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

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

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 muscle of the hip, 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, in addition to the three superficial buttocks (large, medium and small buttocks).

Triangular in shape, the pyramidal is the largest and most 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 foramens.


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


The pyramidal muscle is innervated by the pyramidal nerve.


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 rotation of the thigh.

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

Instructions: Stand on all fours, with your hands flat on the floor. Do a lateral hip extension and then return to the starting position. Perform 5 sets of 15 reps.

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

Skip squats

Directions: Stand with your feet shoulder-width apart, bend your legs, and then do a vertical jump. Clear the reception and then go straight with a new vertical jump. Perform 5 sets of 10 to 12 successive jumps.

To perform this exercise with greater difficulty, skip your squats with a pair of dumbbells.

Stretching the pyramidal while lying down

Instructions: lie on your back. Place your right ankle on your left knee. With both hands, grasp the back of your left thigh. Bring your knee closer to your chest, making sure to “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 down and forward while pressing down on your left knee. Hold the position for about ten seconds and then do the same exercise on the other side.

Pyramidal muscle syndrome

Pyramidal syndrome, also called “false sciatica,” can be the result of 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 pyramidal syndrome, sitting and squatting becomes painful, affecting walking and most physical and sports activities. Therefore, it is important to see a doctor at the first sign and establish a consistent muscle strengthening program.

In fact, a study has shown that this syndrome could be the result of 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.