Top 3 Exercises for Piriformis Syndrome

Top 3 Exercises for Piriformis Syndrome


The first exercise that we are going to do
is a piriformis stretch. There are 2 different variations that we use in the clinic. The
first is laying down, bend one knee up. So if you want to stretch the right piriformis,
you bend the left knee up. Cross the right leg over the left leg. Reach across with the opposite
hand, the left hand, and pull towards you. You should feel this directly in your
butt muscle, your piriformis muscle. In the clinic, we hold that for 30 seconds and we
do 3 of them. One variation to that especially for people that have hip arthritis or hip
osteoarthritis, we will do it this way: Put your hand here and press down. My personal preference
is the first method but we have had a lot of people who like this as well. And
they still get that buttock stretch. The second exercise that we are going to do
is another piriformis stretch. This is a little more advanced especially for runners. How
we do it is this: start with your leg propped up. This would be to stretch the left piriformis.
Left leg is up crossed over, then you can lean forward. So definitely more advanced
than the first one but on this we do the same thing, hold for 30 seconds and we do this
3 times in the clinic. The third exercise that we are going to do…the
first 2 were stretching. The third one is going to be one to strengthen the piriformis
muscle and this is the best one that I know of. It fires the piriformis in all 3 ways
that it moves your hip joint. The first one is to turn your leg out. The next one is to lift your
leg out. And it also extends the hip. So it does all 3 of those. We call this the prone figure
4 isometric. What you do is you lay on a mat table or on a bench or on the side of
a bed or a sofa. Lay on your stomach and position one leg off the edge, the leg that
you want to exercise. Lock your foot behind your opposite knee then raise your knee up.
You should feel this fire in your buttocks muscle pretty good. We do a 5 second hold.
We start with 10 of these in the clinic. When we are talking about piriformis syndrome,
the first thing that we want to do is define what is the piriformis? Also we want
to look at what is a syndrome? The piriformis is a muscle in your rear. It attaches
to the side of the tailbone. This would be a person standing facing that direction. This
is the tailbone. This is the right half of the pelvis. This is the left half of the pelvis.
The piriformis attaches to the front side of the tailbone and comes across and attaches over
here to the top of your thigh bone. Piriformis is a muscle syndrome which means
a cluster of signs and symptoms with no known cause. With piriformis syndrome, there
are 4 or 5 main causes. The most common is that there is an underlying pelvic
issue where the pelvis isn’t moving the way that it is supposed to. That puts extra pressure
on the piriformis and that creates sciatic nerve problems. The one thing with piriformis
syndrome the way that it is commonly used at least in our area of the Eastern United
States, is if the lumbar spine is ruled out, so there is no problem in the low back but
the person has sciatica meaning that nerve pain down the back of the leg. Many times
that is attributed to piriformis syndrome.

99 comments on “Top 3 Exercises for Piriformis Syndrome

  1. Philip Dodson Post author

    I rarely run, and I decided to just go out and run 4 miles. At first I had pain in my foot; this went away after a week. Now 2 weeks later the pain it is concentrated around my butt and down my leg and it gets worse when sitting or bending over. Sound like piriformis syndrome?

    Reply
  2. Madden PT Post author

    Phil, find the best hands-on PT in your area and have them screen your pelvis and lower back…they will be able to tell.

    When calling to schedule, ask if they routinely do "grade 5 lumbopelvic mobilizations"…you may not need that specifically, just a PT who knows what that is.

    Reply
  3. jags105 Post author

    I think I may have SIJ/unstable pelvis issues due to what I believe a sacral torsion in yoga 12 years ago (pushing too hard in a seated spinal twist). When aggravated, my left hip gets shoved noticeably out to the left side, it is most apparent. I am confused if it is just simple SJI pain or if the piriformis is involved as well, and what to do about it. Can you recommend some at home excercises that will be effective? I've seen your video for top 3 SIJ relief excercises. Any other suggestions?

    Reply
  4. Madden PT Post author

    The piriformis crosses the SIJ and is usually involved…

    Other suggestions?

    1. Find the best hands-on PT in your area.
    2. Buy Pain Free Motion for your Lower Back on iBooks or call our office to order.

    Reply
  5. Koni Post author

    I most certainly have this. I have pain in my butt going down to the leg and I can barely move my leg up, it's very tensed up. I've had these problem for over a year, will stretching still work? The pain is very intense and it's driving me nuts sometimes.

    So stretch or other solution? Should I do these stretches? For how long?

    Reply
  6. Madden PT Post author

    ConnyP, find the best hands-on PT in your area and see them to screen out your pelvis.

