Strengthening Exercises for Piriformis Syndrome

Strengthening exercises that target the piriformis and larger buttock muscles are crucial for building muscle strength and developing resilience in the lower back, pelvis, and hip.¹Suchomel TJ, Nimphius S, Bellon CR, Stone MH. The Importance of Muscular Strength: Training Considerations. Sports Medicine. 2018.48:765-785. https://pubmed.ncbi.nlm.nih.gov/29372481/

Effective strengthening exercises for piriformis syndrome are discussed below.

Bridge

To perform glute bridges, start by lying on the back with both legs straightened out and flat on the ground.

• Slowly bend both knees while keeping feet flat on the ground and toes pointed straight forward.
• Lay the arms flat on the side of the body with palms facing down.
• Slowly raise the hips while engaging the abdominal and buttock muscles.
• Lift the hips as high as possible, without pain, to make a straight line from the shoulder to the knee.
• Hold this position for 5 seconds.
• Gently lower the hips back to the ground.

Begin holding the bridge position for 5 seconds initially and slowly work up to 30 seconds. Aim to complete a set of three stretches daily.

Straight Leg Raises

To perform the straight leg raise exercise, start by lying on the back with legs straightened out and flat on the ground.

• Bend one leg and place the foot flat on the floor
• Raise the opposite leg making an angle of approximately 45˚ with the floor.
• Hold the raised leg for 5 seconds and return to the starting position.

Hold the stretch for 5 seconds initially and slowly work up to 30 seconds. Repeat the exercise with the opposite leg. Aim to complete one set of three stretches on each side.

Side Leg Raises

To perform the side leg raise exercise, start by lying on the right side and placing a towel under the head to support the head and neck.

• Place the right hand on the hip or in front of the waist to stabilize the upper body.
• Extend the body to form a straight line with legs stacked on top of each other.
• Engage the core and slowly begin to raise the right leg 10-15 inches away from the ground.

Perform 10-15 leg raises and repeat with the opposite leg. Aim to complete 3 sets of repetitions daily.

Clamshell Lifts

To perform the clamshell lift exercise, start by lying on the right side of the body with the right leg on top of the left leg and knees slightly bent.

• Keep both feet together and lift the right knee until it’s parallel with the hip.
• Engage the core and buttock muscles throughout the exercise.
• Slowly lower the right knee back to the initial position.

Perform 10-15 clamshell lifts and repeat with the opposite leg. Aim to complete 3 sets of repetitions daily.

A variation of this exercise is to use a resistance band around the knees while performing the clamshell lifts.

Bird-Dog Exercise

To perform the bird-dog exercise, start by getting on all fours with arms and legs shoulder-width apart in the quadruped position.

• Extend the right leg outward with a straight back and toes pointing away from the body.
• Simultaneously, extend the left arm out in front of the body.

Hold the stretch for 5 seconds initially and slowly work up to 30 seconds. Repeat with the opposite arm and leg. Aim to complete one set of three stretches on each side.

Incorporating strengthening exercises into a daily routine effectively improves muscle balance and alignment in the hip, thigh, and leg. Strengthening exercises help reduce the strain on the piriformis muscle and prevent it from becoming tight or spasming.