The piriformis stretch is quite a classic position, especially for yoga and pilates, where it is sometimes referred to as the Sign of Four. 

The piriformis muscles attach the sacrum at the back of the pelvis to the femurs or thigh bones. Classically their action is to rotate the leg outwards at the hip.  Although their function is more to stop the leg turning in to much.  

These muscles can get very tight in people who stand and walk with their feet turning outwards.

For some unfortunate people there are fibres passing through the sciatic nerve, or there isn’t quite as much space as ideal between the piriformis and the sciatic notch within the pelvis and so when the piriformis tightens they get a sharp pain down the back of the leg and into the foot.  This is referred to as Piriformis syndrome.  If you suffer from this or you get a sharp pain in the back of the thigh when doing this then come out of the position and seek further advice.

I will show two options for this: lying supine on the floor and in a chair.

 

 

Equipment

None really necessary, but something soft to lie on is nicer than a wooden floor.

Position 1: Lying supine on the floor.

 

Steps

  1. Lie on your back with the knees bent.
  2. Fold one leg in towards your chest.
  3. Rotate at the hip so the side of the ankle of the folded in leg can come to rest on the thigh of the other leg, close to the knee.
  4. Softening at the hip, the knee of folded in leg should move towards the bottom of the mat, so that (ultimately) the shin is perpendicula to the other leg.
  5. This is a good place to pause for 30 seconds letting the strong buttock muscles soften.  And you may want to skip the next step if this position feels enough.
  6. To enhance, or deepen, the stretch, you can fold the underneath leg in so you can reach through and hold the thigh with your hands.  Hold this position for 30 seconds.
  7. A further enhancement adds a stretch into the underneath leg, but straightening the knee so that food points up to the ceiling.
  8. Unravel your legs and return to the starting position before repeating with the other leg folded in.
Things to think about
  • As the folded in leg is softening, I like to imagine that the femur is turning in the hip socket to achieve the movement at the knee.
  • The knee should not feel threatened at any point, if it does ease the stretch.

Video – Supine

Here is a video of me running through the stretch lying on your back (supine).  You can click on the four arrows to make it full screen.

Position 2: Seated Piriformis stretch

If you can’t get down to the ground, then the piriformis stretch can be modified to be done in a chair.  This is ideal for meeting or video conference calls.

  1. Sit tall in the chair, up on your sitting bones, feet flat on the floor.
  2. Cross one leg over so the outside of the shin rests on top of the other thigh, but closer to the knee of that leg than the groin.
  3. Let the folded in leg soften and turn at the hip to the knee sinks towards the floor. I like to image the thigh bone spiraling in the hip socket to achieve this movement.
  4. This may be as far as you can go, but give your body a chance to soften the big buttock muscles but waiting 30 seconds or more in the position.
  5. To enhance or deepen the stretch, tip the pelvis forward so you roll onto the front of the sitting bones, breast bone aiming towards the foled in shin (which keeps the back flatter). Pause in this position for 30 seconds.
  6. Unravel the legs
  7. Repeat on the other side.

Video – Seated

Here is a video of me running through the stretch in a chair.  You can click on the four arrows to make it full screen.

 

The buttock muscles are strong so don’t rush these stretches.  Give yourself time to do these regularly and it might be worth repeating a couple of times on each side.

Why do I say to hold the static stretch for 30 seconds?  I put it like this: the first 10 seconds it feels like the muscles are shocked into wondering what this position is.  Then the next 10 seconds they start to relax into the position, and the final 10 seconds they might also be able to move a bit deeper into the movement, and accept that this is possible.

These movements should not cause additional pain or discomfort, or cause new pain.  If they do then please stop and get some advice on what is happening to your body. This is particularly true of the knee: with the knee bent some of the internal structural stability is reduced and there is a greater stress placed on the lateral ligaments, so don’t over force things.

 

Thanks for reading this my lovely Interonauts.

Tim

The observant might notice that I have short hair in the photos, and yes the photos of me doing the exercise were taken before the pandemic.