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Six of the Best Piriformis Syndrome Stretches and Exercises
Stretching and exercise are a proven way to relieve piriformis pain and enhance healing. These are the siz best
stretches and exercises.
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Depending on the specific study, estimates are that 2.4 million people are affected by piriformis syndrome. Research indicates that the presence of piriformis syndrome in people with low back pain is about 17.2%.
Piriformis syndrome develops when the piriformis muscle, located in the glutes, spasms or becomes inflamed. The inflammation or spasms irritate or compress the sciatic nerve, which runs from the back down the leg. This can cause various symptoms, such as pain, tingling, and numbness that may extend down the leg to the foot.
The piriformis muscle is involved in hip movement, proper posture, and overall spine health. Piriformis syndrome can cause chronic pain, adversely affect walking, and negatively impact quality of life.
Treatment for piriformis may vary depending on the severity of symptoms. Usually, physicians recommend starting with the least invasive treatment options, including heat and cold therapy, rest, and piriformis syndrome exercises.
The article below covers six of the best piriformis syndrome exercises and stretches, including tips for maximizing the stretch and avoiding mistakes.
Stretches for Piriformis Syndrome
Piriformis stretches are intended to lengthen the shorted piriformis muscle and decrease pressure on the sciatic nerve. By reducing pressure, pain should also decrease.
It is essential to avoid overstretching. A stretch should not cause pain, and the amount of time you hold the stretch is also substantial.
Research indicates that holding the stretch for 30 seconds is optimal. Studies showed that 60-second or 30-second stretching was more effective than 15-second stretching. However, some studies suggested that 60-second stretching resulted in decreased muscle strength, but 30 seconds did not.
Stretching exercises for piriformis syndrome include the following:
Supine Piriformis Stretch
The supine piriformis stretch targets the deep piriformis muscle. It can improve hip flexibility and may reduce piriformis pain. To perform this piriformis stretch:
- Start by lying on your back with both feet flat on the ground and legs straight
- Pull the left knee up using the left hand and grab the ankle with the right hand.
- Keep your right leg straightened out.
- Continue to pull the left knee across the body until you feel a stretch in the hip and glutes.
- Hold for 30 seconds and return to your starting position.
Keep your lower back in contact with the floor when performing this stretch. Only pull until you feel the stretch in your glute and hip. Don’t forcefully pull across your body. Aim for three sets of 30-second stretches.
Figure-Four Stretch
This piriformis stretch helps target overall hip flexibility. It can help release the piriformis, which may decrease entrapment of the sciatic nerve and relieve pain.
To perform a figure-four stretch:
- Lie on your back and place your feet flat.
- Place your left ankle over your right knee. Keep the foot flexed.
- Bring your right knee towards your chest.
- Reach your left hand through your legs and place your hands behind your knee.
- Pull your knee towards your chest. You should feel a stretch in your hip and glute.
- Hold for 30 seconds and repeat twice.
To get a deeper stretch, interlace your fingers in the front of the shin instead of behind your knee.
Piriformis Pigeon Stretch
A piriformis pigeon stretch targets the hip extensor muscles, including the glutes and hamstrings. It helps improve the range of motion in the hips, which support the lower back and hips. It also stretches the muscles and tendons in the spine, which may help reduce pain associated with piriformis syndrome.
To do the piriformis pigeon stretch:
- Start on your hands and knees.
- Lift and bend at the hip and bring the left leg forward, bending the knee and resting the outside of your lower leg on the foot on the floor.
- Place both hands on the ground in front of the bent leg.
- Extend the right leg back until it is as straight as your range of motion allows.
- Lower your body until your weight is on the forearms and you feel the stretch in your hips.
- Hold for 30 seconds and repeat twice.
Move in and out of the pigeon stretch slowly to avoid injury. Slowly crawl the back leg out. Do not move your bent leg as you extend the back leg.
Exercises for Piriformis Syndrome
Strengthening the piriformis muscle and the supporting muscles is also helpful in healing piriformis syndrome. Home exercises to stretch or strengthen the piriformis also include the exercises below.
