Stabilizing the Sacroiliac Joint: The Piriformis Muscle in Yoga

If a picture’s worth a thousand words, then what is an animated video worth? In this yoga blog post, we look beneath the skin to see what happens with the piriformis muscle in Reverse Pigeon Pose. We’ll provide an overview of the muscle, its attachments and action, and its role in stabilizing the sacroiliac joint. We also examine the use of joint rhythm to optimize the stretch.

What is the Piriformis Muscle and How does it affect the sacroiliac joint?

The piriformis muscle originates on the anterior (front) surface of the sacrum and inserts onto the greater trochanter of the femur (thigh bone). Figures 1(a) and 1(b) are front and back views of the piriformis muscle. Figure 1(c) illustrates the stout ligamentous stabilizers of the sacroiliac joint.

piriformis origin insertion

(Figure 1 (a) is a front view of the piriformis, (b) is a back view, and (c) illustrates the ligaments that stabilize the sacroiliac joint. )

Note that the piriformis is a muscular stabilizer of the sacroiliac joint. Imbalances between the piriformis muscles can contribute to subtle asymmetries within the pelvis, which then may transmit to the vertebral column. This underscores the importance of achieving a balanced stretch between the two sides when working with this muscle in yoga.

The Biomechanics of Reverse Pigeon Pose

To understand why Reverse Pigeon Pose (Supta Kapotasana) works to stretch the piriformis we need to know that the actions of this particular muscle vary according to the position of the hip joint. For example, when the hip is in a neutral position, the piriformis acts to externally rotate (turn outward), flex and abduct the hip joint. When we flex the hip joint beyond about 60 degrees the piriformis becomes an internal rotator and extensor (and remains an abductor). Muscles stretch when we move a joint in the opposite direction of the action of the muscle. In Reverse Pigeon Pose, the hip is flexed and externally rotated. This stretches the muscle (which extends and internally rotates the hip in this position). This video illustrates the stretch.

When viewing the video, note how flattening the back moves the origin of the piriformis on the sacrum further away from its insertion on the femur. This accentuates and refines the stretch. It is an example of lumbar-pelvic and femoral-pelvic rhythm. The last section of the video, where we have digitally hidden one half of the pelvis to expose the movement of the sacrum, illustrates this concept.

Stretching the Piriformis Muscles for Sacroiliac Joint Health

( Figure 2: variations for stretching the piriformis muscle.)

  • Figure 2(a) is the classic stretch typically utilized in yoga.
  • Figure 2(b) shows a modification for persons with hip restrictions. This variation is also useful for experiencing the effect of flattening the lumbar in the pose.
  • Figure 2(c) stretches the piriformis of the lower side leg by adducting and internally rotating the femur.
  • Figure 2(d) adducts (draws toward the midline) the upper side leg, thus opposing the action of the piriformis for abducting the femur.
  • Figure 2(e) illustrates a variation commonly employed in physical therapy as part of the regimen for Piriformis Syndrome,  a condition which can cause sciatica. In this variation, the upper leg crosses all the way over, thus adducting the femur and stretching the muscle. This is a good alternative for those who experience knee issues in the classic stretch.

How to Practice

I typically do several 20-to-30-second stretches on each side, easing into and out of the pose. If you experience pain in this (or any) stretch, carefully come out of the pose. Folks with sciatic-type pain should consult a healthcare practitioner who is appropriately trained and qualified to diagnose and manage such conditions. Follow their guidance, working with yoga as an adjunct in prevention and treatment (where appropriate).

Reprinted with permission from dailybandha.com

YogaUOnline contributor Ray Long MD Author Ray Long, MD, FRCSC, is a board-certified orthopedic surgeon and the founder of Bandha Yoga. Ray graduated from The University of Michigan Medical School with post-graduate training at Cornell University, McGill University, The University of Montreal, and Florida Orthopedic Institute. He has studied hatha yoga for over twenty years, training extensively with B.K.S. Iyengar and other leading yoga masters.                 

YogaUOnline contributor Chris Macivor

3D Graphic Designer / Illustrator Chris Macivor has been creating digital content for well over ten years. He graduated from Etobicoke School of the Arts, Sheridan College, and Seneca College. Chris considers himself equally artistic and technical. As such, his work has spanned many genres, from film and television to video games and underwater imagery.         

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