The external rotators of the hip can be summed up in one muscle, the piriformis. There are a number of external rotators, but the piriformis is the most important and virtually the only external rotator that is ever covered in the literature.
External rotation happens in two ways. If you are standing straight, point one of your toes to the outside. Your leg/hip just externally rotated. External rotation also occurs when your leg is abducted (moved away from the midline of the body). Think of when you sit Indian style. In order to do sit Indian style you need to move your leg away from the middle of your body (abduction) and then bring your foot in front of you (external rotation). If you have trouble sitting Indian style, and many people do, it’s usually due to a tight piriformis.
How does the piriformis get tight? Often it gets tight when your glutes stop working as external rotators and abductors. Gluteal amnesia- a condition when your glutes stop performing their intended functions- results in the piriformis working overtime to produce the desired movements. The overworked piriformis gets tight from repeated activity. Although you can still perform external rotation while standing, abduction and external rotation, sitting Indian style, is another story.
Gluteal amnesia is fairly widespread. Desk jobs are often a main culprit. Sitting with the hips flexed causes the glutes to be in a permanently stretched position. When a muscle on one side of the body is tight, its antagonist, the muscle that performs the opposite movement of the tight muscle, has to elongate to accommodate the other sides shortness. In this case the hip flexors get tight so the glutes, which produce hip extension, lengthen in response.
An elongated muscle loses the ability to contract forcefully. It weakens and gets little activation. Eventually, the brain will stop recruiting it to produce desired movements. Your brain “forgets” how to use the glutes, hence gluteal amnesia. Other muscles must pick up the slack for the dormant glutes. Hello groin pulls, hamstring strains, lower back pain, and a tight piriformis.
In normal situations the piriformis will work with other muscles to produce movement. When the piriformis has to pick up the slack for an underperforming muscle, it gets tighter than normal. It can also get tighter from daily habits such as sleeping in a certain position or doing repetitive movements. When we encounter a tight piriformis, we need to stretch it so that we can re-establish hip external rotation. Here is the stretch to be performed.
You can’t tell by the video, but I’m actively pressing down on my knee and pushing up on my ankle. You should feel a stretch in the back of your hip. Keep perfect posture. You can hold it 15-20 seconds.