinileyo ukucima i-piriformis muscle ekubeni ngumthombo wentlungu. Ukuba oku kungaphumeleli, ke oku kulandelayo kucetywayo kwaye kunokuzanywa: ibhloko ye-anesthetic yendawo, eyenziwa ngokuqhelekileyo yi-anesthesiologist enobuchule bokulawula intlungu kunye nokwenza iibhloko ze-nerve; iinaliti ze-steroid kwi-piriformis muscle; iiliti ze-toxin ye-botulinum kwi-piriformis muscle; kunye neurolysis yotyando.

Ungenelelo olujolise kunyango, njengolule imisipha ye-piriformis kunye nokusingathwa ngokuthe ngqo kwendawo yokubamba, kunokusetyenziswa njengonyango. Kukhuthazwe ukuba ukolulwa kwemisipha ye-piriformis kwenziwa kwizikhundla ze-hip flexion enkulu kune-90 degrees, ukunyuswa kunye nokujikeleza kwangaphandle ukusebenzisa ukuguqulwa kwesenzo sentshukumo yemisipha ye-piriformis ukwahlula ukuzolula kwesi sihlunu esizimeleyo somnye umjikelo wangaphandle ojikelezayo. .

Nangona kunjalo, ubungqina obutsha obusebenzisa uphando lwe-ultrasound bunqume ukuba akukho nxu lumano phakathi kwe-angle ye-hip flexion kunye nobukhulu be-tendon ye-piriformis ye-muscle kwi-internal and lateral hip rotation stretching, oko kuthetha ukuba i-piriformis muscle ayiguquli isenzo sayo. Ukongezelela, abaphandi abenza izifundo ze-cadaveric baphetha ukuba ukufakwa kwe-piriformis muscle kuhluke kwaye kuyinkimbinkimbi kakhulu kunokuba kwakukholelwa kuqala. Kungenzeka ukuba i-piriformis muscle inokuguqula isenzo sayo kuphela kubantu abathile kodwa kungekhona kwabanye.

Ngokufanelekileyo ngenxa yokungavumelani kunye nokudideka malunga nombono wokuguqulwa kwesenzo, kucetyiswa ukuba abaqeqeshi bezempilo kufuneka benze iinguqu ezimbini ze-piriformis muscle stretch: i-stretch in flexion, i-adduction kunye nokujikeleza kwangaphandle kunye nokwelula kwi-flexion, i-adduction kunye nokujikeleza kwangaphakathi.

I-Pigeon Ukutyelela umsizi we-piriformis wesobunxele: i-hip flexion, ukutshintshwa kwamanye amazwe kunye ne-hip ephezulu yokujikeleza kwangaphandle.

 

 

Tyalela i-muscle ye-piriformis yesobunxele: i-hip isendaweni, ukunyuswa kwe-neutral kunye nokujikeleza kwangaphandle.

 

 

Ukwelula kwesikhewu esingasemva komnxeba we-piriformis isisindo esifanelekileyo: umlenze ungaphakathi kwe-90 degree degree, ukutshintshwa kunye nokujikeleza okungathathi hlangothi.

 

 

Iimpawu zoTywala kunye nokuSasa

 

 

Isiphakamiso esilungileyo kunokuba siphumelele iipiriformis muscle trigger points kulesi sikhundla siphakanyisiwe. Kule mpahla, umqeqeshi wezezempilo unokuvakalelwa ngeengongoma eziphambili ze-piriformis kunye nokusebenzisa uxinzelelo oluqhubekayo lokunciphisa iingongoma zokuqala kunye nokufaka ukusilalisa umsizi kwisistim kule ndawo. Kule ndawo, i-gluteus maximus ikhululekile kwaye ilula ukuziva i-piriformis muscle ejulile.

I-piriformis muscle iyisihlunu esinzulu se-hip yangasemva efana ne-anatomically efana ne-joint sacroiliac kunye ne-nerve ye-sciatic. Isisihlunu esisebenza njenge-rotator ye-hip ephezulu kunye ne-stabilizer, ene-propensity yokunciphisa kwaye ibe yi-hypertonic. Ngenxa yeso sizathu, iindlela zokolula kunye ne-massage zisetyenziswa kakuhle kwaye zihlala zicetyiswa ukunciphisa ithoni ngesihlunu. Ekugqibeleni, kuye kwachazwa ngokunyanzeliswa kunye nokucaphuka kwe-nerve ye-sciatic, edla ngokubizwa ngokuba yi-piriformis syndrome.

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NguDkt Alex Jimenez