Supine Figure-4
The supine figure-4, also called the supine piriformis stretch, is the foundational version: lying on your back takes balance and body weight out of it while still placing the hip in the flexion-and-external-rotation line that lengthens the piriformis. Its main safety advantage is that you control the depth exactly, by how far you draw the back leg in. That matters because Hopayian and colleagues (2010), reviewing 55 studies, found that pain increased by manoeuvres that tension the piriformis is one of the most commonly reported features of piriformis syndrome, so a stretch that reproduces leg symptoms should be backed off, not pushed.
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
The evidence
The supine figure-4, also called the supine piriformis stretch, is the foundational version: lying on your back takes balance and body weight out of it while still placing the hip in the flexion-and-external-rotation line that lengthens the piriformis. Its main safety advantage is that you control the depth exactly, by how far you draw the back leg in. That matters because Hopayian and colleagues (2010), reviewing 55 studies, found that pain increased by manoeuvres that tension the piriformis is one of the most commonly reported features of piriformis syndrome, so a stretch that reproduces leg symptoms should be backed off, not pushed.
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