Written by Kiel DiGiovanni | Co-founder
Fact checked by Kirsten Yovino, CPT Brookbush Institute
FACT CHECKED
The piriformis muscle can be a real pain in the butt. The piriformis muscle enables us to walk, one of the most important aspects of daily life. Unfortunately, many people can suffer from piriformis pain with some unlucky enough to suffer from piriformis syndrome at some point in their lives.
In this article we will go over 19 best piriformis stretches and exercises that will help to keep your muscles loose and pain free. If you are a runner or athlete, desk jockey or couch potato then you should continue reading to learn some simple piriformis stretches and exercises that can be done in the comfort of your house.
What is the piriformis muscle?
The piriformis muscle is located in the gluteal region underneath the gluteus maximus. This flat pyramidal shaped muscle is one of the six muscles of the lateral rotator group. The name piriformis is derived from Latin, meaning “pear shaped”. The piriformis muscle starts from the front part of the sacrum (part of the lower spine). It is attached to the second third and fourth sacral vertebra and from there it’s connected to the upper surface of the thigh bones.
The piriformis is responsible for laterally rotating the femur during hip extension. To get an idea of this movement, while sitting, lift one leg and cross it over the other so that your outside ankle is resting against the knee of the other leg. The second import function of the piriformis is the abduction the femur with hip flexion. This is an especially important for walking. This abduction of the thigh moves bodyweight to the opposite side of the foot being lifted. Without this we would fall down.
Although many people might not be familiar with the piriformis muscle, they might be familiar with sciatic pain. This is because the sciatic nerve runs beneath the piriformis or for some people the sciatic nerve will run through the muscle.
Top 19 Piriformis Stretches and Exercises
The following stretches and exercises are meant to help ease pain or soreness of tight piriformis muscles. These stretches can also be used to help alleviate pain caused by piriformis syndrome. None of these piriformis stretches or exercises require equipment although you can add mini bands to a few in order to increase difficulty.
If you feel any exaggerated pain from performing these movements you should stop what you’re doing. As always you should consult with your doctor before beginning any new exercise or stretching routines
1. Standing Piriformis Stretch (0:35)
2. Standing Step Behind Piriformis Stretch (0:46)
3. Short Adductor Stretch (0:58)
4. Long Adductor Stretch (1:04)
5. Half Spinal Twist (1:15)
6. Supine Piriformis Stretch (1:23)
7. Lying Knees Side Stretch (1:35)
8. Knee to Chest (1:48)
9. Sleeping Pigeon (1:59)
10. Outer Hip Stretch (2:17)
11. Seated Piriformis Stretch (2:31)
12. Modified Pigeon Stretch (2:45)
13. Seated Piriformis Leg Cradle Stretch (2:58)
14. Side Lying TFL Stretch (3:07)
15. Lying Side Clamshell (3:20)
16. Glute Bridge With Feet Externally Rotated (3:43)
17. Prone Adductor Side Stretch (3:58)
18. Kickback (4:16)
19. Fire Hydrant (4:36)
Below we have pictures of all the piriformis exercises in the video above with how to's...
1. Standing Piriformis Stretch
- Stand with feet hip width apart next to a prop to help with balance
- Place leg with pain over the knee of your other leg(you should look like a big 4)
- Drop your hips down and back as far as you can while bending the leg you’re standing on
- Hold this position for 30 seconds
- Repeat with the other leg
2. Standing Step Behind Piriformis Stretch
- Stand with feet hip width apart
- Step back then internally rotate your hip pointing your toes inward
- Then internally rotate front foot by turning toes inward
- Rotate your hips to the side of your back leg then shift your weight on your back leg
- Hold for 30-60 seconds
3. Short Adductor Stretch
- Sit on the floor and bring feet together in front of you with the soles of your feet touching
- Push down on your knees as far as comfortable
- Hold for 20-30 seconds
4. Long Adductor Stretch
- Sit on the floor then bring legs straight out in front of you spreading them as far as you can
- Lean forward as far as comfortable
- Hold this position for 20-30 seconds
5. Half Spinal Twist
- Sit up straight with both legs out in front
- Cross one leg over the other to the outer thigh
- Rotate towards your crossed leg placing your elbow on your knee and your other hand on the floor behind you hold for 30 seconds
- Repeat with the other leg
6. Supine Piriformis Stretch
- Lie down with knees bent and feet on the floor
- Cross your sore leg over your other leg
- Place your hands under your unaffected leg and pull towrads you
- Hold for 30-60 seconds
- Repeat with the other leg
7. Lying Knees Side Stretch
- Lie down on the floor with your legs straight
- Bend your knees bringing them towards your chest
- Bring arms out to your sides
- Rotate your kees to the side so they rest on the ground
- Hold for 30-60 seconds
8. Knee to Chest
- Lie down on back with legs stretched out
- Bring affected leg up towards your chest
- Pull knee towards opposite shoulder
- Hold for 30 seconds
- Repeat with other leg
9. Sleeping Pigeon Stretch
- Get down on the floor on your hands and knees
- Bring your sore leg’s knee up towards your hands then fold knee under the middle of your body with your outer ankle against the floor
