5 Things to Know About the Piriformis Stretch

Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on August 14, 2014Written by David Heitz

piriformis stretch

The piriformis is a difficult-to-reach muscle that runs from your spine to the thigh bone. When it begins to push against your sciatic nerve, often due to too much sitting, it can cause excruciating pain. A tight or inflamed piriformis is what is known as piriformis syndrome.

Here are five things you should know about your piriformis, and how to keep it healthy.

What Causes Piriformis Syndrome?

Vivian Eisenstadt is a Los Angeles-based master physical therapist who specializes in pain prevention.

“Think of your body as a pulley system,” she says. “Muscles cross joints and connect bone to bone, and pull the bones in one direction. If one muscle is too tight, then it creates strain on the next joint over on both sides.”

“A tight piriformis from slouching in a chair with your hips rotated outward puts a lot of strain on your low back and makes your hips so tight that you create an imbalance in the entire system.”

Piriformis syndrome isn’t always caused by inactivity. It can occur after an accident or even after vigorous activity such as running.

Before You Stretch, Make Sure to Sit Straight

The key to a successful piriformis stretch is sitting up straight, says Eisenstadt: “What’s the use of stretching out a muscle if you’re going to keep tightening it back up?”

  1. First, roll up a hand towel into a Tootsie Roll shape.
  2. Next, sit on a firm surface, and find your “butt bones” – the two bones at the lowest part of your posterior.
  3. Sit directly on top of those bones.
  4. Then take the towel and place it under the roll of fat behind the bones, not directly under them.

How to Stretch the Piriformis

Once you find that perfect spot perched on the butt bones, contract your abdominals (like you’re trying not to go to the bathroom) and relax your upper body, especially the shoulders and neck.

“Make sure that you are creating your lumbar arch from the lowest levels of your spine,” Eisenstadt stresses. In other words, your lower back “rainbow” needs to be at the same level as the upper abdominal “T-point.” Don’t overly arch your mid-back (like you’re hunching over).

“Lastly, pull your shoulders back and down using your armpit muscles, not your pecs, and relax your neck.”

In that posture, with your feet flat on the floor, lift your right leg and place the ankle on the opposite knee. Reverse and repeat to stretch the muscle.

Piriformis exercises also can be done lying flat on the floor, arms outstretched with palms facing the floor. Positioned about a foot from the wall, completely extend your legs and rest your heels against the wall. At that angle, rest one ankle against the opposite knee, just as in the sitting position.

What a Healthy Pirformis Can Do For You

Doing the piriformis stretch can help knee pain and ankle pain as well, Eisenstadt said. “Walking with a tight piriformis puts extra strain on the inside and outside of your knee joint, making the outside too tight and the inside weak, which creates an unstable joint.”

The stretch can also help with symptoms of plantar fasciitis (inflammation of the fascia on the bottom of their feet). People with tight piriformis and hamstring muscles often end up walking a “duckwalk,” Eisenstadt said, that puts an extra strain on the bottom of their foot.

“Fixing the body mechanics of how you walk by stretching your piriformis can not only help alleviate injuries but prevent you from getting them in the first place,” she says.

Don’t Overdo It

Like with any type of exercise, you should stop doing it if it hurts.

Don’t try to “work through” the pain, Dr. Mark Kovacs, a former tennis professional who has a doctoral degree in sports medicine. “Those pain receptors are there for a reason.”

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