Piriformis Stretch

The piriformis is a small muscle deep in the buttock, and the sciatic nerve runs right next to it. When the muscle is tight, it can cause a deep ache in the buttock and sometimes pain down the back of the thigh. This stretch, often called the figure 4 stretch, eases the muscle while you lie on your back.

Written by Dr. V. B. Rajendra Prasad, MPT, licensed in the US and UK.

1. Lie with both knees bent and cross one ankle over the other knee
2. Hold behind the lower thigh and draw it towards your chest

How to do it

  1. 1

    Lie on your back on a bed or mat with both knees bent and feet flat.

  2. 2

    Cross one ankle over the opposite knee, so the crossed knee points out to the side.

  3. 3

    Hold behind the thigh of the bottom leg with both hands, reaching through the gap between your legs.

  4. 4

    Gently draw that thigh towards your chest until you feel a stretch deep in the buttock of the crossed leg.

  5. 5

    Hold for 20 to 30 seconds, breathing slowly. Lower the legs and repeat on the other side.

How many

3 holds of 20 to 30 seconds on each side, once or twice a day.

Common mistakes

Pulling hard or bouncing. A gentle, steady stretch is enough.

Lifting the head and shoulders. Keep them relaxed, and loop a towel around the thigh if you cannot reach.

Pushing down hard on the crossed knee. This strains the hip and knee.

Holding your breath.

Make it easier

Stop at step 2: cross the ankle over the knee and let the crossed knee fall gently outwards, keeping the other foot on the floor. Or do it sitting in a chair: cross one ankle over the other knee and lean forward a little with a straight back.

Make it harder

Draw the thigh a little closer to the chest, or hold for up to 45 seconds. Your physiotherapist may add strengthening for the buttock muscles, such as the bridge and the clamshell.

Who it helps

Deep ache in the buttock
Tight hips from long hours of sitting
Some kinds of sciatica
Runners and walkers
Long rides on a two-wheeler

When to stop and check

Most sciatica comes from the lower back, not the piriformis. If the stretch sends pain, tingling or numbness further down your leg, stop and have your back assessed. After hip replacement, avoid crossing the legs unless your surgeon allows it. Any loss of bladder or bowel control, or numbness around the groin, needs emergency care.

Not sure these are the right exercises for you? A physiotherapist can assess you on a video call and build a programme around your problem, guiding each exercise and correcting your form in live sessions.

Get a personal programme

Frequently asked questions

Does the piriformis stretch help sciatica?
It can help when a tight piriformis is part of the problem. Most sciatica, though, starts in the lower back, where a disc or narrowing irritates the nerve root, and that needs a different approach. A physiotherapist can tell the two apart.
What is piriformis syndrome?
It is buttock pain, sometimes with pain down the back of the thigh, thought to come from the piriformis muscle irritating the sciatic nerve. It is less common than sciatica from the back, and it is usually diagnosed by examination after the back has been ruled out.

Related

Online physiotherapy: SciaticaOnline physiotherapy: Back Pain and SciaticaSciatica Exercises and Stretches for Pain ReliefBack Pain from Two-Wheeler Riding: What Every Rider Should KnowBack pain self-check

More hip and buttocks exercises

BridgeSide Lying Leg RaiseClamshellBridge MarchStanding Hip AbductionAll exercises
Dr. Rajendra

Written by Dr. V. B. Rajendra Prasad, MPT. Licensed to practice in the US (NY state) and UK (HCPC).
20 years of clinical experience. About Dr. Rajendra