Pyramidal Muscle: Definition, Location, Anatomy, Function, Strengthening, Associated Syndromes and Treatments

It begins at the sacrum, passes through the buttock, and ends at the femur level.

It is a muscle of the anterior abdominal wall. The pelvic pyramidal muscle belongs to the thigh and pelvis region.


The pyramidal muscle is located in the pelvis and separates the viscera from the upper legs. The pyramidal nerve and the sacral and gluteal arteries pass to the pyramidal muscle. Allows for spacing and rotation of the thighs outward and to the sides.

In turn, it is a deep hip muscle; the piriformis plays a vital role in stabilizing and positioning the pelvis.


The piriformis belongs to the pelvistrochanteric family, which are deep muscles of the hip. They are related to the deep buttocks and the three superficial buttocks (large, medium, and small).

Triangular in shape, the pyramidal is the most significant and superior pelvic-trochanteric muscle. It is powerful and participates in the anteroposterior stabilization of the pelvis in the sagittal plane.


The pyramidal muscle attaches to the anterior surface of the sacrum, between the four anterior sacral foramina.



Its muscle fibers converge to form a tendon attaches to the medial side of the superior border of the greater trochanter and the femur.


The pyramidal nerve innervates the pyramidal muscle.


The pyramidal muscle is the hip flexor, abductor, and lateral rotator. It also participates in the retroversion of the basin. In other words, this muscle makes it possible to climb the knee (flexors), move the leg out (abductor), and perform an external thigh rotation.

Retroversion, meanwhile, corresponds to the action of recovering your pelvis (iliac bone).

Muscle-strengthening of the piriformis

Assimilated to a deep gluteal muscle, exercises to exercise the piriformis muscle will inevitably engage the gluteal muscles.

Lateral hip extension


  1. Stand on all fours with your hands on the floor.
  2. Do a lateral hip extension and then return to the starting position.
  3. Perform five sets of 15 reps.

On a more challenging level, perform this exercise with an ankle weight or by placing an elastic band between your thighs.

Skip squats


  1. Stand with your feet shoulder-width apart, bend your legs, and then do a vertical jump.
  2. Clear the reception and then go straight with a new vertical jump.
  3. Perform five sets of 10 to 12 successive jumps.

Skip your squats with a pair of dumbbells to perform this exercise with more incredible difficulty.

You are stretching the pyramidal while lying down.


  1. Lie on your back.
  2. Place your right ankle on your left knee.
  3. With both hands, grasp the back of your left thigh.
  4. Bring your knee closer to your chest and “open” your right knee.

Hold the stretch for 20 to 30 seconds, and then do the same exercise on the other side.

Stretch the pyramid while standing

Instructions: Standing, place your left ankle on your right knee. Gently bend your right leg forward while pressing down your left knee. Hold the position for about ten seconds and then do the same exercise on the other side.

Pyramidal muscle syndrome

The pyramidal syndrome, also called “false sciatica” can result from a fall, a bump to the buttocks, or uneven leg length.

This syndrome is characterized by pain in the buttocks or pseudo decomposition. The pain radiates from the buttock, the back of the thigh, and, more rarely, to the back of the foot.

It is a compression of the sciatic nerve that generally passes just below the lower border of the pyramidal. For some people, the sciatic nerve passes through the pyramidal muscle and is more likely to be compressed by the latter.

What treatment can you get?

When suffering from the pyramidal syndrome, sitting and squatting becomes painful, affecting walking and most physical and sports activities. Therefore, seeing a doctor at the first sign and establishing a consistent muscle strengthening program is essential.

A study has shown that this syndrome could result from a weakness of the hip abductors, hence the interest in using a qualified sports trainer who can tailor a 100% personalized and safe sports program. Find a coach.

In parallel and depending on the severity, a consultation with an osteopath and treatment by a physiotherapist may be sufficient. In some cases, botulinum toxin injections or surgery may be necessary to treat this syndrome.