Piriformis syndrome can cause sharp, shooting pain all the way down to your toes. While some people might immediately reach for medications or other invasive interventions, there are stretches that can provide relief and help your body heal. Here are 15 piriformis syndrome stretches and exercises to help you find relief.
What causes a tight piriformis muscle?
The piriformis muscle is located deep with the buttocks, just underneath the gluteus medius. Running underneath the piriformis (and sometimes threaded directly through) is the sciatic nerve. If the piriformis muscle becomes tight, irritated, or inflamed, the sciatic nerve bears the brunt of it.
Symptoms of an irritated sciatic nerve may include:
- Pain that worsens following prolonged periods of sitting
- Pain where the piriformis attaches to the top of the femur or base of the spine
- Numbness in the feet
- Pain walking up an incline
- Muscle weakness in the lower limbs
- Difficulty walking
- Reduced range of motion within the hip joint
- Radiating pain (sciatic pain)
- Abdominal pain, pelvic pain, or groin pain
- Muscle spasms
- Pain during bowel movements
- Pain during sex in women
Piriformis syndrome has a variety of causes, the most common of which is overuse (or misuse). People who are very active and regularly lunge, jump, or run may see an increase in the likelihood of developing piriformis syndrome.
Even sitting too long can cause a tight piriformis that becomes painful and shortens your range of motion in the hips.
How can I relieve piriformis pain?
If you are feeling any of the above symptoms, the best thing to do is head to the doctor. If you don’t make any changes, the condition may linger and lead to other problems.
Once you are diagnosed with piriformis syndrome and cleared for some targeted piriformis syndrome stretches, use the following guide to help you get started.
3 easy piriformis stretches for beginners
Once you get the go-ahead from your doctor, these piriformis syndrome stretches can be a great place to start. They are designed to be done lying down, a posture that allows gravity to gently aid in your stretch.
As always, listen to your body and keep your breath even, steady, and deep. You may feel some therapeutic irritation while completing these, but if the pain is sharp and stabbing or you cannot catch your breath, take a break.
Start with these three piriformis syndrome stretches that help you gently ease into the muscle.
1. Knees to chest
Knees to chest pose is a great place to start, especially if you are feeling very sore anywhere in the hips.
Lie on your back with your knees bent and your feet flat on the ground. Breathe here for a couple breaths, then on an exhale bring one knee to your chest and then the other. If your back and hamstrings are tight and knees don’t quite come to the chest, that’s okay. You can use a strap around the outside of your knees, or extend your arms. Your lower back should stay comfortably resting on the ground. Your shoulders and head should be relaxed on the ground as well.
Take ten full, slow breaths, then place one foot on the ground at a time. Repeat at least once.
2. Reclined figure four stretch
Use reclined figure four in stages as a way to gradually increase the stretch of your piriformis and hamstrings.
Start on your back with your knees bent, feet hip-width distance apart and about a handprint’s distance from your hips. Take a few deep breaths here, then on an exhale pick up your right foot and place the right ankle on your left knee. Keep the right foot flexed, and gently press the right knee away from you.
If your piriformis is very tight, you may not be able to apply any pressure to the right knee. You might feel the stretch when you place your ankle on the knee. This is a great place to start.
As you progress, there are deeper options to explore. Once your right ankle is on your left knee, intertwine your hands behind your left thigh and pick the entire shape up, bring it closer to your chest. Keep both feet flexed and breathe.
From the lifted shape, you can extend the left leg towards the sky, with that foot “standing” on the ceiling. This gives a bit of a hamstring stretch, especially if you walk your hands towards your calf. Only do this if you can keep your lower back, shoulders, and head on the ground.
Whichever variation you choose, hold the shape for ten full, even breaths before switching sides.
3. Easy twist
The last easy piriformis stretch on the ground is an easy twist. Bring your knees into your chest and open your arms out into the shape of a T. Inhale deeply, then on an exhale with good control, lower your knees to the right.
Try to relax your left shoulder down to the ground, and breathe here for ten full, even breaths. On an exhale, press the bottom leg into the top leg to come to the middle, then lower to the other side, also on an exhale.
If your hamstrings are open, once you are twisted you can extend both legs straight out from the hip. This is not necessary to get the benefits of a stretch to the piriformis but can be a nice variation.
Sitting piriformis syndrome stretches
Because the piriformis muscle can get sore from too much sitting, sitting piriformis syndrome stretches are great to break up your day.
These can be done throughout the course of your day, even at work. Sitting piriformis stretches are also great for people who have trouble getting down to or up from the floor.
4. Seated figure four
This pose comes up from the ground but has the same principles. Sit in a chair with both feet on the ground, ankles directly beneath the knees. Make sure you are sitting tall with your belly lightly engaged.
On an exhale, lift your right leg and place your right knee on your left ankle. Apply gentle downward pressure to the right knee, but not too much to hurt.
If you are alone in your office and would like a deeper stretch, you can fold forward over your right leg. If your lower back is tight, make sure your hands are grounding into something – a block or a big book can be used here.
Take ten deep breaths (or stay here as much as feels good), then release and switch sides. Make sure to spend equal amounts of time on both sides of the body.
5. Seated twist
There are two versions of this sitting piriformis stretch. The first one is good for sitting in a chair; the next is a variation for the floor.
