Do you sit at a desk for a long time, drive lots of miles, run or cycle? These stationary or repetitive activities could put you at risk for dead butt syndrome, where your gluteal muscles are weak, deconditioned or hard to engage.
“Dead butt syndrome, otherwise known as gluteus medius tendinosis, happens when the stabilizing muscles of the butt forget how to work properly. More specifically, the gluteus medius and minimus tendons forget how to help stabilize the stronger muscle, the gluteus maximus,” said Matthew Steele, DO, a sports medicine specialist with Banner Health.
“Despite the name, the muscles aren’t dead, but just in a deep sleep and need the right encouragement to begin working again,” he said. “The challenging aspect of attempting to wake something up is that sometimes they can be pretty grumpy upon awakening and cause pain when attempting to use them.”
The condition can cause pain and discomfort in your buttocks, hip or lower back and can limit your mobility. You may notice symptoms when you shift from standing to sitting. Over time, dead butt syndrome can lead to hip instability and other musculoskeletal issues.
It’s important to figure out what’s causing the syndrome exactly — muscle imbalances, inflammation, tendon issues or nerve problems — and treat it.
The first lines of treatment are physical therapy and a prescribed exercise program. For a lot of people, that takes care of the problem. But sometimes, the stabilizing muscles or tendons are too damaged and they need more help to heal.
“If pain persists after physical therapy and exercise, other treatments can help you recover,” Dr. Steele said. “Many people do not know about minimally invasive options. You don’t have to live with the symptoms. There are many options available that will not cause much downtime.”
Gluteal injections
In some cases, corticosteroid injections can reduce inflammation and pain. They are temporary, but you can make more progress in physical therapy if you don’t have as much pain.
Platelet-rich plasma (PRP) therapy
PRP injections use your own blood’s healing properties to repair damaged tissues. This therapy may help you regenerate tissue in the muscles or tendons affected by dead butt syndrome.
Dry needling or trigger point therapy
These treatments target painful muscle knots or “trigger points” to release tension, improve blood flow, relieve discomfort and improve muscle function.
Anti-inflammatory medications
Over-the-counter (OTC) or prescription anti-inflammatory medications can help manage pain and swelling. You can use them as part of a larger treatment plan.
Low dose radiation therapy (LDRT)
Treatment by a radiation oncologist may block the pathways that are causing inflammation and pain.
Lifestyle and ergonomic adjustments
In addition to medical treatments, changing your environment can help keep your condition from getting worse and support your recovery. If you sit for long periods, try adjusting your posture, using lumbar support or switching between a sitting and standing desk to reduce strain on your glutes.
Surgery
Most people don’t need surgery for dead butt syndrome but it may be an option if there is a lot of damage to the tendons or tissues or if there are structural issues, like labral tears or hip dysplasia.
If you need surgery, you may be able to have a minimally invasive procedure called gluteal percutaneous tenotomy. “This used to be a major procedure but now it can be quickly performed through a small incision with minimal downtime,” Dr. Steele said.
Personalized sports medicine plans
For runners, cyclists and other athletes, a customized sports medicine treatment plan may help. Sports medicine professionals can design a program tailored to your sport and activity level, focusing on strengthening exercises that target your weaker muscles.
Cross-training and restorative movement
Cross-training exercises, such as swimming or strength training, can reduce your risk of further injury and help balance your muscle use. You may also want to try low-impact activities like yoga and Pilates, which can help restore function, improve flexibility and promote blood flow.
Long-term management and prevention
After treatment, keeping your glutes strong is key to keeping dead butt syndrome from returning. Squats, lunges, hip thrusts, flexibility training and foam rolling can help improve mobility and reduce stiffness. Using proper posture and taking regular breaks from sitting can also help keep your muscles healthy.
When to see a specialist
If you’ve tried physical therapy and at-home exercises but still have pain or mobility problems, it may be time to see a health care provider such as an orthopedic specialist or sports medicine physician.
“Seek medical care if you start noticing persistent pain in the outside or back of the hips when you go from sitting to standing, pain while laying on one side or discomfort even if you’ve modified your exercise routine,” Dr. Steele said. It’s especially important to get care for symptoms like severe pain, numbness or difficulty performing daily activities.
Your health care provider may suggest imaging studies such as X-rays or MRI scans to check for damage. They can develop a personalized treatment plan for you.
The bottom line
You could get dead butt syndrome if you sit a lot, run or cycle. Untreated, it could cause chronic pain and impact your mobility. The first step is usually strengthening your glutes and core through physical therapy and targeted exercises but you may also need more advanced treatment.
If you’re dealing with discomfort or pain that you think might be caused by dead butt syndrome, reach out to your health care provider or an expert at Banner Health. You can get back on track with a personalized treatment plan.
