The piriformis is a strap of pear-shaped muscle running across your backside deep to the much larger (and more celebrated) gluteus maximus. It is small but mighty especially when it is unhappy. Poor piriformis is often plagued with tightness or overuse/overstrain due to its size, geography, and general work performance.  An unhappy piriformis can be at the root of your sacro-iliac, sciatica, and pelvic pain. Poor hip, knee, and/or foot alignment in stance and gait are major contributing factors in this scenario. So let’s take a closer look “behind” the scenes.

Originating along the anterior surface of the sacrum, the piriformis traverses and gives padding to the posterior pelvic wall before its insertion on the greater trochanter of the femur. It acts as a muscular bed for the sacral plexus (bundle of nerves – literally) and proximal sciatic nerve. Other duties of the piriformis include stabilizing the hip joint by steadying the head of the femur in the acetabulum, stabilizing the sacro-iliac joints through approximation or compression, laterally rotating an extended hip, and abducting a flexed hip. That is a lot of work for such a little muscle! No wonder it is easily overwhelmed!

So how do you know if your piriformis is unhappy? Do you have a pain smack dab in the center of your butt? Do you have pain near your sacrum on either side? Does the pain radiate into the posterior thigh? Do you stand and walk like a duck (or a dancer) with your toes pointed out? Do you stand and walk with pronated (unsupported arch) feet and kissing knees? If yes to any of these, then you might just have an issue with the piriformis tissue.

Here are some Yoga Tune Up® poses that feature and awaken the piriformis as well as address lower extremity alignment:

Tune Up Tadasana

½ Happy Baby to Playing the Violin Minivini

Leg Stretch #3

Dawn McCrory

Dr. Dawn is an expert in the field of physical therapy and movement science. She has worked in a variety of settings affording her insights and perspectives along the continuum of body care. Dr. Dawn's illustrious career includes a long list of celebrity clients, athletes, and others who insist on working with the best to achieve their optimal physical functioning. Yoga Tune Up® embodies Dr. Dawn's philosophy of precise movement with a keen focus on musculo-skeletal alignment. Low volume and high quality are the cornerstones of her individualized small group Yoga Tune Up® sessions. Every person leaves each session with the self-care knowledge to continue their health and wellness journey.

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kaoline

Thank you for the clear anatomical information. If you can provide some of the ball rolling technique that release the tension in the area, I really appreciate it. I’ve been suffering from the pain in the area, and have been doing almost everything that I can find so far, but unfortunately it didn’t work as I expected. Is there any other situation that can cause the similar pain in the buttocks along side of the outer-side of the leg to the feet?

Tanja

Such valuable information! Thank you esp for the connection between hip, knee and foot alignment!

Erika E Belanger

With the amount of steps we take in a day, it’s very interesting to start looking at stance and gait. Most article talk about sitting being the most important cause but walking is also something we do a lot of! Can’t wait to go and look at how my student walk in the door!

Amalea Fisher

We tend not to think of foot issues when thinking about the hips. Thanks for including pronated feet as it’s a sign to work farther up the chain. I will definitely add the recommended exercises to my routine to see if I can improve not only hip function but foot function as well.

Connie

Great post. Too often I have seen athletes or lay people walk , run or train duck feet. This post makes me aware that they might possibly have problem with this piriformis muscle behind their butt. Very helpful!

Kirsten

After many years of dancing and yoga, reading your article makes it much clearer where my pain might come from. Thanks for sharing the poses!

Tracy E.

Thanks for the clarity in visualizing what exactly the piriformis does and it was eye opening to realize that my foot pronation and pirifromis are connected.

Genevieve

This has opened my eyes regarding possible causes of pronation, thank you.

Jayme

Sometimes it seems as though piriformis is the understudy to sciatica. Similar (symptom) presentation but often behind the scenes and overlooked. I work as an RMT in a town where the majority of people commute over an hour each way to work. Many suffer from a ‘pain in their butt’. One of the questions I ask is where is their foot placed while they drive? More often than not, it’s externally rotated or turned out. Shortening of the muscle coupled with compression (from sitting) creates the perfect scenario for a pissed off piriformis. The YTU balls and regular practice of… Read more »

Ann

Its amazing how people don’t associate a dysfunctional piriformis with pelvic or back low back pain. As said above it can also transfer pain to the knee or foot. Don’t forget it can also be transferred the other way. A dysfunctional foot or knee can cause the piriformis to be tight. I don’t know which came first the chicken or the egg so I always treat all three.