- Straighten out your other leg behind you while placing your elbows on the ground in front of you
- Lean down and push hips towards the floor
- Hold this position for 30-60 seconds
- Repeat with the other leg
10. Outer Hip Piriformis Stretch
- Lie down on your back then turn on your side bringing your sore leg’s foot up placing the top of your foot on the back of your upper calf
- Place your hand on your sore leg’s knee pressing towards the floor
- Reach up with your other arm, keeping it straight and rotate away to the other side as far as possible
- Hold this stretch for 20-30 seconds
- Repeat with the other leg
11. Seated Piriformis Stretch
- Sit up in a chair then cross your sore leg over your other leg placing your outer ankle on the knee
- Keep your back straight then lean forward
- Hold this position for 30-60 seconds
- Repeat on the other side
12. Modified Pigeon Stretch
- Sit down then with knees bent
- Lower knee on the the floor straight in front of you so that your ankle outer ankle is against the floor with your knee bent at 90 degrees
- Bring other leg behind you with your knee bent
- Lean forward
- Hold for 30 seconds
- Repeat with the other leg
13. Seated Piriformis Leg Cradle Stretch
- Sit down on the ground with legs out in front of you
- Bend knee and bring foot up towards your chest
- Placing your hands on your bent leg's calf/ankle pull towards you
- Hold for up to 30 seconds
- Repeat with the other leg
14. Side Lying TFL Stretch
- Sit down with legs out in front of you
- Then cross one leg over your other so that your ankle is against your knee
- Rotate towards your straight leg using your hands to brace you
- Hold for 30 seconds
- Repeat with other side
15. Lying Side Clamshell
- Lie down on your side starting with the side not experiencing pain
- Bend your knees, bringing your feet behind you
- Keeping your feet together, raise your upper knee up as far as comfortable
- Slowly lower to starting position
- Repeat for desired reps then switch sides
16. Glute Bridges with Feet Externally Rotated
- Lie on back with knees bent and feet flat on the floor, hip width apart and arms to your sides
- Turn your toes outwards
- Drive through your heels bringing your hips up until you’re in a bridge position
- Contract your glutes and hold for 5 seconds then slowly return to starting position
- Repeat for desired reps
17. Prone Adductor Stretch
- Lie on stomach then brace yourself with your forearms on the ground
- Bring one knee out and up to the side until you feel the piriformis stretch
- Hold for 30-60 seconds
- Repeat with the other leg
18. Kickback
- Get on your hands and knees with your hand stacked under your shoulders
- Lift your sore leg up off the ground then kick up and back away from you until your leg is fully extended
- Slowly lower to starting position
- Repeat for desired reps then switch sides
Related: Glute Kickbacks with Cable Machine, Bands, and Bodyweight
19. Fire Hydrant
- Get on your hands and knees
- Lift leg out to your side as far as comfortable keeping your knee bent
- Lower back to starting position
- Repeat for desired reps then switch sides
Benefits of Stretching the Piriformis
A tight piriformis muscle can lead to debilitating pain making life miserable. It’s important to keep this muscle limber. The benefits of piriformis stretches or piriformis exercises can really enhance quality of life for some. Here's a look at a few of the benefits of piriformis stretches.
- Helps to Alleviate Ankle and Knee Pain: When the piriformis muscle becomes tight the simple daily activity of walking can be a real pain. The knee joint can be under too much strain creating an unbalanced joint. The outside of the knee joint becomes too tight making the inside of the joint weaker. This imbalance can lead to ankle and knee pain.
- Relieves Sciatic Pain: Previously mentioned the sciatic nerve runs through the piriformis area and whenever there is added pressure due to tight piriformis muscles there’s a chance to experience sciatic like pain. This miserable pain can make your hips and glutes numb or send shooting pain down your legs. By relaxing the piriformis muscle, the strain on the sciatic nerve can be reduced.
- Reduce Lower Back Pain: Tight piriformis and glute muscles can cause lower back pain. By relaxing the piriformis muscles you can reduce stress on your lower back as your hips will move with more range of motion.
- Eases Plantar Fasciitis: Plantar fasciitis is when the fascia (a thin layer of connective tissue that has nerves) becomes inflamed. People with very tight piriformis muscles can end up walking like ducks which puts extra stress on the soles of the feet. Loosening up the piriformis can fix your body mechanics thus reducing nagging injuries like plantar fasciitis.
- Reduce Risk of Injury: By stretching or exercising the piriformis muscles you will lower the chances of experiencing potential injuries. People who enjoy sports or activities involving running or any sudden change of direction need to stretch their piriformis muscles to avoid injuries or muscle tears.
- Better Overall Muscular Function: Tight piriformis muscles will cause limited range of motion in the lower back and hips. Piriformis stretches and exercises can help us move better through a fuller range of motion.
What is piriformis Syndrome?
Piriformis syndrome is when the piriformis muscle spasms causing irritation or compression to the sciatic nerve. The symptoms of piriformis syndrome may feel like sciatica but technically it is different as it isn’t a spinal problem.
