piriformis syndrome

Quit stretching your Piriformis!


In my experience, Piriformis Syndrome can quickly be tackled with more focus on waking up the primary hip flexors (The Psoas and the Iliacus which, combined, make the Iliapsoas).

The Iliacus and the Psoas combine to make the Iliapsoas
As mentioned, the Iliapsoas is the primary hip flexor (eg. brings the knee towards the torso) but also has a role in external rotation of the hip as well (and a bunch of other stuff – it’s a really important muscle!)

The Piriformis is an external rotator of the hip too.

Location of the piriformis muscle

When your Iliapsoas isn’t working to it’s full potential, you will be missing out on the bit of external hip rotation during movement of the leg that should be driven from the Iliapsoas.


What then happens is that other external rotators (eg. the Piriformis) work too hard/compensate for what should be happening from the dysfunctional Iliapsoas.


When a muscle works too hard in a way it isn’t designed to do, it’s going to get tired and irritated from overwork. So even though your Piriformis IS an external hip rotator, it’s doing a bit too much external hip rotation because your Iliapsoas isn’t pulling its weight.


This is what your Piriformis Syndrome likely is (not always, but in my experience with my clients generally is).


One of my favourite exercises to help many of my clients with Piriformis Syndrome is Sitting Knee Pillow Squeezes.


This won’t help everyone, but if you’ve got your Piriformis area symptoms now, give these a go for me and see if they take it away!


Do 3 x 20 reps for me but ONLY start counting the reps when you feel the work come from your groin and inner thighs. It’s all about the tilt of your pelvis – watch you are sat in pelvic extension to really fire in that strength at the front of your pelvis.


Let me know if it helps!


N.B – You might find when you start the exercise that you exacerbate the Piriformis symptoms you have. This is a sure-fire sign your Piriformis compensates for your hip flexors because you are asking your hip flexors to switch on and your Piriformis is responding instead of the desired muscle.


Continue through 20 more reps or so and see if you can get the responding muscle to shift to your groin/inner thighs and away from your piriformis area. If you do 20 reps and feel more irritated, stop the exercise. At the moment, your compensations are too strong to benefit from this particular exercise.