Karen Bulmer

Great post. I hear people complain about their piriformises (piriformi?) all the time and I often wonder if they really know what the muscle does or if it is just fun to say. I am in YTU training right now and struggling to get my head around the muscles and their jobs in such a detailed way. This is very helpful – thank you.

Linda Zanocco

I love the succinctness with which Dr. Dawn describes and locates the piriformis; cuts to the heart of issues one may have with it; and provides visuals for assessing posture and gait that could ultimately cause pain. Her movements to help awaken the piriformis and contribute to proper lower extremity alignment are most useful.

Therese

Thanks for opening my eyes to this info. I have been experiencing periodic discomfort about my sacral area and believe it could be related to the piriformis. I’ll try those poses.

Jaro

Great article on that pesky little pear shape muscle called piriformis; as an active runner, cyclist and former triathlete I was always tight around the area and now I routinely roll with YTU balls on it or practicing a happy baby and leg stretch #3! What an amazing relief for the tight piriformis!!

Murielle Corwin

Can’t tell you how many students come to me with sciatic pain. This gives me a direction on how to help and alleviate the pain that my students are experiencing as a result of their tight piriformis. Thanks

Stephanie B.

Thanks for sharing information about the Piriformis muscle. I just started reading up on this tiny muscle that does big work. I answered yes to almost every question. I like the 1/2 Happy Baby pose.

Stacy Jackson

My left piriformis is the muscle that can overwhelm me quite often. I have been practicing the three poses you have suggested and I have definitely noticed some relief. Thank you for your clear and conscise article!

Jen F.

Thank you for this post Dawn! I’m so happy that I have learned the proper techniques to these 3 YTU poses last week in training to properly use them to alleviate pain or tightness, not only with myself, but with my clients as well.

Katy Forline

Thanks for the refresher on piriformis location and function. I had never heard it described as “a muscular bed for the sacral plexus and proximal sciatic nerve”. That is a great way to explain to clients in my massage world that it needs to be both supportive and soft. Just like that new mattress!

Minh

One of my best friends has sciatic nerve pain. He always complains about pains in his lower back,glutes and hamstrings. I noticed that he walked with his feet externally rotated out like a duck. I am going to share this infomation with him and hopefully it will help shed light on his condition.

Amanda Zerbini

Sciatic nerve pain does not let up with movement, with rest, with anti-inflamatory medications and it surely won’t let up if you don’t change your habits. It’s horrible. My weak core strength after the birth of my second son almost 4 years ago, combined with the sudden return to fitness flared up my lower back and glutes. The MD’s recommendation was an X-ray and muscle relaxers. It wasn’t until I found a chiropractor who was conservative with adjustments, suggested I get a new mattress and revamp my sleeping habits, started spinal decompression and doing stablizing core exercises, that the pain… Read more »

Andrea Loper

Thank you for proving the QA on how to estabish if the piriformis is part of the cocktail problem in one’s hips/low back. I answered “yes” to a pain smack dab in the center of your butt, pain near the sacrum on either side and radiating pain (at least on the left side) into the posterior thigh? And yes…I pronate. I appeciate even more the suggestions on how to self heal–I love Happy Baby to Playing the Violin Minivini…I’ll be doing that one tonight. Thanks again.

Jackie

My mom mentioned today that she had some pain “smack dab in the center of her butt” and I suggested it might be her piriformis. I showed her how to use the tune-up balls to massage the area out and gave her some poses to try at home. Now I’ve read this article and I’m quite happy that my instincts were on. Instincts I honed through my YTU training!

Meghan Cowens de Sturdze

Great information on the piriformis. The poses you gave are so helpful to activate and release this lovely little muscle. I am always amazed at how often people complain of lower back pain when they really mean my piriformis is sad!

Stephanie

Great clear description of the piriformis and its significance for the hip and sacrum. It’s amazing how many people I hear (and read like in the comments here) with piriformis-related symptoms. Why is it tight on folks with pronated feet and knock knees (locked long)? Thanks.