    Stretching is OK…strengthening is better. A good hands-on PT can help you best.

    Hope this helps!

    Reply
  7. Edie Nicholson Post author

    I recently experienced a jolt after a fall directly to my buttock area. It is extreme painful when I get up in the morning and after lying down for long periods.

    Reply
  8. rogar61 Post author

    Madden PT, there is one thing I never understood about the piriformis stretch: It's an ext. hip rotator but all the stretches for it put the muscle into external rotation. Why isn't the leg internally rotated instead?

    Reply
  9. Madden PT Post author

    Welcome.

    People we see in the clinic heal in about 4 weeks with hands-on PT to pelvis + exercise…

    Reply
  10. Madden PT Post author

    True…most piriformis stretches are truly gluteus maximus and medius stretches.

    You can pull the knee up and internally rotate to stretch the piriformis…

    Reply
  11. James Mathews Post author

    How do you diagnose piriformis syndrome, by eliminating other causes? I have had sciatic-type pain for 2 years, mostly between my rump and knee. I've had MRIs, no disc issues or bone spurs. I've had PT, epidural shots in L4/L5/S1, acupuncture, etc…My massage therapist says my piriformis is locked up, and that can cause that pain. My orthopedic claims that piriformis syndrome does not exist, I gather there is some disagreement on that point…

    Reply
  12. FlipsideUSA Post author

    My pain started nearly 2 months ago. It started to go away on its own. But then 2 weeks ago, got majorly aggravated. But no sharp pain. Just deep muscle pain in the left buttock. Then, a week ago, majorly aggravated again. And the sharp pain started. Pain is only in the buttock. Sometimes, just above the buttock(very lower back). I've watched like a thousand videos and have been doing the various Piriformis stretches(assume its Piri?). Just went to try the one at 1:20 and sharp pain! Help???

    Reply
  13. William T Post author

    I'm a martial artist and I've been experiencing pain that runs from my lower back into my buttocks. I believe I may have this piriformis syndrome but I'm not sure. I remember physio said something about my pain being triggered by the cause of either my glutes being too weak causing my back to have extra stress or vice versa, and if I work out that muscle, I'll fix the problem. Problem is i can't remember which muscle i need to strengthen. Any suggestions?

    Reply
  14. Jake Hommel Post author

    I'm 16, an amateur boxer and in excellent condition, i do intense training and cardio 5 days a week to train for fights but this disorder has killed me and my game in every way shape and form. It's hell to live with and none of these rehab stretches or treatments have made any progress.

    Reply
  15. jeff palmer Post author

    Piriformis is a external hip rotator, therefore to stretch it completly you need to do internal hip rotator stretch, when it's placed in a external position such as these your piriformis is being partialy contracted, if you do this guy's stretches just make sure that knee is being brought up towards your chin to ensure some kinda stretching is going on.

    Reply
  16. Jan Hynouš Post author

    Im 27 hockey player.. and for 4 years i feel this pain.. its not periodicly but when this pain come.. cant walk without pain cant do anything in this pain time.. girls thing that u are an idiot when still thing about pain in butt.
    . Hard to live with this… Good luck for all piriformers!

    Reply
  17. 박정수 Post author

    Last year pain was suddenly started..i could not find what was the problem even examing MRI results. It made my life worse. I hope it can help for my pain

    Reply
  18. Well & Good Pilates Classes Post author

    this small muscle can cause big pain. here are some stretches and exercise to provide relief. Elizabeth  

    Reply
  19. Åsa Stenström Post author

    Thank you for this excellent video! It's all about me! I knew about a similar exercise standing by the table, but the instructions I got was not exactly like yours. I'm going to try all your exercises. Thank you!

    Reply
  20. John Cook Post author

    Great video thank you!!! Just found out I do not have a bulging disk…Thank goodness and now focused on Piriformis…way better than disk BS…

    Reply
  21. Inez Patino Post author

    I did same kind of piriformis exercises and I was in lot of pain so had to see osteopath again, can't do any exercise apart from walking.

    Reply
  22. Terry Jordan Post author

    Thank you for taking the time to create this video. I especially like that you included the skeleton section of the pelvic area where the piriformis and sciatic nerve lie. I shared your video with my massage client. Thanks again!

    Reply
  23. Stephen Hughes Post author

    Great video – excersize number 2 (55 seconds into this) works so well for me and I'm a runner and its almost shifted all the pain in one go!

    Reply
  24. Spider Post author

    I'm so glad I found out what was causing this pain. I remember trying to explain this to friends and not knowing how to explain it other than, "MY BUTT CHEEK HURTS!" Haha. Walking around actually makes the pain feel better for me. But shifting my weight or standing for too long makes it uncomfortable. It hurts when I sit too, but it sort of feels like a good pain. Like the stretching is relieving pressure.

