Free Back Pain Exercises Physical Therapy Library
NERVE GLIDE Floor Mat • Beginner Discs: L4-L5, L5-S1

Reclined Figure-4 Piriformis Stretch

The piriformis muscle lies deep in the buttocks directly over (or around) the sciatic nerve. When hypertonic, it compresses the nerve causing tingling, numbness, and burning pain down the leg. The supine Figure-4 allows targeted piriformis release with zero lumbar spine strain.

BIOMECHANICAL MOVEMENT DIAGRAM
Clinical back pain images demonstration - PIRIFORMIS / SCIATIC RELEASE
PIRIFORMIS / SCIATIC RELEASE
🎯 Deep Gluteal Tension

Step-by-Step Execution

CLINICAL PROTOCOL
  1. 1 Lie flat on your back with both knees bent and feet flat on the floor.
  2. 2 Cross your right ankle over your left knee, creating a number 4 shape with your legs.
  3. 3 Reach your hands around your left thigh (or use a towel/strap) and gently draw the left knee toward your chest.
  4. 4 You should feel a deep, soothing stretch in your right outer buttock/glute area.
  5. 5 Hold for 30 seconds while keeping your head and shoulders relaxed on the ground. Repeat on the opposite leg.
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KEY FORM CUES

  • ✓ Flex your right foot (pull toes toward shin) to protect your knee joint throughout the stretch.
  • ✓ Keep your sacrum (tailbone base) grounded flat on the mat rather than curling your pelvis up.
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MISTAKES TO AVOID

  • ✗ Do not yank your thigh aggressively; stretch to a 4/10 mild tension, never sharp pain.
  • ✗ Do not tense your shoulders or neck.
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CONTRAINDICATIONS & WHEN TO AVOID

Do not perform this movement or modify strictly under clinical supervision if you have:

  • Recent total hip replacement (check posterior precaution limits with orthopedic surgeon)
SCIENTIFIC FOUNDATIONS & CITATIONS

Clinical Biomechanics & Evidence

This exercise protocol utilizes proven spinal mechanics: active core co-contraction (McGill stabilization), directional preference extension (McKenzie MDT), and non-compressive axial elongation to facilitate nutrient exchange in the avascular intervertebral disc matrix.

• McGill, S.M. (2016). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics.
• Delitto, A., et al. (2021). Low Back Pain Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy (JOSPT).
CLINICAL DOSAGE
Hold Duration 30 Seconds
Repetitions 3 holds each side
Prescription Sets 1 set
Difficulty Beginner
Position Floor Mat
TARGET MUSCLES
Piriformis Gluteus Medius Obturator Internus
STABILIZER MUSCLES
Hamstrings Tensor Fasciae Latae