The 11 Best Piriformis Stretches to Help Eliminate Butt and Hip Pain

Your body is made up of over 600 muscles. Some of those muscles are HUGE, like your gluteus maximus. That’s the big old cushion you are currently sitting on. Other muscles are so tiny that they’re barely visible, like the ciliary muscle, which is responsible for focusing your eyes.

However, big or small, strong or weak, when muscles go wrong, they can put you in a world of pain, affecting your ability to train or even just function normally.

Weak muscles are unable to perform their jobs, forcing other muscles to take on their workload. In turn, these helper muscles become overworked and often affect their neighbors. This creates a cascade effect across joints and even throughout your body.

In contrast, tight muscles can pull bodily structures out of alignment, putting pressure on the wrong parts of your body. Tight muscles also restrict blood flow and often cause pain – both locally and radiating to nearby limbs.

Both weakness and tightness can be caused by and be the result of injuries. However, sometimes they’re due to the activities of daily living, such as sitting or working at a desk.

The piriformis muscle is small and hidden beneath your glutes, but when it goes bad, it can cause a lot of pain and dysfunction. The good news is that this muscle is relatively easy to stretch, and piriformis pain is usually very treatable.

In this article, we discuss the structure and function of the piriformis muscle, explain how and why it can go wrong, and reveal the best exercises to fix it.

Piriformis Anatomy 101

The piriformis is located in the gluteal region beneath the more prominent and better-known gluteus maximus.

Piriformis is flat and runs from the front of the sacrum, which is part of the pelvis, through the greater sciatic notch and attaches to the head of the femur at the greater trochanter [1]. It is shaped not unlike a pyramid and lies parallel to the posterior edge of the gluteus medius.

The functions of the piriformis are:

• Lateral (external) rotation of the hip when standing.
• Abduction of the hip when it is flexed.
• Tilting the pelvis laterally.
• Tilting the pelvis posteriorly by pulling the sacrum down towards the thigh.
• Stabilizing the hips during walking and running.

While a tight piriformis can cause the usual range of movement restrictions associated with short muscles, it can also cause additional problems by putting pressure on the sciatic nerve. This nerve runs through the piriformis and down your legs to your feet.

Pressure on the sciatic nerve can cause muscle weakness and radiating pain. This pain is often severe and can be debilitating and known as piriformis syndrome, or PS for short.  

Because the pain originates in the sciatic nerve, piriformis pain is sometimes confused with a condition called sciatica. However, with sciaticasciatica, the source of pressure on the sciatic nerve is usually a herniated lumbar disk or spinal stenosis – a narrowing of the space through which the sciatic nerve passes.

Symptoms of PS include:

• Numbness or tingling in your butt and the back of your leg.
• Burning or shooting pain in your butt and the back of your leg.
• Pain or numbness in your feet.
• Pain that gets worse during activity or exercise, or pain that gets worse with prolonged sitting.

Stretching the piriformis can help reduce the pressure on the sciatic nerve, eliminating the source of irritation and pain.

Causes and Treatment of Piriformis Tightness and Piriformis Syndrome

So, what causes good muscles to break bad? These are the most common reasons that the piriformis tightens up. However, it’s important to note that a tight piriformis does not always result in piriformis syndrome. Still, your chances of developing PS are much higher if your piriformis is tight.

• Prolonged periods of sitting.
• A high volume of repetitive movements, e.g., walking, cycling, and running.
• Overuse of booty bands and abduction exercises.
• Accident or injury affecting the hip.
• Piriformis muscle weakness.

In general, stretching and strengthening the piriformis can help keep this muscle in tip-top shape. Still, in some instances, you may need medical help to reduce inflammation and allow this muscle to heal.

Common treatments for piriformis syndrome pain include:

• Passive and active rest
• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Muscle relaxant medications or injections.
• Osteopathic manipulation.
• Botox injections.
• Electromuscular stimulation (iontophoresis).

Do You Have a Tight Piriformis?

If you have pain that radiates from your hip down your leg, you may have a tight piriformis. However, before you start stretching your piriformis, it’s best to check that it really is the source of your pain and you are not actually suffering from sciatica.