- In a chair: Sit with both feet flat on the ground, ankles directly beneath the knees. Inhale to lengthen your spine, then on an exhale begin to twist to the left. The right hand can come to your left thigh, and your left hand can move behind you, either to the seat or the back of the chair. Take ten deep breaths, then release on an inhale and switch sides.
- On the floor: Sit up tall with both legs extending long on the floor. Cross the right knee over the left, bending the knee to place the right foot on the floor near the left hip. Hug your right knee towards your chest on an inhale, lengthening the spine. On an exhale release the right hand to the floor behind you and begin to twist your body to the right. Keep the crown of the head reaching towards the sky and the lower belly engaged. Hold for ten full and even breaths.
Release on an inhalation, then switch sides.
Standing piriformis stretches to try
Standing piriformis stretches combine targeted stretching of the piriformis with strengthening work that involves balance.
6. Hip flexor stretch
This stretch requires a bit more balance and control, but it stretches the long sides of your body as well as the psoas muscle. The psoas muscle is the only muscle in the body that directly connects the upper and lower body, and it is famously responsible for the fight-flight-freeze response when under stress. This muscle is also responsible for stability and can get very tight.
Come to all fours (you can pad your knees with a blanket if they are sensitive). Bring the right foot up between your hands (keep the back knee on the ground for now). Make sure the knee is directly above the ankle.
Inhale and engage your lower belly to bring both hands up to your right knee. If you do not feel a stretch in your left hip flexor, you can move your left foot back to increase the stretch.
Inhale to lift your arms overhead, then exhale to drop your right hand to your hip and reach the left arm overhead. Move slowly and keep your lower belly engaged for stability. Take at least five breaths here, more if you can keep the breath even and steady, then inhale to come up. Exhale back to all fours, then switch sides.
As you get stronger, you can lift the back knee off the ground before you lift your arms and stretch to the side. When you do this, press back through the back heel while pressing forward in the front knee to keep the hips balanced, stable, and strong.
7. Half chair pose
Half chair pose builds on the previous figure four poses and adds an element of balance (which means the lower belly must be engaged).
Stand tall and inhale your arms above your head. On an exhale, sink your hips back (like you are sitting in a chair) and bring your hands to your heart. You should be able to look down and see your toes. Carve your tailbone under a bit to lift and engage the lower belly, and roll your shoulder blades onto your back.
Shift some weight to your left foot and begin to lift the right foot up to place the right ankle on the left knee. Keep your lower belly engaged, shoulders and jaw relaxed as you transition. Press the right knee gently towards the earth and sink deeper in your chair. Hold for at least ten breaths, then slowly release the ankle and fold forward on and exhale (deeply bend both knees). Repeat on the other side.
Yoga postures for piriformis syndrome
Because most yoga poses work the entire body, there are many yoga poses for piriformis syndrome. Here are two of our favorites. Find even more in our post on yoga for hip pain.
8. Baddha konasana
Also known as bound angle or cobbler’s pose, baddha konasana is infinitely variable for everyone. Sit on the floor and bend your knees. Open knees wide and bring the soles of your feet to touch. If the feet are closer to the body, you will feel the stretch in the inner thighs. Farther away and you will feel a stretch on the outer thighs. You can use blocks under your knees if that makes the stretch more comfortable. If you want to go deeper, inhale to sit tall, then reach forward with your heart, hinging at the hips to fold forward. Keep the lower belly engaged when folding, and tuck your chin slightly to lengthen the back of the neck. Take ten full breaths, and come up on the inhale.
9. Prasarita padottanasana I
This standing wide-legged forward fold releases the adductors (inner thigh muscles) to loosen tension on the piriformis. Keeping your feet parallel to each other, step wide and extend your arms out from the shoulder (wrists should be directly above your ankles). Bring your hands to your hips. Inhale to lengthen your spine, then exhale, hinging at the hips and folding forward. Release your hands to the ground (or to blocks) and bend your knees as much as you need to.
You should feel a nice stretch in the center of your hamstrings (not at the top of them or behind the knee). Relax the crown of the head (shake your head no, nod your head yes) and breathe here for at least ten breaths.
To come out, bend your knees deeply and inhale to come halfway up, hands to hips. Pause for the exhale, then press into your feet and inhale to come all the way up, lifting with the back of your heart.
Piriformis syndrome exercises to add to your routine
Piriformis syndrome exercises utilize a variety of tools to provide relief. Try some of these after your stretches.
10. Foam rolling
Foam rolling is a great way to release tight muscles in the hips, thighs, and buttocks.
11. Tennis ball release
For more targeted pressure, place a tennis ball underneath you and lean the weight of your body on it (see below for video on this). This can be very intense, so proceed with caution.
12. Stretchy band walking
This exercise requires an exercise band. Place the band around your ankles and your hands on your hips. Take ten steps to one side, then ten to the other. Rest and repeat.
3 piriformis syndrome stretches: video routines
Maybe you need a visual for some of the above exercises, or perhaps you’re looking for a full workout. We’ve got you covered with the following three videos.
- Five-minute daily routine
- How to release the piriformis with a tennis ball
- Full-body yoga practice to release tension in the hips
Need more guidance? A pain specialist can help you diagnose the cause of your hip pain and suggest alternate treatment options.
You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.