McGill Strengthening With and Without Integrated Neuromuscular Inhibition Technique in Piriformis Syndrome

These exercises were divided into 3 phases, each lasting 2 weeks. Patients performed 4 repetitions of each exercise during 1st and 2nd week at each hospital visit. Then, increased by 4 repetitions every 2 weeks for up to 6 weeks. These exercises were performed with a maximum of 12 repetitions with a 1-minute of rest interval between each exercise. These exercises were performed by patients at each clinical visit, 3 days per week for total of 6 weeks.

This technique was applied at piriformis muscle. The procedure was repeated 3 times for up to 10 minutes at each clinical visit. This intervention was performed 3 days per week for total of 6 weeks.

These exercises were performed by patients at the end of each hospital visit (3 days per week for total of 6 weeks) and also at home twice a week during the 2 months follow-up period after treatment ends.

• Continuous-mode ultrasound therapy was applied at a frequency of 1 MHz and an intensity of 1.0 W/cm² for 3 minutes to the tender or trigger points on the posterior aspect of the pelvis.
• A hydrocollator pack (40°C) was applied for 10 minutes at lumbopelvic region.
• Piriformis, hamstring/calf stretching was performed progressively in phases.

• Phase 1 consists of weeks 1 and 2 with 1 set of 3 repetitions with 30 seconds hold per day.
• Phase 2 consists of weeks 3 and 4 with 2 sets of 3 repetitions with 30 seconds hold per day.
• Phase 3 consists of weeks 5 and 6 with 2 sets of 3 repetitions with 30 seconds hold twice per day.
• Follow-up period consists of 2 sets of 3 repetitions with 30 seconds hold twice per day.