Stretching exercises are important in the rehabilitation of piriformis syndrome. The piriformis muscle itself should be stretched on a daily basis, as should the groin and other buttock muscles.
To stretch the muscles that rotate the hip outwards. Lie on your back and bend the knee of the leg to be stretched. Use the opposite hand to pull the knee over to the side as shown opposite. You should feel this in the hip and buttocks. Hold stretch for 20 to 30 seconds, repeat 3-5 times and stretch 3 times a day.
Lay on your back and bend both knees with the feet flat on the floor. Place the outer foot of the leg you wish to stretch on the lower thigh/knee of the other leg. Grip behind the thigh and pull this knee in towards your chest. You should feel a stretch in the buttock. Hold this position for 30 seconds, repeat 3-5 times and stretch 3 times a day.
Another version of this stretch can be done standing up where the knee is placed under and across the body resting on a table. The patient then leans forward using bodyweight to increase the stretch.
Play piriformis stretching exercise video.
It is important to stretch the long aductor muscles which attach at the knee as well as the short adductor muscles which attach above the knee. Long adductor muscles need to be stretched with a straight leg. This can be done either sitting or standing. Short adductor muscles are stretched with the knees bent.
Play long adductor stretch video.
Sit on the floor and put the soles of your feet together. Use your elbows to apply a gentle downward pressure to your knees to increase the stretch. You should feel a stretch on the inside of the thigh. Hold this position for 30 seconds, repeat 3-5 times and stretch 3 times a day.
Play short adductor stretch exercise video.
With a partner lie on your front and get the partner to rotate the bent leg outwards (towards the horizontal) as far as it will comfortably go. Then the athlete applies gentle pressure at about 25% effort to try and return the leg to the vertical. The partner resists this movement.
Hold this pressure for about 10 seconds and then relax. The partner then moves the leg further to stretch the muscle and holds this position for 30 seconds. Repeat this process until you get no further improvements in mobility. This is an excellent stretching method and has produced some exceptional and instantaneous results. This should only be done by trained therapists.