IMMEDIATE EFFECTIVENESS OF PNF HOLD RELAX HAMSTRING AND QUADS STRENGTHENING ON PAIN AND QUALITY OF LIFE IN PIRIFORMIS SYNDROME: A CASE REPORT.

Abstract

Introduction: Piriformis syndrome is a neuromuscular disorder in which there is entrapment of sciatic nerve ‎under the piriformis muscle. The current cases study explained the effectiveness of stretching ‎exercises along with quads strengthening exercises in treatment of a patient with piriformis ‎syndrome (PS).

Case Presentation: The 35-years old female patient with the episodes of previous back pain from last 1 year ‎presented to the physiotherapy department of District Head Quarter Hospital Jhelum for ‎physiotherapy treatment due to persistent pain in the lower lumbar and buttock areas radiating ‎towards the left leg. The treatment of the patient included the PNF hold relax hamstring and ‎quads long arc exercise. Outcome measures include NPRS for pain intensity, ROM, and Lower ‎extremity functional scale (LEFS) was used to measure lower limb function. Patient was assessed ‎immediately after treatment. ‎

Results: The post intervention measures indicated improvement in all symptoms i-e; NPRS = 2, SLR = ‎‎95°, hip abduction= 40° and hip internal rotation= 36°, LEFS=93.8%.

Conclusion: The PNF stretching exercise of the hamstring along with quads strengthening exercise resulted in immediate improvement in pain, ROM and lower limb function in patient having piriformis syndrome.

Keywords: Piriformis syndrome, PNF Hold Relax, Quads Strengthening

https://doi.org/10.37939/jnah.v4i01.236
PDF

References

‎1.‎ Shahzad M, Rafique N, Shakil-ur-Rehman S, Ali Hussain S. Effects of ELDOA and post-‎facilitation stretching technique on pain and ‎functional performance in patients with piriformis ‎syndrome: A randomized controlled trial. Journal of back and musculoskeletal ‎rehabilitation. ‎‎2020;33(6):983-8.‎

‎2.‎ ‎Salam A, Khalid A, Waseem I, Mahmood T, Mahmood W. Comparison Between Effects ‎Of Passive Versus Self-Mobilization Of Sciatic ‎Nerve In Piriformis Syndrome For Relieving Pain ‎And Improving Hip Outcomes: soi: 21-2017/re-trjvol06iss01p298. The Rehabilitation ‎Journal. ‎‎2022;6(01):298-302.‎

‎3.‎ ‎Arora A, Sinha I. Effectiveness of Muscle Energy Technique among Piriformis Syndrome ‎Patients with Pain, Disability, and Limitations in ‎Internal Rotation Range of Motion of Hip Joint: ‎A Systematic Review. INTERNATIONAL JOURNAL. 2025;14(3):404-10. [Reviewer ‎‎Comment: Limitations section is brief; consider adding more limitations such as single case ‎design and lack of follow-up.]‎

‎4.‎ ‎Monteleone G, Stevanato G, Alimandi M, Cappa E, Sorge R. Piriformis syndrome: a ‎systematic review of case reports. BMC surgery. ‎‎2025;25(1):468. [Reviewer Comment: Case ‎description is detailed, but consider organizing into subsections (history, examination, ‎‎intervention).]‎

‎5.‎ ‎Danazumi MS. Effect of integrated neuromuscular inhibition technique in the ‎management of piriformis syndrome: a case report. Middle East ‎Journal of Rehabilitation and ‎Health Studies. 2020. [Reviewer Comment: Case description is detailed, but consider organizing ‎into ‎subsections (history, examination, intervention).]‎

‎6.‎ ‎Laha K, Sarkar B, Kumar P, Patel L, Sarkar N. Efficacy of hip abductor and extensor ‎strengthening on pain, strength and lower extremity ‎function in piriformis syndrome: a ‎randomized clinical trial. Int J Health Sci Res. 2018;8(9):80-8.‎

‎7.‎ ‎Liyanage E, Malwanage K, Senarath D, Wijayasinghe H, Liyanage I, Chellapillai D, et al. ‎Effects of different physical therapy interventions ‎in improving flexibility in university students ‎with hamstring tightness-A systematic review and network meta-analysis. International Journal ‎‎of Exercise Science. 2024;17(3):359.‎

‎8.‎ ‎Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an ‎individual with piriformis syndrome focusing on hip ‎muscle strengthening and movement ‎reeducation: a case report. journal of orthopaedic & sports physical therapy. 2010;40(2):103-11. ‎‎‎[Reviewer Comment: Case description is detailed, but consider organizing into subsections ‎‎(history, examination, intervention).]‎

‎9.‎ ‎Idrees K, Khan K, Sharif K, Ahmad K, Rahman H, Fahad F. Efficacy Of Hip Abductors ‎Strengthening As Compared To Piriformis Muscle ‎Stretching In Improving Lower Extremity ‎Function In Patients With Piriformis Syndrome. Pakistan Journal of Medical & Health Sciences. ‎‎‎2022;16(07):721.‎

‎10.‎ ‎Syed Abudaheer K. The Impact of PNF Stretching on Pain and Range of Motion ‎Compared to Static Stretching in Patients with Piriformis ‎Syndrome: A Randomized Controlled ‎Trial. Journal of Neonatal Surgery. 2025;14(15s):2348.‎ Savarese G, Lund LH. Global Public Health ‎Burden of Heart Failure. Card Fail Rev [Internet]. ‎‎2017;03(01):7. Available from: https://www.cfrjournal.com/articles/global-public-health-‎burden-‎heart-failure

‎ ‎

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2026 Journal of Nursing and Allied Health