    Reply
  25. Heroldthehound Post author

    Nice video… Been doing these exercises for a long time and I must say they work. I do exercise two and three which have helped me tremendously, but the first exercise never did anything. I work in an outpatient clinic and whenever I have a patient with a tight IT band or Piriformis, I start them on these exercises first.

    Reply
  26. abhijeet3135 Post author

    in thee second exercise the electricity is flowing down to the leg. should i continue or stop

    Reply
  27. Maggie Wanbon Post author

    I am 14 months post hip replacement. Are these exercises safe for me to do. I have extreme pain in the piriformis. Thanks very much for this insight.

    Reply
  28. SoSearious Post author

    Hi There thanks a lot for the video! After I do the 3rd exercise (the one for strength) the gluteus is very tight. Is it normal during the first times?

    Reply
  29. jrs4780 Post author

    The stretch with the knee up and undet the body is fabulous. The most relief i have had from piroformis . I wish i could stay on that position all day. So much relief!!

    Reply
  30. Joe Dunford Post author

    I have been self diagnosing what this problem of mine was for a few days now. This man's exercises helped be significantly within 10 repetitions. Thank you sir!

    Reply
  31. anettewithers Post author

    When I tried the exercise where you lie on your stomach and raise the bent leg outside of the bench, I only felt it in my trouble area- my groin, but not my buttocks as you said you should. Is it because of tight hipflexors?

    Reply
  32. Mary Beck Post author

    I had a hip replacement due to a congential condition called femoro acetabular impingement (FAI).3 years ago. About a year ago I developed pain in the piriformis/sciatica area which my doctor called Piriformis syndrome. Will these exercises affect or harm my hip replacement? I walk about 3 miles 4-5 times per week too.

    Reply
  33. Bea Nicholson Post author

    Watched the other video (30 second test – plus one quick relief!) and this, both very useful – but not mentioned in the downloadable book and I have a short memory. Would have been very helpful to include them – is there a reason?

    Reply
  34. David Levinsohn Post author

    your a champion for sharing this for free! 2nd technique is amazing (I'm doing it while writing. this)

    Reply
  35. Tim Jansen Post author

    I don't know if anyone can answer a few simple questions. I do a walk/jog combination three or four times a week. Over the last month I have found that I get a fairly sharp pain in my left hip when I slow down from a jog. When I start walking the pain is gone. So the pain is only when I am actually slowing dowe and even then not all the time. I figure physical pain is a no-go so I have curtailed the jogging. My self-diagnosis is some form of Piriformis Syndrome, but I sure don't know for sure. I'm thinking of trying these exercises, just to see if it helps. Anyway, any input would be welcome.

    Reply
  36. Gaurav Post author

    hey can you help me to tell the procedure to do exercises…. when i can bend my leg … i mean i cant put my affected leg on the other leg to do the stretching and exercises

    Reply
  37. Gaurav Post author

    hope to have a new video… pls to help me… as i am really struggling to do the exercises… as i am not in a position to lift the left leg and bend it and put it on other leg… i will be highly grateful. ..if u will help me..thanks

    Reply
  38. Dr Who Post author

    This is an informative video, so thanks for that, but it has so many pop up adverts it's too difficult to watch.

    Reply
  39. Holly Sato Post author

    I have been fighting this pain for over a year now. I am going to try these. It is my right side that hurts. Should I still do the exercises on the left to keep things even?

    Reply
  40. Rishiraj Beeponee Post author

    Hello Sir, I think am suffering from this syndrome for more than 3 years and am fed up now! Do you think I'll recover completely if am going to do these exercises? I would be very grateful to you Sir. Waiting impatiently for your reply.

    Reply
  41. MIKE MCDANIEL Post author

    MIKE MCDANIEL What is the optimal height for the P.T. table when doing the standing piriformis stretch ? I have mine set to where the table is about 1 inch below my crotch, yet it seems that it stretches my lower back MORE than the piriformis muscle.

    Reply
  42. Kate Batstone Post author

    I am currently experiencing a flare-up of both this and IT Band Syndrome. I walk everywhere nearly all the time. The terrain is varied in my city, and especially bad in winter months. One problem aggravates the other, and while I have a list of helpful exercises for IT Band Syndrome, I did not have exercises for Piriformis Syndrome. The exercises outlined in your video helped alleviate my discomfort immediately. I expect that with continued use, they will reduce the frequency of future incidents. Thank you for posting this video.

