Quadratus Femoris Pain: The Hidden Cause of Deep Hip and Buttock Pain

If you’ve been struggling with deep buttock or hip pain that feels like sciatica or piriformis syndrome and therapies have not been helping? You might be dealing with an overlooked condition involving a small but powerful muscle: the Quadratus Femoris.

At Pain Free Health Physiotherapy Clinics in Langley, Ladner, Richmond, Queensborough, and South Surrey, our physiotherapists often see patients with hip and gluteal pain that originates from this deep stabilizing muscle. Understanding how it works  and how it can become irritated is key to finding lasting relief.

What Is the Quadratus Femoris?

The Quadratus Femoris is a deep gluteal muscle located between the sit bone (ischial tuberosity) and the femur. Its main job is to help you rotate and stabilize your hip joint during activities like walking, climbing stairs, or bending. 

However, because it sits very close to the sciatic nerve, tightness or inflammation in this muscle can easily cause nerve-like pain radiating down the leg and often can mimic sciatica.

Why It Hurts: Ischiofemoral Impingement

When the space between the hip and the pelvis (called the ischiofemoral space) narrows, it can compress the Quadratus Femoris. This leads to a condition known as Ischiofemoral Impingement (IFI).

Common causes include: 

• Repetitive hip movement or heavy lifting
• Postural strain (especially from prolonged sitting)
• Muscle imbalances or weakness around the hip
• Post-surgical changes (like after hip replacement)

Patients with IFI often describe deep, aching pain in the buttock, worsened by walking, standing, or rotating the hip.

Common Symptoms

If you have Quadratus Femoris or deep gluteal pain, you may notice:

• Pain deep in the buttock, especially when standing or walking
• Discomfort sitting for long periods
• Pain with hip adduction (crossing your leg) or extension
• Limited hip internal rotation
• Pain that mimics sciatica, but scans show a healthy spine

If this sounds familiar, it’s worth having a physiotherapist assess your deep gluteal muscles — not just your back.

How Physiotherapy Can Help

At Pain Free Health, our physiotherapists perform a comprehensive hip and spine assessment to pinpoint the true source of your pain.

Treatment may include:

• Manual therapy: Soft tissue release, joint mobilization, and myofascial techniques
• Dry needling (IMS): To release tension in deep hip rotators
• Shockwave therapy: To stimulate blood flow and healing in chronic cases
• Rehabilitation exercises: To improve hip strength, posture, and stability
• Patient education: On posture, stretching, and ergonomics to prevent flare-ups

Our goal is not only to relieve your pain — but to restore mobility and prevent recurrence.

Best Stretches and Exercises for Quadratus Femoris Pain

 Your physiotherapist may prescribe:

• Seated Hip External Stretch- 30 sec hold 3 sets daily 

•  Glute Bridge or Clamshells- 12-15 Repetitions 3 Sets Daily 

•  Hamstring Stretch- 30 Sec Hold 3 Sets Daily

Physiotherapy Clinics Near You

If you’re experiencing persistent deep hip, gluteal, or sciatic-like pain, our expert team at Pain Free Health can help.

We offer personalized physiotherapy, chiropractic, acupuncture, and massage therapy across multiple locations:

Pain Free Health – Langley

Pain Free Health – Richmond (Queensborough)

Pain Free Health – Ladner

Pain Free Health – South Surrey

Whether your goal is to get back to sports, improve mobility, or simply live without pain, our team of professionals will guide you every step of the way.