Piriformis syndrome isn’t a very common health problem whereas piriformis pain is rather common. Every year less than 200,000 people are diagnosed with piriformis syndrome in the U.S.
Piriformis syndrome can be caused by injury, overuse or strain as the piriformis tightens, spasms or swells. Piriformis syndrome can also be caused by frequent long distance running or sitting for prolonged periods of time.
Piriformis syndrome pain can be triggered by running, sitting, climbing stairs or applying press directly on the muscle.
Symptoms of Piriformis Syndrome
People can experience a number of symptoms if suffering from piriformis syndrome. Some of these symptoms can affect your buttocks, legs and even your feet. These symptoms include:
- Pain
- Tingling (pins & needles)
- Numbness
- Pain that travels all the way from glutes to back of the foot
- Pain that comes and goes
- Sharp pain when doing certain activities such as climbing stairs, walking or running
Piriformis Syndrome Test
It’s important to distinguish whether or not the pain or soreness you’re experiencing is actually piriformis syndrome. We will cover two piriformis syndrome tests that can help to determine whether or not you’re suffering from piriformis syndrome. It’s important to note that these aren’t definitive tests and you should consult with a doctor to diagnose the exact issue.
- Seated Piriformis Test: This test is performed by sitting down with back straight with feet on the ground. The patient will then cross the affected leg over the other placing the ankle on the knee. The examiner will place one hand on the ankle and the other on the lateral side of the knee for stabilization. The patient should bend forwards to feel the stretch in the piriformis.
- Side Lying Piriformis Test: This test is performed with the patient lying on their side without pain, facing the examiner. The sore leg is then placed in 60- 90 degrees of flexion at the hip and with 90 degrees of flexion at the knee. The examiner will place one hand on the pelvis with the other hand on the lateral side of the knee to stabilize them. The examiner will then apply pressure to the lateral side of the knee to stretch the piriformis muscle. This test is called the FAIR Test which stands for Flexion Adduction and Internal Rotation.
If the patient is experiencing pain in the piriformis muscle or gluteal area then it’s probably piriformis muscle tightness not related to sciatic nerve. If there’s pain or numbness in the glutes that radiates down into posterior of the thigh then this usually indicates piriformis syndrome where the sciatic nerve is compressed or pinched by the piriformis muscle. To rule out cases of a herniated discs, other tests such as a MRI may be needed.
Related: More Mobility Tests
How is piriformis syndrome treated?
The treatment of piriformis syndrome is dependent on the severity of the condition. Common treatments include, exercise, physical therapy, stretching, steroidal medicine injections, pain medicine and occasionally surgery. Most home remedies like stretching, exercises and ice/heat will help to treat piriformis syndrome. If it becomes a chronic condition then medical professionals will determine if a more drastic treatment is needed.
Piriformis Muscle FAQs
What causes tight piriformis muscle?
A tight piriformis muscle can be the result of daily life activities such as frequent running or sitting at a desk day in and day out. Tight piriformis muscles can also be caused by overuse in sports or an accident/trauma to the muscle.
How Do I Relax my Piriformis?
There are a number of ways to relax a tight piriformis muscle including stretches, exercises, trigger point therapy and massage. A good starting point would be to complete some of the stretches that were covered above. These stretches can be done a few times a week, after sitting for a long time or after exercise.
How do you treat piriformis pain?
It’s important to diagnose if your piriformis pain is tightness or if you’re suffering from piriformis syndrome. Stretching, cold packs, myofascial release or trigger point therapy can treat most cases of piriformis pain. It’s important to note that strengthening the piriformis can help reduce the chances of experiencing piriformis pain in the future. Piriformis strengthening exercises target the glutes, lower back, hip flexors, adductors and abductors.
Can piriformis pain go away on its own?
Piriformis pain can go away on its own through rest and avoiding the activities that caused it to begin with. However, it’s better to treat this pain with simple piriformis stretches and exercises that we covered in this article.
How to Sleep with piriformis pain?
Piriformis pain can make it difficult to get a good night’s rest. The wrong mattress or sleeping position can make piriformis pain worse. Generally speaking, sleeping on your unaffected side with a pillow between the knees will be the most comfortable position to sleep in.
Does heat help ease piriformis pain?
Yes, both heat and ice can help lessen piriformis pain. You can apply a cold pack, ice or heating pad to the sore area for 10 to 20 minutes at a time. Try alternating between heat and cold to see what works best for you.
FINAL THOUGHTS
Piriformis stretches and exercises can save you from going through unnecessary piriformis pain or experiencing piriformis syndrome. If you’ve just finished a run or a long day at the office, take five minutes to stretch your piriformis muscles. We gave you a few of the best piriformis stretches you can do to avoid lower back, hip, glute or sciatic-like pain caused by tight piriformis muscles. Now it’s your turn to put them into practice.
More Resources on Stretching:
- Tibialis Anterior Stretches
- Chest Stretches
- Glute Stretches
- Lat Stretches
- Biceps Stretches
- Triceps Stretches
- Deltoid Stretches
- Levator Scapulae Stretches
- TFL Stretches
- Ab Stretches
Kiel DiGiovanni
Author