Ideally, you should have your pain diagnosed by a medical professional. After all, they’re the experts! However, an initial self-diagnosis may be helpful, especially if your pain is mild and you want to attempt to fix it yourself.

Seated piriformis test

To perform this test, sit on a chair or bench so that, with your feet on the floor, your knees and hips are flexed to about 90 degrees.

1. Sit up tall and place your affected ankle on your other knee.
2. Next, lean forward and lower your chest down toward your crossed leg. You can also turn your upper body toward your raised knee or gently pull your knee in toward your chest.
3. If you are a) unable to perform these movements or b) they cause your pain to intensify, there is a high probability that your piriformis is tight and maybe inflamed. You may also feel pain in the upper thigh and gluteal region.

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Remember, this test is not meant to replace diagnosis and treatment from a medical professional. If in doubt, go and see a medical professional!

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The 11 Best Piriformis Stretches

Stretching your piriformis can help prevent and alleviate general hip tightness and reduce your risk of developing piriformis syndrome. In most cases, stretches are included in PS treatment regimens, too.

Here are 11 of the best stretches for your piriformis muscle.

• Seated piriformis stretch
• Supine piriformis stretch (figure-four stretch)
• Standing piriformis stretch
• Assisted standing piriformis stretch
• Seated half spinal twist
• Pigeon pose
• Spine lumbar twist stretch
• Seated leg cradle
• Standing step behind piriformis stretch
• Knee-to-opposite-chest stretch
• Foam rolling the piriformis

1. Seated piriformis stretch

This stretch should look familiar as it’s basically the same move you used to determine whether your piriformis was tight or not. The great thing about this exercise is that you can do it whenever you are seated, so it’s ideal for breaking up long periods of sitting. Also, it’s quite a passive stretch, so you can hold it for extended periods without getting tired.

Steps:

1. Sit on a chair so your knees are roughly level with your hips.
2. Cross your left ankle over your right knee.
3. Gently press on your left knee to open your hip.
4. Without rounding your lower back, lean forward until you feel a stretch in your gluteal region.
5. Rotate your upper body toward your left knee to increase the stretch.
6. Hold for 30-60 seconds, and then relax.
7. Swap legs and repeat on the other side.

2. Supine piriformis stretch (figure-four stretch)

Some people prefer to stretch while lying down. This is especially true during cool downs. This exercise is very similar to #1, but you perform it in the supine position. For some, this will be more relaxing. However, others may find it uncomfortable. It also requires a reasonable level of flexibility to perform correctly and may be too advanced for some exercisers.

Steps:

1. Lie on your back with your legs bent and feet flat on the floor.
2. Cross your right ankle over your left knee.
3. Lift your legs and grip the sides of your left knee. Gently pull it toward you. Keep your shoulders and upper back on the floor.
4. You should feel a deep stretch in the right hip and glute. The closer you pull your leg toward you, the more intense the stretch will be.
5. Hold for 30-60 seconds, and then relax.
6. Swap legs and repeat on the other side.

3. Standing piriformis stretch

In most cases, the last thing you want to do before or during a workout is sit or lie down. Being so stationary will cause your heart rate to drop and your body temperature to fall. This is far from ideal when you are exercising. This piriformis stretch is pretty active and performed while standing, so it’s ideal for use during a warm-up or mid-workout if you want to briefly stretch your hips, e.g., between sets of squats or lunges.

Steps:

1. Standing near a wall for balance if needed, cross your right ankle over your left knee.
2. Bend your supporting leg slightly and then lean forward, lowering your chest toward your raised leg.
3. Hold for 15-30 seconds and then release.
4. Switch sides and repeat.

4. Assisted standing piriformis stretch

While exercise #3 is an excellent stretch, the balance component may mean that, for some people, it’s impractical or too challenging to hold for long enough to be effective. This assisted variation makes balancing much easier and also allows you to achieve a deeper stretch. This is also a better move if you plan on stretching your piriformis for longer, e.g., 60 seconds.