Glute Bridge
A glute bridge stabilizes the hips and strengthens the glutes. Depending on the position of your foot, you can also strengthen your hamstrings.
To perform a bridge:
- Lie on your back on the floor with your hands at your sides. Bend your knees and place your feet flat on the ground.
- Tighten your glutes by pushing your lower back to the floor.
- Lift your hips to create a line from the knees to your shoulder.
- Pull your belly button back towards your spine and squeeze your core.
- Hold for 10 seconds.
- Lower your hips back down to the starting position.
- Repeat 8 to 10 times and do one to two sets.
There are also variations of a bridge that increase the difficulty. For instance, you can add a sandbag, placing it on your hips as you bridge up.
Another option is to add a bridge march. After your bridge up, step forward with one foot, then the other, and step back. Doing a one-legged bridge also increases difficulty.
To get the most from the exercise, avoid common mistakes when performing a bridge. For example, do not raise your hips too high or allow them to sag.
Short Clams
The short clam exercise targets the external hip rotators and may help prevent future flare-ups of piriformis syndrome.
To do short clams exercise:
- Start by lying on your right side on the floor. Your right leg should be on top of the left, and your knees should be slightly bent.
- Keep both feet together.
- Lift the right knee until it is parallel with the hip.
- Slowly lower your right knee back to the starting position.
To get the most from the exercise, engage your core and glute muscles during the move. To increase the intensity of the exercise, place a resistance band around your knees while doing it.
Also, avoid rolling back onto your glutes as you lift your leg. Aim for 10 to 14 repetitions and two to three sets.
Side Plank with Leg Lift
A side plank with a leg lift improves hip stability and strengthens the core. Stabilizing and strengthening the core along with increasing flexibility in the hips may help prevent the future recurrence of piriformis syndrome.
To do a side plank with a leg lift:
- Lie on your side and place yourself on your bottom elbow and the side of the foot.
- Lift your hips into the air.
- Form a straight line from the shoulders to the ankles.
- Keep the torso stable and engaged, and lift your top leg without bending your knees.
- Return to the starting position.
To do the move correctly, do not lean forward or let the hips drop. Also, avoid letting your torso sway from side to side.
If you need an easier modification, lift the hips and skip the leg lift until your core strengthens.
Another easier variation involves doing the exercise with a bent knee plank. The bent knee version takes the pressure off your upper body, allowing you to focus on your core.
Additional Considerations
There are additional things to consider when performing home exercises to stretch or strengthen the piriformis. Consider the following:
- Warm up before performing stretches and exercises. You do not want to stretch cold muscles—instead, warm up for about 10 minutes. For instance, perform a few minutes of light calisthenics or walking. Warming up before piriformis stretches helps improve your range of motion during the stretch and may reduce the risk of injury.
- Cool down after your routine. After doing exercises for piriformis syndrome, take a few minutes to cool down, such as light walking.
- Listen to your body and avoid pain. Do not stretch to the point of pain. While you should feel the stretch, you do not want it to hurt. Stretch slowly, and do not bounce. If you feel a sudden pain, stop what you are doing.
- Be consistent. Like any exercise, performing piriformis exercises consistently is vital to get the best results.
Sometimes, piriformis exercises are not enough to reduce symptoms, and you need to seek help from a physical therapist.
See a physical therapist in the following cases:
- Pain from piriformis syndrome becomes worse
- You have trouble sitting or walking
- Home treatment is not working
- You have recurrent bouts of piriformis syndrome
About the Author
MaryAnn DePietro CRT is a licensed respiratory therapist with over 15 years of clinical experience in critical care, emergency medicine, and pulmonary rehabilitation. She is also an American Council on Exercise certified personal trainer and holds specialty certifications in orthopedics, senior fitness, and weight management. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy.
In addition to her clinical experience, she has written extensively about all things medical, as well as health, fitness, and aging for various websites, magazines, and newspapers.
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