Aerobic activities, also called endurance or cardiovascular exercises, involve the rhythmic movement of large muscles for a sustained period of time. In treating piriformis syndrome, aerobic exercises can help improve muscle function and increase blood flow to the buttock, pelvic, and hip areas, promoting healing.

Aerobic exercise is generally considered most beneficial when done for a minimum of 20 to 30 minutes, about 3 to 5 times a week. 1 Tian D, Meng J. Exercise and Prevention and Relief of Cardiovascular Disease: Prognoses, Mechanisms, and Approaches. Oxidative Medicine and Cellular Longevity. 2019.3756750. Running, brisk walking, bicycling, playing sports, dancing, and swimming are common examples of aerobic activities.

Low-impact aerobic exercises for piriformis syndrome are discussed below.


Walking is a simple yet effective way to treat piriformis syndrome and improve overall health. Walking is a low-impact exercise that people of all ages and fitness levels can do.

Walking can help relieve sciatic nerve pain or piriformis syndrome pain and can help improve back mobility, release endorphins, and promote the body's natural healing processes. Watch: 2 Walking Tips for Piriformis Syndrome Video

  • Walking helps strengthen the muscles in the legs and buttocks, 2 Grant G, Machaczek K, Pollard N, Allmark P. Walking, sustainability and health: findings from a study of a Walking for Health group. Health & Social Care in the Community. 2017;25(3):1218-1226. including the piriformis muscle.
  • Walking reduces muscle tightness and spasm in the piriformis, thereby improving lower back and hip flexibility. 3 Hanson S, Jones A. Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. Br J Sports Med. 2015;49(11):710–715.

When starting a new walking exercise routine, it is recommended to start slow and gradually increase the duration and intensity of the walk.


Elliptical Trainer

An elliptical trainer is a low-impact exercise equipment that targets a full-body workout. Working out on an elliptical trainer does not stress the joints, making it a great option for people who may be recovering from an injury or have chronic pain. 4 Bosch AN, Flanagan KC, Eken MM, Withers A, Burger J, Lamberts RP. Physiological and Metabolic Responses to Exercise on Treadmill, Elliptical Trainer, and Stepper: Practical Implications for Training. International Journal of Sport Nutrition and Exercise Metabolism. 2021.31(2):135-142.

  • The elliptical trainer allows for a range of motion that mimics the natural movement of walking or running but without impact.
  • This form of exercise makes it an ideal choice for people with piriformis syndrome, as it allows them to exercise without putting additional stress on the affected area.
  • The elliptical trainer also allows resistance adjustment, allowing the user to tailor their workout to their specific needs.

A piriformis syndrome exercise program typically begins with a low-resistance level that gradually increases as the lower back and buttock muscles gain strength.

Water Therapy

Water therapy consists of exercises performed in a pool.

Water therapy is especially beneficial in cases where a land-based exercise program may be limited because of the intensity of the pain or disability. Water counteracts the effect of gravity and helps support the body’s weight, and the buoyancy of water makes it easier to perform an exercise. 5 Cuesta-Vargas AI, Garcia-Romero JC, Arroyo-Morales M, Diego-Acosta AM. Exercise, Manual Therapy, and Education with or Without High Intensity Deep-Water Running for Nonspecific Chronic Low Back Pain. American Journal of Physical Medicine & Rehabiliation. 2011.90(7):526-538.


Aerobic Exercises to Avoid with Piriformis Syndrome

Before starting any form of aerobic exercise, consultation with a physical therapist helps minimize the risk of causing or exacerbating a lower back/hip condition that may be associated with the patient's piriformis muscle dysfunction. Long-distance running and cycling may not be recommended in people with piriformis syndrome because they may cause excessive strain on the piriformis muscle and worsen symptoms.

Dr. Natalie Ullrich is a physical therapist specializing in orthopedic and sports medicine at Plymouth Physical Therapy Specialists. She is passionate about treating each individual as a whole.

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