Steps:

1. Stand facing something like a hip-high countertop, massage couch, or a couple of stacked plyo boxes.
2. Bend one leg, place your foot on the top of your platform, and let your knee rotate outward. Your foot should be roughly in front of your opposite hip. Hold your foot and place your other hand on your knee.
3. Lean forward to increase the stretch while keeping your bent knee out to the side.
4. Hold for 30-60 seconds and then release.
5. Switch sides and repeat.

5. Seated half spinal twist

While this yoga pose is usually described as an exercise for the spine, it’s also a gentle yet effective way to stretch your glutes and piriformis. Try doing this stretch while watching TV to relieve piriformis tightness and offset all that couch time! Forget Netflix and chill; Netflix and stretch, yo!

Steps:

1. Sit on the floor with both legs straight. Your torso should be upright.
2. Bend your left leg, cross it over your right, and place your left foot flat on the floor next to your right thigh. Pull your foot as far in toward you as possible.
3. Rotate your right shoulder toward your left knee using your arm(s) to gently pull you around to get a good stretch in your hips and glutes.
4. Hold for 30-60 seconds and then release.
5. Switch sides and repeat.

6. Pigeon pose

Pigeon pose is an intermediate/advanced yoga pose and, as such, may be too intense if your piriformis is very tight. However, if you can manage it, this exercise is a very effective total hip stretch that will open your hips and lengthen your piriformis muscle.

Steps:

1. Get on the floor on all fours so your shoulders are over your hands and your hips are over your knees.
2. Extend one leg straight out behind you.
3. Sit back and roll your bent knee outward so your front foot is below your opposite hip.
4. Lower your body down toward the floor as far as feels comfortable. Use your body weight to stretch your hip.
5. Rest your forearms on the floor in front of you if you can. Otherwise, just keep your arms straight.
6. Hold for 30-60 seconds and then release.
7. Switch sides and repeat.

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You can also do this exercise with your rear leg bent and extended out to the side. Some people may find this modified version more comfortable.

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7. Spine lumbar twist stretch

This is another so-called spine stretch that’s actually very good for stretching your piriformis and glutes. This gentle stretch is ideal for use during a cool down or anytime that you want to relax. And yes, it’ll help mobilize your spine too!

Steps:

1. Lie on your back with your legs straight and arms extend out to your sides to form a T-shape.
2. Bend your left foot and place it on the floor above your right knee.
3. Place your right hand on your left knee.
4. Gently pull your left knee across your body, twisting your hips, and lowering your leg down toward the floor.
5. Keep your shoulders and upper back stationary.
6. Hold for 30-60 seconds and then release.
7. Switch sides and repeat.

8. Seated leg cradle

This stretch hits your entire glute complex as well as that all-important piriformis. However, to do it correctly, you will need reasonable flexibility, including in your hamstrings. If you find this exercise impractical, do something like the seated piriformis stretch (#1), which is a lot more accessible.

Steps:

1. Sit on the floor with your legs extended and your torso upright.
2. Bend one leg and bring it toward your chest.
3. Support your foot and rotate your knee outward. Your shin should be parallel to the ground.
4. Rotate and pull your leg toward you to deepen the stretch.
5. Hold for 30-60 seconds and then release.
6. Switch sides and repeat.
7. You can also do this exercise in the supine position, i.e., lying on your back.

9. Standing step behind piriformis stretch

The piriformis muscle does most of its work when you’re standing. It contracts to stabilize your hips and stop your thighs from falling inward when you walk, run, lunge, squat, etc. This exercise is also performed standing, so it’s arguably one of the most natural ways to stretch the piriformis muscle.

Steps:

1. Stand with your feet together.
2. Take a small step forward and cross one foot in front of the other to form a T-shape.
3. Push the hip of your rear leg out and back to get a stretch in your outer glutes and piriformis.
4. Hold for 30-60 seconds and then release.
5. Switch sides and repeat.

10. Knee-to-opposite-chest stretch

The standard knee-to-chest exercise is a great general hip and glute stretch. However, when you pull your knee diagonally across your body, your piriformis gets lengthened more, and you’ll feel it in your upper, outer glutes and thighs. This is one of the easiest ways to stretch the piriformis, but it’s not the deepest stretch, so it’s best for beginners.

