Stretch · beginner · 45s hold

Supine Figure-4

The supine figure-4 is the foundational piriformis stretch because the supine position decompresses the lumbar spine while still placing the femur in the flexion-external-rotation line that lengthens the piriformis. It is widely prescribed as the first-line stretch in piriformis syndrome rehab protocols, particularly because it can be regressed for acute cases by simply reducing how far the back leg is drawn in.

PiriformisDeep external rotatorsGlute med

Illustration · follow the steps below for the actual technique

How to do it

1
Lie on your back, both knees bent, feet flat on the floor
Supine start
2
Cross your right ankle over your left thigh, just above the knee
Ankle over thigh
3
Flex your right foot to protect the knee joint
Foot flexed
4
Thread your right hand through the gap, clasp your hands behind your left thigh
Hands behind thigh
5
Draw the left thigh gently toward your chest. Hold 45 seconds, switch sides
Draw in, breathe

What you should feel

A deep, opening pull through the right buttock and outside hip. Should feel productive, not sharp. Keep the foot flexed, because a relaxed foot transfers load into the knee.

Red flag

Pins-and-needles down the leg, or a sharp electric pain at the back of the buttock when you draw in, means the sciatic nerve is irritated. Reduce the draw, or back out and try the lying piriformis stretch on a bolster.

Easier

Press the crossed ankle down toward the floor with your hand instead of pulling the back leg in. Same stretch, less hip flexion load.

Harder

Hook the right elbow against the crossed knee and use it to gently rotate, deepening the external-rotation component.

Don't do this if

Acute disc herniation with leg radiation
Knee ligament injury (avoid the foot-flex strain)
Hip replacement within 12 months

The evidence

Citation: Hopayian K, Song F, et al. (2010). The clinical features of the piriformis syndrome: a systematic review. European Spine Journal · DOI: 10.1007/s00586-010-1504-9

Routines that use this stretch

4-Minute Quick Relief 8-Minute Runner Routine 6-Minute Desk Worker Routine 12-Minute Strengthen-Stretch Combo

Last reviewed 2026-05-12

Written by Oliver Wakefield-Smith, Founder of Digital Signet

Researches and writes evidence-based consumer health content. Not a clinician. Every clinical claim on this page links to its primary source. Email corrections.