Featured Stretch – Piriformis Stretch

Anatomy

The piriformis is one of six deep lateral hip rotators, all of which insert on some portion of the greater trochanter. When these muscles are hypertonic, they contribute to a toe-out gait, commonly seen in dancers, and they restrict internal rotation of the hip. Stretching the piriformis also stretches the other lateral rotators.

Piriformis Stretch, With a Partner

This stretch is used to improve medial rotation of the femur. You may have to experiment a little with the starting position of this stretch because each stretcher will feel the muscle stretch in a different position.

  1. The stretcher is supine, with his left hip and knee flexed to 90 degrees and drawn up toward the right shoulder; the right leg rests on the table. Be sure the stretcher keeps his sacrum on the table to anchor the origin of the piriformis. The stretcher then rotates his left thigh laterally by bringing his left foot closer to his right shoulder while maintaining flexion at the hip.
  2. Place one hand on the stretcher’s lateral knee and the other at his lateral ankle to passively assist him in finding the leg position that begins to stretch the piriformis. Be sure the stretcher keeps his sacrum on the table. From this starting position, offer resistance to the isometric contraction.

  1. Direct the stretcher to begin slowly to attempt to push his leg toward you diagonally (with equal pressure at both the knee and ankle), isometrically contracting the piriformis for 6 seconds.
  2. After the isometric push, the stretcher relaxes and inhales deeply. As he relaxes, maintain the leg in the starting position.
  3. As he exhales, he contracts his hip flexors and adductors to deepen the piriformis stretch. You may assist by gently pushing to assist hip flexion and adduction, then by adding more lateral rotation to deepen the stretch.
  4. Repeat two to three times.

Piriformis Self-Stretch, Sitting

  1. Sit at the edge of a chair and cross your right ankle over your left knee. Keeping your spine lengthened, bend at the hips (no stooping) until you feel a stretch deep in the buttocks. Many people experience pain when they try to do this because they are overstretching. Stretch only in the “feels-good” range, and not into discomfort.

  1. From this starting position, push your right ankle into your left thigh, isometrically contracting the piriformis, for 6 seconds. It may also feel good to push against the inside of your right knee with your right hand. After the isometric push, relax and inhale deeply.
  2. As you exhale, sit up tall and bend forward from the hips to deepen the piriformis stretch. Repeat two to three times.