Piriformis Pain: A Yin Yoga Sequence to Alleviate Piriformis Syndrome Symptoms

The piriformis is a little muscle that can be a big pain.

In our modern world, we are highly susceptible to a number of incongruencies in the body because of weakness and inflexibility within certain muscles. This is particularly true of the piriformis due to one very important factor: sitting.

It’s said that “sitting is the new smoking,” and this may very well be the case when it comes to conditions such as piriformis syndrome. Piriformis syndrome is a condition in which one—or both—of the piriformis muscles compresses and irritates the sciatic nerve, which runs beneath (or, in some people, through) the piriformis, causing (literal!) pain in the buttocks and/or tingling or numbness. The discomfort or pain may extend to the lower back, legs, and feet as well.

Situated deep within the buttock (beneath the gluteus maximus), the piriformis muscle is both an external rotator of the femur (the thigh bone) and a stabilizer of the sacroiliac joint. When the hip is flexed, the piriformis also abducts the femur (draws it away from the centerline of the body) and even reverses roles to assist as an internal rotator as well.

Because it is a bilateral muscle (mirrored on both sides of the body), if one piriformis muscle is weaker or tighter than the other, this can cause instability—and consequential pain—within and around the sacroiliac joint and pelvis in general.

While excessive sitting can lead to weakness and tightness within the piriformis muscles, the opposite may also be true. Overusing these muscles by active athletes such as runners may also cause similar symptoms and pain.

Yoga to the Rescue        

Fortunately, yoga may help to alleviate some of the symptoms associated with piriformis syndrome or may even help to eliminate its causes. Yin yoga is the perfect practice to elongate stiff muscles and stretch connective tissue as postures are held for extended periods of time in order to apply mild, healthy stress on the joints and connective tissues. It can be an ideal practice for those that suffer from piriformis syndrome.

This sequence is designed to lengthen the piriformis muscles and their surrounding tissues. However, if this practice creates further irritation to this sensitive area, it may be wise to work on strengthening the piriformis muscles and their connective tissues before stretching them. As with any health concern, it is highly recommended to check with your healthcare provider before beginning a new exercise regimen.

It should be noted that, as with any yin practice, you should move slowly and mindfully, particularly when working with conditions such as piriformis syndrome. Overstretching or over-activating any muscle (especially one that is already inflamed) can cause it to react strongly and move deeper into a contracted state, creating even more discomfort. Approach this practice with caution and allow your body and your breath to be your guides as you find the appropriate depth level in each individual pose.

For this sequence, you will need two yoga blocks and a blanket, and, if you’d like, a bolster or firm pillow.

A 40 to 60-Minute Yin Yoga Sequence for Piriformis Syndrome

Piriformis Syndrome Exercises: Agnisthambasana (Fire Log Pose or Simple Square)

1. Begin in a comfortable cross-legged seated position. You may wish to elevate your hips by sitting up on blocks or a blanket.
2. From here, draw your right shin parallel to the top of your mat.
3. Cross your left shin in front of your right so that your left knee stacks over your right ankle and your left foot lands just forward of your right knee.
4. Elongate your spine. Stretch the crown of your head toward the sky and relax your sit bones toward the floor.
5. Soften your shoulders away from your ears and allow the weight of your knees to become heavy. If they are elevated far from the ground, then support them with blocks or blankets.
6. Close your eyes and draw your attention inward. Listen to the sound of your own breath and tune in with the sensations that you feel within your body. Release any unnecessary tension within your body. Soften into the pose and surrender here for about three minutes.
7. When you feel ready, release and stretch out your legs before switching the cross of them. Hold for an equal amount of time on the opposite side.

Piriformis Syndrome Exercises: Utthan Pristhasana (Gecko Pose)

1. From Fire Log Pose, remove any props that may be on your mat. Cross your ankles and roll forward onto all fours on hands and knees. Place your blanket underneath your knees for padded support.
2. Step your right foot forward and place it on the outside of your right hand toward the right edge of your mat. You can either point your right toes straight forward or angle them out toward your right—choose which feels better in your body.
3. Place your hands on top of the blocks and elongate your spine.
4. Either choose to stay as you are or slide your left knee back until you find your own personal “edge” in the pose.
5. Again, you can either stay as you are or roll to the pinky side of your right foot exposing the sole of your foot toward the sky and rolling your right knee toward the outer edge of your mat.
6. If you’d like to amplify the sensations of the pose, you can release your forearms onto your blocks.
7. Hold for three to five minutes before slowly releasing and switching sides.

