Piriformis Stretch Guide – Best 9 exercises to beat Piriformis Syndrome

Piriformis Stretch Guide – Best 9 exercises to beat Piriformis Syndrome

Where is the piriformis muscle?

Our Piriformis Stretch Guide will explain the different types of stretches for the piriformis muscle, which can be a helpful treatment for Piriformis Syndrome.

The piriformis muscle originates from the sacrum and sacroiliac joint. The piriformis runs thru the sciatic notch next to the sciatic nerve and attaches to the back of the greater trochanter of the hip. The piriformis is one of six smaller muscles that attach to the back of the hip also with the inferior and superior gemelli, obturator externus and internus, and quadratus femoris.

What does the piriformis muscle do?

When your leg is straight (hip extension), the piriformis muscle helps externally or laterally rotate the hip. When you bend or flex your hip, the angle of the piriformis muscle changes, and the piriformis because a weak hip abductor (moves the leg away from midline)

piriformis muscle
Anatomy of the piriformis muscle from Wikipedia

The fact that the piriformis has two different movement functions in two different hip positions gives us a few options when trying to find the best stretch for dealing with Piriformis Syndrome

Standing Piriformis Stretches

Standing Step-Behind Piriformis Stretch

The Standing Step-Behind piriformis stretch is one of my favorite piriformis exercises because its simple to do and can be done almost anywhere without any equipment. It’s a straight forward stretch that will help you learn which positions are the best to get at that pesky piriformis muscle.

Standing Figure-4 stretch on table

The Standing Figure-4 piriform stretch can be done with the affected leg up on a table, countertop or bed. You can increase the stretch on the piriformis and buttock muscles by leaning forward.

Standing Figure-4 piriformis stretch

Standing Adductor Stretch

While the Standing Adductor stretch doesn’t stretch the piriformis, the stretch does help stretch the adductors. The adductor muscles ares the opposing muscles to the piriformis when the hip is flexed.

Seated Piriformis Stretches

Seated Figure-4 Piriformis Stretch

The seated Figure-4 Piriformis Stretch is one of the easiest and most basic of the piriformis stretches.

  • Start sitting in a chair with both feet on the ground.
  • Take the side you want to stretch and put the foot of that leg on top of the knee of the other leg.
  • Let the knee of the side you are trying to stretch fall out to the side by letting the hip externally rotate out. This will put your leg in the Figure-4 position.

This seated stretch of the piriformis can be modified in two ways. The first modification is to put a hand on the knee that is in the figure-4 position and apply gentle downward pressure. As you feel the stretch in the back of the hip and buttock, slowly try to resist the downward force from your hand. You should feel a stretch in the posterior hip.

The second modification of the seated Figure-4 piriformis stretch is also done from the seated Figure-4 position, but instead of using your hand, slowly bend forward at the waist. You should feel a slight stretch begin in the back of flexed and rotated hip. You can twist your torso and lean either towards the side your trying to stretch or rotate your torso away from the side your trying to stretch and then slowly bend forward at the waist. Both of these rotated torso stretches will apply a different stretch on the piriformis and other hip muscles.

Seated Cross-over Piriformis Stretch

The seated Cross-over Piriformis stretch essentially brings the leg of the side you are trying to stretch across the midline of your body and will stretch the piriformis in this flexed and adducted hip position. You can continue the stretch by slowly internally rotating your hip to place more tension on the piriformis.

Seated Frog Adductor Stretch

The seated Frog or Adductor stretch is a modification of the seated Figure-4 stretch. For the Frog or Adductor stretch, inside of putting the foot on the knee of the other leg, bend the knee more and bring the foot close to the groin. You’ll place the hip into a little more abduction and external rotation and that will give a slightly different stretch on the piriformis and hip muscles.

Supine Piriformis Stretches

Supine Figure-4 Piriformis Stretch

The Supine Figure-4 Pirformis stretch is another Figure-4 position stretch with the hip flexed and externally rotated and the knee bent. Some find that the supine position gives them better stability to bring the leg closer to their body and really feel the stretch on the piriformis.

Supine Cross Leg Piriformis Stretch

The Supine Cross-leg Piriformis stretch brings the affected leg across the body with the hip slightly flexed with slow internal rotation of the hip. You can use the opposite hand to apply gently pressure on the affected leg to increase the stretch on the piriformis.

Prone Piriformis Stretches

Prone Piriformis Stretch

I’ve found that the prone piriformis stretch works the best for most people suffering with piriformis issues. Stretching the Piriformis in the prone position allows for more stability of the pelvis as the affected hip is brought up into flexion and internal rotation. This prone position also allows for transition into a piriformis strengthening exercise with an isometric or static contraction of the piriformis against the floor.

Piriformis Exercises

Piriformis stretches are mostly static stretches that try to slowly lengthen the piriformis muscle. Piriformis exercises are movements through a range of motion of the piriformis that also tries to strengthen the muscle (as well as the surrounding hip and buttock muscles.)

Other Piriformis Stretches and Exercises

Yoga and Piriformis Exercises and Stretches

There are several yoga poses that can also help stretch and strengthen the piriformis muscle.

  • Standing Forward Bend (Uttanasana)
  • Tree Pose (Vrksasan)
  • Extended Hand to Big Toe Pose (Utthita Hasta Padangustasana A-B)
  • Reclined or Supine Big Toe Pose (Supta Padangusthasana)
  • Pigeon Pose
Reclined or Supine Big Toe pose
More yoga poses for stretching the piriformis

Pilates and Piriformis Exercises and Stretches

Pilates also has some helpful exercises and stretches for the piriformis.

Piriformis sketch on the Wunda Chair has two different variations that can be done to get an effective stretch on the piriformis. This stretch is a variation of the yoga Pigeon Pose or the Standing Table piriformis stretch.

Piriformis Stretches and Exercises to Avoid

Stop any of the above exercises that cause increased pain into the buttock or leg or weakness into the leg. The worsening pain or weakness could be a sign that the piriformis is irritating or inflaming the sciatic nerve. If your symptoms are getting worse, definately see a sports medicine specialist that can do a thorough exam and determine the next course of action for your piriformis pain.

Don’t be too aggressive with the stretches. Each stretch should be slow and only go to the point where you begin to feel your muscles in the buttocks begin to stretch.

Don’t do any of these stretches where you bounce at the end of the stretch trying to take the piriformis stretch any further. The bouncing can injure muscles or tendons and make your problem worse.

Pylometrics or other high-intensity exercises or movements. These explosive movements can put a lot of stress and strain on the piriformis and other hip and leg muscles and lead to more dysfunction and pain.

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