If you spend hours a day sitting and not getting up frequently to stand, walk, or otherwise move around, you may have experienced a problem commonly known as “dead butt syndrome” (DBS).
The clinical term for this condition is gluteus medius tendinopathy, though it’s also often referred to as gluteal amnesia.
As you might expect from its common name, the condition results from the gluteal muscles essentially “forgetting” their main purpose: supporting the pelvis and keeping your body in proper alignment.
Moving more and sitting less can help prevent or treat dead butt syndrome, but you need to be aware that this odd-sounding condition can lead to other problems if not taken seriously.
After sitting for a long time, the gluteal muscles (glutes) in your buttocks can feel numb or even a little sore. But walking and some mild stretching can bring them back to life fairly quickly.
In more serious cases, the symptoms of dead butt syndrome can cause pain and stiffness elsewhere. You may experience pain in one or both hips, your lower back, and knees. Pain may shoot down the leg, similar to the way sciatica feels.
A loss of strength in your glutes and hip flexors can also occur if DBS isn’t treated. If one hip in particular is affected, it may hurt just by lying down on that side.
DBS can even lead to inflammation of the hip bursa, a fluid-filled sac that eases movement within the hip joint. Other signs of bursitis (bursa inflammation) include pain and swelling around the affected area.
Pain in your lower legs can also result because of balance and gait problems triggered by DBS symptoms.
To help ease hip and back pain when you walk or run, you might change your normal stride. But this can put a strain on your knees, ankles, and feet that they’re not used to, causing soreness to emerge far from your butt.
A sedentary lifestyle — one with too much sitting or lying down and not enough movement — can cause the gluteal muscles to lengthen and your hip flexors to tighten.
Hip flexors are muscles that run from your lower back, through your pelvis, and across the front of your thigh. They’re responsible for moving your legs when you walk, run, and climb stairs.
If the hip flexors aren’t stretched, just taking a brisk walk can trigger an episode of dead butt syndrome. Allowing your hip flexors to tighten and your gluteal muscles to lengthen can lead to inflammation of the gluteal medius tendons.
The gluteal medius is one of the smaller muscles in the buttocks, and the tendons that support it are vulnerable to this kind of injury.
Interestingly, people who run a lot are at a higher risk of DBS if they spend too much of their non-running time at a desk.
The strain of distance running, or any strenuous exercise, can be too much for muscles and tendons that go long periods in the same positions. Other types of athletes and ballet dancers are also at higher risk.
If you experience symptoms of dead butt syndrome — especially during weight-bearing exercises, such as walking or stair climbing — see your doctor.
A sports medicine specialist or orthopedist may also be a good choice to evaluate your symptoms and get you started on a treatment program if needed.
The doctor will review your symptoms and medical history, and examine the areas experiencing pain and stiffness. You may be asked to move or stretch your legs in different positions and share any changes in symptoms.
They may also order an X-ray or MRI, but only to rule out other potential conditions. These types of imaging tests aren’t especially effective for diagnosing DBS.
The proper treatment for dead butt syndrome will depend on how far it has progressed and on your physical activity goals. If you’re a runner trying to get back on track as soon as possible, you’ll want to work closely with a sports medicine specialist to return to action safely.
For most people, including runners and other athletes, the usual treatment involves a break from your exercise or sports routine. You’ll probably be advised to follow the RICE protocol, too:
- Rest: staying off your feet as much as possible
- Ice: reducing pain and swelling with an ice pack or cold compress
- Compression: wrapping a sore knee or back may be advisable, but consult your doctor for specific instructions
- Elevation: keeping your leg or legs up and well-supported
In serious cases, physical therapy and massage therapy may be necessary. Part of physical therapy may include flexibility and strengthening exercises that you can do at home.
If there’s been serious injury to the tendons and muscles, platelet-rich plasma (PRP) therapy or a similar treatment may be in order.
With PRP, you’re injected with a concentration of your own platelets, the types of blood cells involved with blood clots and healing. The injections are done at the site of your injury. They’re meant to speed up the healing process.
Taking acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn), can improve symptoms of DBS.
The simplest preventive strategy for dead butt syndrome is to break up long periods of sitting with periodic walks. Going up and down stairs can be particularly helpful.
If you need a reminder, set a timer on your phone or computer to alert you every hour or half hour. The movement will stimulate blood flow to the tight areas and revive your “dead butt.”
In general, try to take the stairs as often as possible. Not only does this activate the muscles and tendons affected by DBS, but it’s a good weight-bearing and cardiovascular workout.
There are several simple exercises you can do a few times a week to help preserve the strength and flexibility of your glutes, hip flexors, and hip joints.
Hamstring stretches
There are several ways to stretch the muscles in the back of your thigh, but a simple one is to stand with your left leg in front of your right.
- With your right leg slightly bent and your left leg straight, bend slightly at the waist until you feel a slight pull on your left hamstring.
- Hold for 10 seconds, then switch legs.
- Work up to holding the stretches for 30 seconds at a time.
Learn how to do hamstring stretches here.
Glute squeeze
You can also do this exercise standing up.
- Stand with your feet about hip-width apart and your knees slightly bent.
- Pull your abdominal muscles in and hold your shoulders back while you squeeze your glutes tightly for about 3 seconds.
- Then relax your glutes slowly for 1 full repetition.
- Aim for 3 sets of 10 repetitions.
Squats
This exercise works your glutes, quadriceps, hamstrings, abdominal muscles, and calves. You can do it with or without weights.
- Stand with your feet shoulder-width apart.
- With your core muscles tightened, slowly bend your knees so your thighs are almost parallel to the ground.
- Then slowly return to your starting position. This is 1 repetition.
- Do 12 to 15 reps a couple of days a week.
For added resistance, use a barbell across your shoulders or a specially designed squat rack.
Learn more about squats and see variations here.
Leg lifts
This is one of the best exercises for your core muscles and hip flexors.
- Lie down on a firm, but comfortable, surface.
- Keeping your legs straight, slowly lift them together high enough that you keep them straight, but feel your muscles flexing.
- Then slowly lower them again until your heels are a few inches off the floor.
- Do 10 reps.
Glute bridge
This exercise is also done lying on your back.
- With both knees bent at about a 90-degree angle and your shoulders flat on the floor, lift your hips toward the ceiling.
- Then lower them back down. Think of pushing down through your heels for stability.
See how to do the glute bridge and learn fun variations here.
With proper treatment and exercise, you can bring your “dead butt” back to life and keep it that way for a long time.
And if you take time to move throughout the day — while adding DBS-preventing exercises into your weekly routine — you may never have to deal with this problem again.
However, keep in mind that if you don’t manage your glutes and hip flexors, and then tax them by running or other strenuous activities, you may start to feel those symptoms return.
If you’re a serious runner, you may want to talk with a sports medicine specialist about getting a functional movement screening (FMS), which analyzes the biomechanics of your running form. It can help improve your performance and reduce the risk of a DBS return.