Video Demonstration

What Is the Figure-Four Stretch?

The Figure-Four Stretch (also known as the Supine Piriformis Stretch, Reclined Pigeon Pose in yoga, or 4字拉伸 in Chinese) is a supine hip stretch that targets the piriformis muscle, gluteus medius, gluteus maximus, and the deep external rotators of the hip.

The name comes from the shape your legs form: when you cross one ankle over the opposite knee, your legs create the number “4”.

This stretch is widely recommended by physical therapists, orthopedic surgeons, and sports medicine professionals as a first-line treatment for:

• Piriformis syndrome — tightness or spasm of the piriformis muscle that can compress the sciatic nerve
• Non-specific lower back pain — especially when caused by tight hip muscles pulling on the pelvis
• Sciatica symptoms — radiating pain from the buttock down the leg
• Hip tightness — common in people who sit for prolonged periods

Muscles Targeted

Primary Muscles

• Piriformis — a small, deep muscle in the buttock that externally rotates the hip. When tight, it can compress the sciatic nerve (piriformis syndrome)
• Gluteus medius — stabilizes the pelvis during walking and standing
• Gluteus maximus — the largest muscle in the body, responsible for hip extension

Secondary Muscles

• Deep external rotators (obturator internus, gemelli, quadratus femoris) — a group of small muscles beneath the gluteus maximus
• Hip joint capsule — the stretch mobilizes the hip joint itself
• Lower back muscles (indirectly) — by releasing tension in the glutes and piriformis, pressure on the lumbar spine is reduced

Step-by-Step Instructions

Supine Version (Recommended for Beginners)

Starting Position:

1. Lie flat on your back on a firm surface (yoga mat or carpet)
2. Bend both knees, feet flat on the floor, hip-width apart
3. Keep your head resting on the floor (use a small pillow if needed for neck comfort)

The Stretch: 4. Cross your right ankle over your left knee, resting it just above the kneecap. Your right knee should fall open to the side — this creates the “4” shape 5. Flex your right foot (pull toes toward shin) — this protects your knee joint and deepens the stretch 6. Reach both hands through the space between your legs and clasp them behind your left thigh (or on top of your left shin) 7. Gently pull your left thigh toward your chest while keeping your right knee pressing gently away from you 8. Hold for 30 seconds, breathing deeply and steadily 9. You should feel a deep stretch in your right buttock and outer hip 10. Release slowly, return to starting position 11. Repeat on the other side

Breathing Pattern

• Inhale as you set up the position
• Exhale as you pull the thigh closer — use the exhale to deepen the stretch
• Continue slow, steady breathing throughout the hold
• Never hold your breath

中文详细说明

仰卧4字拉伸（推荐初学者）

起始姿势：

1. 仰卧在瑜伽垫或地毯上
2. 双膝弯曲，双脚平放于地面，与髋同宽
3. 头部自然放松（如有需要可在颈下放一个小枕头）

拉伸动作： 4. 将右脚踝放在左膝上方，右膝自然向外打开——双腿形成”4”字形 5. 勾起右脚（脚趾向胫骨方向回拉）——这能保护膝关节并加深拉伸 6. 双手穿过双腿之间的空隙，扣住左大腿后侧（或左小腿前侧） 7. 轻轻将左大腿拉向胸部，同时右膝轻轻向外推 8. 保持30秒，缓慢深呼吸 9. 你应该感觉到右侧臀部和髋外侧有明显的拉伸感 10. 缓慢放下，回到起始位置 11. 换另一侧重复

呼吸要领

• 吸气时设置姿势
• 呼气时加深拉伸
• 全程保持均匀呼吸，切勿憋气

Variations & Progressions

1. Seated Figure-Four (Office-Friendly) 🪑

• Sit upright in a chair with feet flat on the floor
• Cross right ankle over left knee
• Keeping your back straight, gently lean forward from the hips
• Hold 20-30 seconds each side
• Best for: Office workers who can’t get on the floor

2. Standing Figure-Four 🧍

• Stand on your left leg (hold a wall for balance)
• Cross right ankle over left knee
• Slowly bend your left knee, sitting back as if into a chair
• Hold 15-20 seconds each side
• Best for: Active individuals, also improves balance

3. Wall-Assisted Figure-Four 🧱

• Lie on your back with your left foot flat against a wall, knee bent at 90°
• Cross right ankle over left knee
• Gently press your right knee away from you
• Hold 30 seconds each side
• Best for: People who can’t reach their thigh comfortably

4. Pigeon Pose (Advanced Yoga Variation) 🧘

• From all fours, bring your right knee forward to your right wrist
• Extend your left leg straight behind you
• Lower your torso toward the floor
• Hold 30-60 seconds each side
• Best for: Advanced practitioners seeking deeper stretch

Common Mistakes to Avoid

Who Should Do This Stretch?

Ideal For:

• 🖥️ Office workers — prolonged sitting tightens the piriformis and hip rotators
• 🏃 Runners — repetitive hip flexion/extension tightens the glutes and piriformis
• 🚗 Long-distance drivers — sitting on the piriformis for hours compresses the sciatic nerve
• 🤰 Pregnant women (1st/2nd trimester, use seated variation) — hormonal changes and postural shifts cause hip tightness
• 🧓 Older adults — gentle enough for most fitness levels, helps maintain hip mobility
• 🏋️ Strength athletes — heavy squats and deadlifts create glute tightness

When to Do It:

• Before exercise — as part of a dynamic warm-up (hold 10-15s, with movement)
• After exercise — as part of a cool-down (hold 30-60s, static)
• Morning routine — to relieve overnight stiffness
• During work breaks — seated version at your desk every 1-2 hours
• Before bed — to relax the lower back and promote sleep

Safety & Contraindications

Important: This exercise guide is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any exercise program, especially if you have existing injuries or medical conditions.

The Science Behind It

Why Does the Figure-Four Stretch Work?

The piriformis muscle runs from the sacrum (base of the spine) to the greater trochanter (top of the thigh bone). It externally rotates the hip when the hip is extended, and abducts the hip when the hip is flexed.

When the piriformis becomes tight or spasms, it can compress the sciatic nerve, which passes directly beneath it (and in ~17% of people, passes through the muscle itself). This compression causes piriformis syndrome — pain in the buttock that can radiate down the leg, mimicking sciatica from a disc herniation.

The Figure-Four position places the hip into flexion + external rotation + adduction, which stretches the piriformis along its full length. This is why it’s considered the gold-standard stretch for piriformis syndrome.

What Does the Research Say?

On stretching for lower back pain:

• A Cochrane systematic review (Hayden et al., 2021) of 249 studies found that exercise therapy, including stretching, is effective for chronic low back pain, reducing both pain intensity and functional limitation. The review concluded that no single exercise type was clearly superior, but stretching combined with strengthening showed the most consistent benefits. ^[1]

On piriformis-specific stretching:

• Tonley et al. (2010) demonstrated that hip strengthening and stretching programs targeting the piriformis and deep rotators significantly reduced symptoms in patients with piriformis syndrome. The Figure-Four stretch was among the key interventions used. ^[2]

On the piriformis-sciatic nerve relationship:

• Smoll (2010), in a meta-analysis of cadaveric studies, found that approximately 16.9% of the population has anatomical variations where the sciatic nerve passes through the piriformis muscle, making these individuals more susceptible to piriformis syndrome and more likely to benefit from targeted stretching. ^[3]

On stretching frequency and duration:

• The American College of Sports Medicine (ACSM) recommends holding static stretches for 15-60 seconds, performing 2-4 repetitions, at least 2-3 times per week for flexibility gains. For therapeutic purposes (such as piriformis syndrome), daily stretching is often recommended. ^[4]

On sitting and hip tightness:

• Research published in the Journal of Physical Therapy Science (Park et al., 2015) found that prolonged sitting (>8 hours/day) was significantly associated with piriformis tightness and hip external rotation deficits, supporting the recommendation for regular hip stretching breaks for office workers. ^[5]

Scientific References

1. Hayden JA, Ellis J, Ogilvie R, et al. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. 2021;9(9):CD009790. doi:10.1002/14651858.CD009790.pub2

2. Tonley JC, Yun SM, Kochevar RJ, et al. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Journal of Orthopaedic & Sports Physical Therapy. 2010;40(2):103-111. doi:10.2519/jospt.2010.3108

3. Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence: a review. Clinical Anatomy. 2010;23(1):8-17. doi:10.1002/ca.20893

4. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 11th ed. Philadelphia: Wolters Kluwer; 2021.

5. Park S, Kim Y, Lee J. Effects of prolonged sitting on piriformis muscle tightness and hip external rotation range of motion. Journal of Physical Therapy Science. 2015;27(7):2189-2192.

6. Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare. 2016;4(2):22. doi:10.3390/healthcare4020022

7. Harvard Health Publishing. Stretching and strengthening exercises to relieve and prevent lower back pain. Harvard Medical School. 2024. Available at: health.harvard.edu

Related Exercises

• Knee-to-Chest Stretch — gentler alternative for lower back relief
• Seated Spinal Twist — complements the Figure-Four by stretching the spine rotators
• Cat-Cow Stretch — gentle spinal mobilization, good warm-up before the Figure-Four
• Child’s Pose — another gentle stretch for the lower back
• Bridge — strengthens the glutes (stretch + strengthen = best results)

Recommended Plans Including This Exercise

• Lower Back Pain Relief — 15-minute targeted plan
• Sciatica Relief — specifically designed for sciatic nerve symptoms
• Office Worker Quick Break — 5-minute desk-friendly routine