Kathy

Can’t tell you how many students come to me with sciatic pain. This detailing of the relationship of this little muscle to their big pain (literally P in the A), will help me flesh out my explanation and ultimately bring students awareness and relief.

“Issue with your tissue,” great phrase. Can I borrow it?

elizabethW

Lots of sitting and airplaning this past weekend and my piriformis is screaming! Thanks for such a clear description of exactly what is happening in the middle of my (kettlebell) butt.

Kevyn

I never thought about how knock knees and flat feet could effect this muscle. Thanks for that insight! Very informative article!

Dawn McCrory

I am reading through all of your responses and marveling in the fact tht so many people have or know someone who has issues with their piriformis tissues! And I am happy that this little post has helped put some puzzle pieces together for you. Jlin Liang, tree pose is definitely a great pose to address the hip-knee-ankle complex! Many however have difficulty balancing in this pose and spend more time with foot pronated and hip/knee adducted and internally rotated as they wobble around on an unstable hip. I lke to start the conversation with Tadasana and Tune Up® Tadasana… Read more »

Jiin Liang

I have flat feet and weak periformus muscles. So, I have always had trouble balancing on one leg. Lately, I have tried to retrain myself to gain better alignment of my ankle, knee and hip. I found that practicing Yoga “Tree” pose everyday has helped me to engage the periformus muscle in my hip, which gives my hip the stability it needs, and lift up my inner ankle of the standing foot. Now I can stand in Tree pose for a long time. Let me know if it works for you!

Jenny Buchanan

My, isn’t it remarkable that a small muscle like piriformus can be responsible for so much and yet until today I had not officially met her. I definitely have poor knee, hip and foot alignment on my left side – (a muscular adaptation to left kidney removal and major cutting on that side as a child)? or perhaps I was born with a compromised left sacral muscular structure along with the non-functioning kidney, which led to left knee injury and arthritis in base of 1st metatarsal (left big toe). Who knows which comes first? Who cares?! The goal is to… Read more »

Judy Swens

This just shined a light on how to help my boyfriend who has flat feet and is experiencing pain in the but! I will definitely suggest these exercises to help relieve what may be causing this pain! Now I know a little more about the deeper muscles within the pelvis and hip area. Always learning!

Victoria Yoffie

Pain due to piriformis dysfunction, or as a like to say, pain due to a “pain in the butt,” has the ability to radiate though your hips, knees, legs, calves and feet. An easy way to begin addressing the pain is to use the Yoga Tune Up balls to stimulate the feet, therefore hydrating the connective tissue not only in your feet but up your body into your legs, hips and even your piriformis. Something as simple as rolling the ball under each foot, up and down and from side to side – imagine you are painting the entire sole… Read more »

Anna-Marie Lawrence

I’ve known fr the last several months that it’s been my Piriformis that’s been giving me so much grief. From Plantar Fasciatis to my lower back pain and right outer hip tightness, but I never saw the connection. I must admit this is a bit troubling since both my parents have knee replacements, and through yoga practice I am hoping to avoid this scenario. Thank you for the insight and the poses.

Chris Walling

As a long time sufferer of Piriformis Muscle Syndrome, I would note too that that this can come on suddenly and out of no where after an intense day at the gym doing lower back exercises, or just doing a hard yoga class. I came to Yoga Tune Up because of this very chronic and excruciatingly painful condition, I was really worried that I had done something serious, and after recurrence upon recurrence I no longer wanted to continue to take low grade muscle relaxers at night. I’ve been doing Leg Stretch #3 and other counternutating movements to help me… Read more »

alex

It’s always so interesting to see how intimately related hip tension and back pain are, especially because hips can hold so much emotional memory and back pain (a la dr. Sarno) can too. So many people come into my classes complaining of all sorts of “back pain” and point everywhere from their head to their butts when showing me where it hurts. It’s a process to start to parse what exactly people mean and what could be going on. The piriformis is another big piece of the puzzle.

Terry Littlefield

So many people show up to yoga with sciatica issues and knowing more about that pesky piriformis is very helpful. Love the half happy baby mini vini! Great article. Thank you!