Lower back pain is very common and can be the result of a variety of causes. One of these isn’t usually the primary suspect but it occurs more often than one might think: constriction of the piriformis muscle. This small slim muscle is behind the gluteus maximus, connecting the spine to the top of the femur.
If the piriformis muscle tightens, gets pulled, becomes inflamed, or spasms, an effective piriformis stretch can restore muscle function and relieve pain.
The piriformis is a difficult muscle to get to—the largest muscle in the body is in front of it. The piriformis allows to move the hip, upper leg, and foot outward from the body. This muscle covers the sciatic nerve (the largest in the body) that runs from the lower back down into the legs.
In some people, the sciatic nerve runs through this muscle. Sciatica is a condition in which the sciatic nerve is pinched in some way, causing pain.
The piriformis is not only important for hip and leg movement but it is a key part of our overall balance while upright. One end of the piriformis is attached to the front part of the sacrum, the triangular bone at the base of the spine. It’s the only pelvic muscle that attaches to the front of the sacrum, providing balance between the pelvis and legs. Its counteraction with the psoas muscle at the front of the pelvis and the gluteus maximus at the back maintains stability. An impeded piriformis limits both mobility and balance.
Surprisingly, piriformis syndrome is a somewhat controversial condition in medical circles. It seems that medical professionals can’t determine a cause, so they have trouble defining and diagnosing it. The piriformis is difficult to see, even with modern imaging techniques.
The term for a collection of sciatica conditions coined in 1947, “piriformis syndrome” wasn’t identified as a specific problem. Since then, lower back pain caused by an impinged piriformis muscle has been determined a true condition in itself and accounts for 6-8 percent of experiences of lower back pain. (1)
Numbness, tingling, and/or severe pain can occur if the piriformis puts pressure on the sciatic nerve. This can manifest itself as a dull ache or shooting pains in the back, hip, buttocks, and legs. (2) Also, a misaligned or inflamed piriformis can cause difficulty and pain while sitting and when changing positions (e.g., from sitting to standing).
Because of its key function in hip and leg mobility, a fully functioning piriformis will not only reduce the potential for sciatica but will keep you mobile. In fact, walking, cycling, running, dancing, and many other activities require a healthy piriformis.
“Here is a way to feel the piriformis muscle at work. Stand with your feet together, your knees bent and your butt stuck out a little. Put your hands on your butt and draw your knees apart slightly. Your piriformis muscle should be working beneath your big gluteal muscles,” writes Core Walking (3)
Exercising and stretching the piriformis takes a conscious effort but it’s worth it. Following are some piriformis stretches you can do to give this often-overlooked muscle some attention
How To Get a Deep Piriformis Stretch With These 12 Exercises
A) Lying stretch
B) Similar to A) but without the crossover:
C) For a deeper stretch:
This exercise will stretch your piriformis and your glutes. You’ll involve the piriformis muscle as your weight shifts and pelvic balance is engaged. Remember that your glute muscles cover the piriformis, so it’s a good idea to exercise them together rather than trying to isolate one or the other. If doing this piriformis stretch hurts your joints, skip it.
This exercise will stretch the muscles required to rotate the hip outwards.
The legs’ adductor muscles are those of the inner thigh: long adductors attach the pelvis to the knee and short adductors go from the pelvis to the femur. Because these muscles are connected to both the pelvis and the leg, it’s important to loosen the thighs as well as the pelvic and gluteal muscles to relieve tension in the piriformis.
You’ll feel this stretching exercise at the top of the inner thigh. If you can’t yet put your feet together, place them as close together as you comfortably can and be careful with the angles of your knees. As you incorporate it into your routine, you’ll be able to move your feet closer to your body for a more intense piriformis stretch.
This is a very effective piriformis stretch but requires a partner who should be a trained professional (massage therapist, physiotherapist, a specialist in sports medicine, etc.)
This is a great glute stretch. Using a resistance band increases the range of motion and provides an isometric stretch for muscles that are otherwise hard to reach. (4) Resistance bands come in different strengths so you can start with a looser one and move to a tighter one as you become more toned and accustomed to the exercise.
Better known as a sciatica exercise, this piriformis stretch will work your glute muscles, piriformis, and loosen the lower back.
This is another piriformis exercise that will stretch both pelvic and glute muscles.
A side stretch will open up the lower back, relieving tension along the sciatic nerve. If you are experiencing sciatica, it’s important to stretch gently so that you don’t injure or inflame the area around the nerve.
Stretching the glute muscles will reach into the piriformis—you’ll feel the muscles tense from back to front as you move. This is an intense piriformis stretch and it’s easy to push too hard too fast. Take it slowly and stretch with controlled movements.
This is an effective lower-body piriformis stretch that will engage all muscles in your pelvis and lower back. It’s a good sciatica stretch too.
When exercising, it’s best to work the entire area and all connected muscles. They support each other and so they must work together. Sciatic pain that is caused by an injured or misaligned piriformis muscle can be relieved by releasing the surrounding muscles.
In the context of the stretches above, you are trying to reduce pain, not increase it. Stretch slowly and if it hurts, modify your extension or don’t do it. You should feel muscle tension but not pain when exercising. “No pain, no gain” doesn’t apply here. You can end up sending a muscle into spasm or pulling it, resulting in more pain and a longer recovery period.
“A gentle stretch relaxes the muscles, letting them release and grow longer. But too intense a stretch can actually create an inflammatory response…meaning your body is trying to repair damage. Any time you cause pain, you actually cause tissue damage,” warns Best Health Mag (5)
Holding a stretch for more than 15 seconds at a time can cut off oxygen to the muscles. The more intense the piriformis stretch, the less time you should hold it. (6)
You shouldn’t stretch cold muscles; doing so can cause injury. Do at least a moderate 5-minute warm-up first to loosen muscles and connective tissue before stretching. You can find a warm-up routine here.