From the Guidelines
To relieve piriformis muscle tension, it is recommended to perform stretches such as the seated piriformis stretch, figure-four stretch, and pigeon pose, holding each stretch for 10-30 seconds, 2-4 times, with a total stretching time of 60 seconds per exercise. Several effective stretches can help relieve piriformis muscle tension. The seated piriformis stretch is particularly beneficial - sit in a chair, cross the affected leg over the opposite knee, and gently lean forward while keeping your back straight until you feel a stretch in your buttock. Hold for 10-30 seconds and repeat 2-4 times, as recommended by the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis 1. The figure-four stretch is similar but performed lying on your back - cross one ankle over the opposite knee and pull the uncrossed leg toward your chest. The pigeon pose from yoga is also effective - from a hands-and-knees position, bring one knee forward between your hands while extending the other leg behind you. For a standing stretch, cross one foot over the other and bend forward at the hips.
- Key points to consider when performing these stretches include:
- Frequency: ≥2–3 day/week is effective in improving joint range of motion, with the greatest gains occurring with daily exercise 1
- Intensity: Stretch to the point of feeling tightness or slight discomfort 1
- Time: Holding a static stretch for 10–30 s is recommended for most adults 1
- Type: A series of flexibility exercises for each of the major muscle–tendon units is recommended, including static flexibility, dynamic flexibility, ballistic flexibility, and PNF 1
- Volume: A reasonable target is to perform 60 s of total stretching time for each flexibility exercise 1
- Pattern: Repetition of each flexibility exercise two to four times is recommended 1 Foam rolling the piriformis area can complement these stretches. Perform these stretches daily, especially after sitting for long periods, as the piriformis muscle can become tight from prolonged sitting, causing pain and sometimes sciatic nerve compression. Start gently and avoid bouncing or forcing the stretches, as this could worsen symptoms. If pain persists after two weeks of consistent stretching, consider consulting a healthcare provider.
From the Research
Piriformis Stretches
To relieve piriformis muscle tension, several stretches can be employed. However, the provided studies do not directly address stretches for the piriformis muscle.
Treatment Options
The studies focus on various treatment options for piriformis syndrome, including:
- Perisciatic injection of steroid 2
- Local anesthetic and corticosteroid injections 3
- CT-guided injection of anesthetic and corticosteroid 4, 5
- Ultrasound-guided piriformis muscle corticosteroid injection versus extracorporeal shockwave therapy 6
Key Findings
Some key findings from the studies include:
- Perisciatic steroid injections can be effective for patients with piriformis syndrome who do not respond to conventional treatments 2
- Local anesthetic injections can be clinically effective for piriformis syndrome, and the addition of corticosteroid may not provide additional benefit 3
- CT-guided injection of anesthetic and corticosteroid can provide significant reduction in pain for patients with piriformis syndrome 4, 5
- Ultrasound-guided piriformis muscle corticosteroid injection and extracorporeal shockwave therapy may have similar efficacy in treating piriformis syndrome 6
Stretches for Piriformis Syndrome
While the studies do not provide specific stretches for the piriformis muscle, some common stretches that may help relieve piriformis muscle tension include:
- Pigeon pose
- Piriformis stretch
- Glute bridges
- Hamstring stretches Note that these stretches are not directly supported by the provided studies, but are commonly recommended for piriformis syndrome.