Steps:

1. Lie on your back with your legs straight.
2. Bend one leg and hold the outside of your knee with the opposite arm.
3. Gently pull your knee in and across toward your opposite shoulder.
4. Hold for 30-60 seconds and then release.
5. Switch sides and repeat.

11. Foam rolling the piriformis

Foam rolling is a sort of self-massage. It’s designed to ease knots, increase circulation, and free up fascia, which is the fibrous tissue that surrounds your muscles. Foam rolling is particularly effective for relieving piriformis pain but is not the most comfortable thing to do. Ease into foam rolling as being too aggressive too soon could result in soreness and even bruises.

Steps:

1. Sit on your foam roller, so it’s lengthways under your butt. Your legs should be bent and your feet flat on the floor.
2. Cross one ankle over the opposite knee.
3. Shift your weight over onto one glute and move the roller forward and back beneath your buttock. Seek out any pressure points and work on them until they ease.
4. Continue for 1-2 minutes, and then swap sides.
5. You can also release your piriformis using a tennis or lacrosse ball. This allows you to concentrate more pressure in a smaller area for a more intense effect.

Piriformis Stretches – FAQs

Do you have a question about piriformis stretching? No problem, because we’ve got the answers!

1. Do I really need to stretch my piriformis?

The piriformis works alongside your glutes, and as such, if you stretch your glutes, you’re also stretching your piriformis. Because of this, you may not need to spend a lot of extra time stretching your piriformis separately.

However, to see if you need to do any of the exercises in this article, you should do the piriformis test. This will reveal if your piriformis is short and tight. If you fail this test, you will probably benefit from stretching your piriformis, even if you have no symptoms.

2. What is the best way to stretch my piriformis?

Most stretches work best when you ease into them. Pick one of the piriformis exercises above and apply the stretch until you feel a mild pulling sensation in the target muscle. Hold this position, called the point of bind, for 10-15 seconds. During this time, you should feel the muscle relax.

Then, move into a slightly deeper stretch until you reach the next point of bind. Again, hold this position for 10-15 seconds or until you feel the muscle relax.

Repeat this sequence several times until your piriformis feels thoroughly stretched and relaxed. Remember to stretch both sides.

3. How common is piriformis syndrome?  

While piriformis tightness is quite common, piriformis syndrome is much less so. In fact, the symptoms attributed to PS are much more likely to be sciatica, which is caused by the lumbar disks pressing against the sciatic nerve [2]. Sciatica is a very common condition.

4. How often should I stretch my piriformis?

If your piriformis is very tight, you should stretch it several times a day to quickly restore it to its ideal length. This is especially true if you also perform a lot of activities that can lead to shortening of the piriformis, e.g., running or hiking.  

However, once your piriformis is sufficiently flexible, you should be able to maintain it by stretching it once a day or even just a few times a week.

That said, because prolonged sitting can cause the piriformis to quickly and noticeably tighten, it’s a good idea to do short, regular stretches for it to avoid the problems that a tight piriformis can cause.

5. It hurts when I stretch my piriformis. What should I do?

Pain during stretching is rarely a good thing. It usually indicates you are trying to stretch too aggressively or that you are taking your joint(s) into an unnatural position. Some mild discomfort is to be expected, but stretching should not be painful.

If you experience pain when stretching your piriformis, try easing off and waiting until the muscle relaxes to increase the depth of your stretch. Alternatively, use another exercise, choosing one that feels more comfortable or natural.

Closing Thoughts

The piriformis is a small but important muscle. It’s very active during walking and running, and prolonged sitting can cause it to become short and tight. A short piriformis can reduce the range of motion of your hip, affect your gait, and even cause piriformis syndrome, although that condition is quite rare.

The good news is that the piriformis is easy to stretch and usually responds well to flexibility training. Therefore, a few weeks of concerted effort should restore your piriformis to its ideal resting length.

However, ignoring a tight piriformis could lead to injury and pain. So, test and assess your piriformis, and if it’s tight, make sure you stretch it with the exercises in this article.

References:

1. National Library of Medicine: Anatomy, Bony Pelvis, and Lower Limb, Piriformis Muscle.
2. Journal of Clinical Imaging Science: Diagnosis and Management of Piriformis Syndrome – A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging.