Knee-to-Opposite-Shoulder Stretch
Draw your knee gently across your body toward the opposite shoulder, breathe into the buttock. Hold 45 seconds each side. You should feel a pulling sensation deep in the buttock and outer hip of the moving leg. Should not feel in the lower back.
The knee-to-opposite-shoulder variation lengthens the piriformis more fully than the same-side knee-to-chest, because adding adduction across the midline takes the muscle through a greater range. It is a gentler alternative for people who find the supine figure-4 too aggressive on the outer hip.
Illustration. Follow the steps for the actual technique.
How to do it
- 1
Lie on your back with both legs extended long
Supine start
- 2
Bend your right knee and bring it up toward your chest
Knee up
- 3
Cross both hands over the knee and gently draw it toward your left shoulder
Knee across to opposite shoulder
- 4
Keep your hips on the floor, your shoulders relaxed
Hips stay down
- 5
Hold 45 seconds, breathing into the right buttock. Lower, then switch sides
Breathe and release
The evidence
The knee-to-opposite-shoulder variation lengthens the piriformis more fully than the same-side knee-to-chest, because adding adduction across the midline takes the muscle through a greater range. It is a gentler alternative for people who find the supine figure-4 too aggressive on the outer hip.
Citation: Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM (2010). Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation. Journal of Orthopaedic and Sports Physical Therapy
Common questions
How long should I hold the Knee-to-Opposite-Shoulder Stretch?
Hold the Knee-to-Opposite-Shoulder Stretch for 45 seconds on each side, breathing slowly. Then switch sides.
What should I feel during the Knee-to-Opposite-Shoulder Stretch?
A pulling sensation deep in the buttock and outer hip of the moving leg. Should not feel in the lower back.
Is the Knee-to-Opposite-Shoulder Stretch right for disc-bias or piriformis-bias sciatica?
The Knee-to-Opposite-Shoulder Stretch targets piriformis-bias sciatica: deep buttock pain that worsens with prolonged sitting, without a clear electric pattern running down the leg. It keeps the lumbar spine neutral, so it is not the first choice for disc-bias sciatica, where symptoms instead centralise with back extension.
When should I stop the Knee-to-Opposite-Shoulder Stretch?
If you feel pain shooting further down the leg as you draw the knee across, release immediately. That is nerve root irritation. Try the supine piriformis stretch instead, which keeps the leg in a more neutral position.