    Reply
  43. R C Post author

    I realized a desk chair at work was causing my piriformis symptoms. I changed chairs, stretched regularly and it was gone after about three weeks. also, I don't sit with my wallet in the back pocket.

    Reply
  44. Prateek Pathak Post author

    the third one was gr8…. i got much relief from it just with the second repetition….thanks for the video..

    Reply
  45. Kathryn Sink Post author

    I have multiple herniated discs and these stretches really help calm the sciatic nerve down

    Reply
  46. Simona Martinez Post author

    Thank you so much!! this video helped me alot. i was in so much pain i could not sleep through a whole night. Just wanted to say So you're awesome THANK YOU

    Reply
  47. Moti Vidos Post author

    hey, what does the lower leg supposed to do? is it perpendicular to the upper leg on the table or just like a closed scissor? thxxx 🙂

    Reply
  48. Beth Klein Post author

    Sciatica SOS™ Your Guide To Eliminating The Pain In 7 Days Or Less –GUARANTEED Click here to watch this free video presentation [Go Here >>>>>https://www.facebook.com/Unlock-Your-Hip-Flexors-1724160277885885/app/208195102528120 ]

    Reply
  49. trog lodyte Post author

    Wow, the first stretch did it for me. Totally relieved the pain and now feels warm there. Been over doing it with the running lately. I thought the pain was coming from my hip.

    Reply
  50. fatfrabbit Post author

    Actually the first 2 stretch is what my chiropractor teach me also. My piriformis is very tight and make my pelvic area can't move. THose 2 exericises here are very good. I do it every morning.

    Reply
  51. Tim O'Malley Post author

    did all these exercises for 8 weeks every morning  about a year and a half ago and have never had my Piriformis Syndrome pain return

    Reply
  52. Felicia Vida Post author

    So I have this symptom for more thsn 5 years now. I did't do any working treatment until now. Do you think that these exercises will cure me? In how much time?

    Reply
  53. kim hutcheson Post author

    I have a labral hip tear with this condition AND tsoas tendonitis. Is this safe? Because the first one FLARES this horribly.

    Reply
  54. Ted Fowler Post author

    I'm doing your recommended piriformis stretches and strengthening exercise. After the first set of 10 strengthening exercises, do I build up to two or three sets of 10?

    Reply
  55. Cryptic XXII Post author

    Can't find any videos on Piriformis Syndrom caused by an elongated piriformis muscle. Doing what's shown in this video will just make things worse…

    Reply
  56. Radomir Pajic Post author

    Congrats! I wish all doctors trying to help like you!
    Sharing the knowledge is the main key for mankind!

    Reply
  57. Fabian Patrizio Post author

    the first stretch is what gave my an issue in the first place! It aggravated an already bulging L5S1 I've had for years…terrific

    Reply
  58. Erin Evans Post author

    This was a really good presentation. Firstly, you got right to the exercises, and that made it so much better than those video makers who believe we're looking for music and a CV. Thank you for not doing that. Secondly, your presentation of the hip bone, the placement of the piriformis muscle and how it's used in the body following the exercises was excellent. I've been to PTs and never seen this. As well, this kind of visual explanation is usually lacking in PT videos. Thank you. I don't have sciatica, I have congenital nerve damage, and a completely blown out labrum with torn guluteus medius and minimus muscles. This was from a biking hill climb that I pushed too hard. I also rowed. I was told that piriformis syndrome is common among athletes who chose sports that lead to shortened piriformis muscles, as I did, particularly when they don't do exercises that stretch this vital muscle. Wish I'd known this when I was young! Again, thank you. That last exercise is a doozie.

    Reply
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  60. Esther Phillips Post author

    Hello. I am in PT for diagnosed piriformis therapy…7 weeks now. Getting nowhere. Still lots of pain. My program involves only glute squeezes, nerve glides, some kind of stepper machine, bridges, some kind of clamshell exercises, etc. A few (30 10 second stretches) but mostly strength stuff. The program is not working as the muscle is still tight, painful, numbness, etc. I had almost no hands on….one particular move done one time did give me some relief but did not get any more. Glutes are weak but the piriformis is tight tight tight and because I am not stretching, the strengthening moves seem to make it worse. Does this sound right…strengthening before stretching?

    Reply
  61. Seth Post author

    I have been treating my piriformis sydrome for a couple weeks now with some improvement, particularly in the butt and calf. Still have sciatic pain the ankle quite a bit. Thoughts?

    Reply
  62. Gordon Wallis Post author

    Here is a novel way to relax the Piriformis muscle. She is a runner. https://youtu.be/_FjXY4RfQVQ

    Reply

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