Piriformis Stretching Routine for Intermediates

Warm Up for Piriformis Muscle Stretch

Even though you're doing intermediate level piriformis stretches, it's still a good idea to warm up with easy moves. Try the following beginner piriformis stretches: 

• Cross one leg over
• Knees to the side
• Outer hip stretch
• Easy back releases

Most beginner's stretches are done in the hook-lying position, a supine position where you lie on your back with your knees bent and feet flat on the floor. The hook-lying position is one of the most supported positions to be in, which may help make stretching accessible for beginners and people in pain. 

Another thing that may get in your way of successfully performing intermediate level stretches is the inability to comfortably sit on the floor. For intermediate work, ideally, you're able to sit on the floor with your spine upright, without hip or back pain. If this is not possible, it could be a sign that you need beginner stretches for the time being.

Cross One Knee Over

Continue the supine (on your back, face up) warm up with a couple more moves before going on to more challenging positions. In the one knee cross overstretch, you'll stretch your hips and flank, wake up your coordination abilities and work your abs—all at the same time.

Here is how to do it:

1. Lie on your back with your knees bent and your feet flat. 
2. Interlace your fingers behind your head. Your elbows should be pointing out to the side, but don't force this if you have limitation or pain in your arms or shoulders. In that case, simply do your best.
3. Put one ankle over the opposite knee.
4. Gently drop both knees towards the side of the "standing" leg, which is the leg that is receiving your ankle. For a challenge, extend the arm that's on the same side as your "standing" leg and then bring your head and the other arm up. Aim your outstretched elbow towards the top knee. Only go as far as you need to feel the stretch.
5. Slowly return your head, neck, shoulders and upper back to the floor.
6. Do up to 10 reps and then repeat on the other side.

As you've likely now experienced, warmups for intermediates are a combination of beginner stretches and variations that may add in coordination and/or strength work. It's now time to assume more challenging positions.

Sitting Piriformis Stretch

The sitting piriformis stretch can be done in a yoga-like fashion or simply as a stretching exercise. To do the stretching version:

1. Sit upright with both legs extended in front of you. One key to sitting upright while on the floor is to try to distribute your weight equally between the sitting bones. Sitting bones are the two hard knobs on the bottom of your pelvis. You'll likely know them by the way they feel—with enough pressure, they can really hurt.
2. Bend one knee and cross that lower extremity over the other, placing the foot on the floor next to, and on the inside edge of, the knee that's outstretched.
3. Wrap your opposite arm around the bent knee. It's OK to also place your other hand on the floor behind you to help you maintain the position. Check again to be sure your weight is equally distributed between your two sitting bones.
4. Hold for 30 seconds
5. Come out of the stretch, inhale, and straighten.
6. Repeat on the other side.

Having the weight evenly distributed on the sitting bones is challenging for a lot of people because as soon the hip joint has to flex, as it does when you bring your leg over to the other side, chronic piriformis muscle tension, along with the tension in one or more of the other hip muscles can make you automatically lift your hip to accommodate.

Don't let this happen, if possible. The more well-aligned you are in this stretch, the better your results will likely be.

A Version for Yogis

The seated piriformis stretch can be done as a yoga pose. An extra challenge can be had by adding a few simple modifications, as follows:

1. Release the grasp on your knee.
2. Raise the newly freed arm straight up. Go just to the point of pain or limitation—don't try to push past that. Don't lock your elbow joint; instead, keep a slight bend. This is to protect the joint from wear and tear or strain.

Keeping the good form in this position as described above makes the work harder. It's also one of the best ways to keep your weight equally distributed between the two sitting bones.

Pigeon Pose

The yoga Pigeon Pose is perhaps the most intense all the piriformis muscle stretches. Here is how to do it:

1. Start on your hands and knees
2. Bring one leg in front of your body so that the knee is bent and the outside of the lower leg and foot is resting on the floor. ​​The hip is bent, as well. If possible, position your leg so that your knee is in line with your hip joint. This may not be possible if you are very tight in your hip muscles and/or iliotibial band. In that case, do the best you can.
3. Place your hands on the floor in front of you.
4. Extend the other leg back until it is straight.
5. Lower yourself down until your weight is on your forearms. Modulate the degree of weight that goes into your forearms to help take the pressure off the pose, as necessary.
6. Breathe.Try to take at least five breaths in this position.
7. Repeat on the other side.

Both Knees to the Side

For this intermediate level piriformis flexibility routine, you not only stretched the muscle, but you added in ab work, balance challenges and challenges to your coordination.

Now it's time to cool down:

1. Resuming the supine position again, which is lying on your back with your knees bent and your feet flat on the floor.
2. Stretch your arms out straight. Don't lock your elbows. Ideally, your arms will be at shoulder level, but be sure to adjust them lower if you experience pain.
3. Drop both knees to one side. Keep your knees at hip level or higher. Keep both sides of your upper back and both arms equally contacting the floor. In other words, when dropping your knees over, don't allow the arms or shoulders on the opposite side to ride up.
4. Stay in this position between 5 and 30 seconds.
5. Gently return your legs to the original "standing" position.
6. Repeat on the other side.
7. Repeat the entire sequence two to three times.