Piriformis Syndrome Exercises: Parvrtta Salamba Bhujangasana (Twisted Sphinx Pose) 

1. From Gecko Pose, return back to all fours, release your seat to the floor, and turn to face the back of your mat.
2. Open your legs out into an L-shape at a 90-degree angle, with your left leg pointing straight to the back of the mat and your right leg opening out toward your right side.
3. Slowly turn your torso to face the top of your mat and allow your left leg to internally rotate as you do this (so that the top of your foot releases to the floor as you turn).
4. Place both hands shoulder-width apart at the top of your mat.
5. Either choose to stay here (as this may already feel like a deep opening) or mindfully release your forearms to the floor underneath your shoulders, creating the shape of Sphinx Pose with a twist.
6. If it feels comfortable, you can release your head onto a block or a bolster for support, allowing the weight of your head and neck to surrender down with the force of gravity.
7. Wherever you choose to be, hold for about two to five minutes before unwinding and practicing on the opposite side.

Piriformis Syndrome Exercises: Deer Forward Fold 

1. From Twisted Sphinx Pose, move into a seated position facing the right side of your mat. As always, you have the option to elevate your hips by sitting up on blocks, a bolster, or a blanket.
2. With your knees bent, place your feet against the floor slightly wider than hip-distance apart.
3. Tent your fingertips behind you to support your weight and release both knees over to your right—you should land with your right shin parallel to the top of your mat and your left knee touching the right foot as if in a “side-saddle” riding position.
4. From here, elongate your spine. Either choose to stay as you are or maintaining as much length as possible through your back body, and slowly begin to hinge forward over your legs. Stop at your own appropriate “edge” and support your torso or head with props to get comfortable.
5. Hold for about four to six minutes and then slowly rise back up; take any movements that your body is craving to counter the effects of Deer Pose. Release, and then switch sides.

Piriformis Syndrome Exercises: Seated Sucirandhrasana (Seated Eye-of-the-Needle) 

1. From Deer Pose, release and counter in any way that you feel you need before returning to a seated position—this time facing the top of your mat.
2. Bend your knees and place your feet on the floor roughly hips-distance apart and about a foot away from your seat. Place your hands behind you to help support your weight.
3. Lift your right leg and dorsiflex your ankle (draw your toes toward your shin). Externally rotate your right leg so that your toes and your knee point toward the right side of your mat. Bend your knee and cross your right ankle over your left knee, creating a figure-4 shape with your legs.
4. Elongate your spine and gently reach your chest toward your right shin.
5. If you’d like to intensify the sensations, you can walk your left foot closer toward your seat drawing your torso closer toward your right shin. Wherever you choose to be, maintain length through your spine.
6. Hold for two to four minutes before releasing and practicing on the other side.

Piriformis Syndrome Exercises: (Supta Parvrtta Garudhasana) Twisted Roots Pose

1. From Seated Eye-of-the-Needle Pose, lie down on your back.
2. Bend your knees and place your feet on the floor.
3. Cross your right leg over your left as if you’re sitting cross-legged in a chair. If it’s available to you, you can double wrap your right foot around your left calf, creating an Eagle bind.
4. Press your left foot into the floor to gently lift your hips and scoot them toward the right side of your mat. Then, slowly release both legs over toward the left side of your mat. Support them with either a bolster, blocks, a blanket, or the floor.
5. Soften and relax both of your shoulders toward the mat and turn your head in any direction that feels appropriate for your neck.
6. Soften into this supine twist for about four to five minutes before unwinding and switching sides.

Piriformis Syndrome Exercises: Savasana 

1. After Twisted Roots Pose, unwind and release everything down to the floor.
2. Release your legs out long forward in front of you and allow them to be about as wide as your mat.
3. Let your heels turn in, and your toes flop out and relax your arms by your sides with your palms facing up as a symbol of surrender.
4. Close your eyes and allow the full weight of your body to sink down into the earth.
5. Soften and surrender here for at least five minutes, allowing your body and your mind to integrate all of the benefits of your practice fully.

Healing in Daily Life

Practicing yoga can be an essential tool in helping to alleviate the symptoms of piriformis syndrome. However, looking at daily patterns in your life that may contribute to the condition may prove to create long-lasting effects.

If you sit too much, try taking short walking breaks whenever possible. Practice simple stretches and yoga poses (some from this sequence work really well!) while sitting at your desk. Gently move your body as often as possible to help release built-up tension and activate dormant tissues. If you overuse your piriformis muscles, try to give them a break to rest and recover. And, if it helps, practice this sequence (or at least pieces from this sequence) regularly and consistently.

Hopefully, the combination of these factors will help to soften or even eliminate the symptoms of piriformis syndrome.