Want to get to the bottom of your persistent back, knee or hip pain? Look behind you, and you’ll find the likely cause.
Dormant butt syndrome is the name that I’ve coined for a serious problem that affects millions of Americans, especially those who spend most of the day sitting. Did you pull a hamstring while playing with your grandkids? Suffer from an aching back after a few hours of TV watching? Weak gluteal (butt) muscles are often the common link. A lack of strength in this area forces other muscles to compensate and do jobs that they’re not designed to do alone, resulting in pain in unexpected parts of the body.
The big muscles in the buttocks do more than give it shape. They absorb shocks and control movements necessary for walking and other activities. When the gluteal muscles are weak, other muscles and joints definitely take the hit.
Dormant butt syndrome strikes people who are generally sedentary—whether they’re sitting behind a desk, driving a car or watching their favorite sitcoms. When you’re positioned on your derriere for hours on end, the glutes aren’t “firing” and there’s more tightness in the hip flexor muscles, which can lead to hamstring injuries or back, hip or knee pain. Runners and other athletes who do repetitive motion can also get tight hip flexors.
When I evaluate clients who have lower-body pain, I always check for adequate glute strength. To do this, I ask the patient to lie on his/her stomach and do a leg lift against resistance from my hand to determine how strong his glutes are.
I also put my fingertips lightly on the hamstring and gluteal muscles of the lifted leg to evaluate the “firing pattern” of muscles. Normally, the gluteal muscles will fire (or activate) first, followed by the hamstrings. If the pattern is reversed, I’ll know that the gluteal muscles are weaker than they should be.
I advise clients to spend the majority of their waking hours standing, if possible. Since this isn’t always practical, at least make an effort to increase your amount of upright time—staying on your feet when watching TV, for example, or standing (and pacing) when talking on the telephone. Six other movements that help—do each one twice a week (except for the hip flexor stretch, which should be done daily)…*
• Glute bridge. It is among the best exercises for targeting the glutes. It gives the abdominal core muscles a bit of a workout, too.
What to do: Lie on your back with your knees bent and your feet flat on the floor. Contract your abdominal muscles slightly. Next, raise your hips up about six inches and hold for a few seconds…then slowly lower yourself back down. Repeat this movement 10 to 12 times.
• Lunges. They strengthen the gluteal muscles, along with muscles in the hips and thighs.
What to do: Stand with your feet together and your hands on your hips. Take a step forward with your left leg, while simultaneously bending that leg until the thigh is parallel to the floor. Keep your front foot flat on the floor as you bend your knee (most of the weight should go onto your heel), and don’t let the front knee extend farther forward than the toes. Return to the starting position, then repeat with the other leg. Work up to 12 to 15 reps on each leg. Note: If a deep knee bend is painful, don’t go down as far.
• Wall squats. Squats are popular because they increase both gluteal and thigh strength. This exercise is easier than traditional squats because it requires only body weight and a wall for support.
What to do: Lean back against a wall with your feet shoulder-width apart and out a foot or two. Keep your back and hips against the wall.
Slide down until your thighs are parallel to the floor. Hold the position until your thighs start to say “enough,” then rise back up. In the beginning, your thighs might start shaking after just a few seconds. Over time, try to work up to holding the position for 30 to 60 seconds.
If you’re out of shape or have weak knees, you can lower yourself about halfway to the parallel position. Don’t let your knees collapse inward, and stop if you feel any pain. Work your way toward the full bend as you build strength.
• Side planks. For those with dormant butt syndrome, it’s important to stretch/strengthen surrounding muscles as well as the glutes themselves. This exercise activates muscles in the midsection, including the hips.
What to do: Lie on your right side, with your legs extended and “stacked” on top of each other. Prop up your upper body by supporting your weight on your forearm, keeping your shoulder aligned with your elbow. Contract the ab muscles and lift your hips and knees off the floor. Hold the position for 10 to 30 seconds, then lower back down. Repeat on the other side. Start with two to three sets, holding the position for 10 seconds, and gradually work up to one minute per set.
• Single leg balance. Most people lose some strength, balance and rotational motion (the ability of their joints to rotate) as they get older. This exercise is a good way to improve hip and core stability while challenging balance.
What to do: Stand on one leg, with your arms held slightly away from your body for balance. Important: For safety, stand next to a counter to catch yourself if you start to topple over. Try to hold the position (without swaying) for 30 to 60 seconds. Then try it on the other leg. It’s challenging at first! Once it gets too easy, lift the leg a bit higher and/or try to do it with your eyes closed. This is harder because vision helps the body orient itself.
• Hip flexor stretch. Tight hip flexors cause dormant butt syndrome. When these muscles are tight, there’s compensatory movement throughout the lower back, which can lead to pain as well as disk damage in the lower back.
What to do: Kneel on your left knee, with your left hand on your hip and your right foot flat on the floor in front of you—the right knee should be bent and the right thigh should be roughly parallel to the floor. Move your left hip forward until it extends beyond the left knee. Don’t bend forward during the movement. Hold the position for 20 to 30 seconds, then repeat for three or four reps. Change position and repeat on the other side.
*Consult your doctor before beginning this regimen—or any other new exercise program, especially if you’ve had knee, hip or back surgery.
