Quit Your Pain in the Butt

I’m about to talk dirty to you. I’m about to talk about your butt. Now I don’t care if you have a big, small, flat, or wide one. I care if it hurts and what you can do to resolve your pain in the butt.

I have this “friend”, who shall remain nameless, that complains about butt pain. He/she asks me to fix it because, you know, that’s what I do. And he/she expects the fix to happen one time miraculously. Yes, I can massage the butt and provide temporary relief, but most of the work relies on the individual (once they’ve been educated, of course) over a course of 4-6 weeks. In most cases, this has been an underlying issue that has been building up over weeks to years.

Anatomy:

Our backside is made up of a couple layers of muscle. The most superficial and main functioning muscles are the three gluteals: gluteus minimus, gluteus medius, and gluteus maximus, also included is the tensor fascia lata (but it’s not a prime hip mover). The deeper layer consists of your hip rotators: piriformis, obturator internus/externinus, superior/inferior gemellus, and quadratus femoris. 

Function:

Gluteus Minimus: hip abduction (pulling leg away from midline of body) and hip internal (medial) rotation when the hip is flexed.

Gluteus Medius: hip abduction, hip internal rotation when the hip is flexed, and hip external (lateral) rotation when the hip is extended.

Gluteus Maximus: Posterior pelvic tilt, hip extension, hip abduction, and assists in hip external rotation. 

Tensor Fascia Lata: assists with hip and knee stabilization.

Piriformis (along with obturator internus, superior and inferior Gemellus): hip external rotator and assists with hip abduction when the hip is flexed.

Obturator Externus and Quadratus Femoris: hip external rotator and assists with hip adduction.

Causes:

1. Under or over use – more than likely under use because of increased sitting habits.
2. Weakness/Tightness
3. Trauma

Treatments:

1. Deep tissue massage/Active Release Technique/Graston Technique
2. Stretch
3. Strengthen with emphasis on proper fire sequencing and movement patterns 
4. Avoiding painful positions (prolonged sitting)

Work with a professional who can correctly guide you to perform these rehabilitation exercises and progress through the proper phases.

Incorporate stretching: Hold each for 30-60 seconds for 2-3 reps, 2-3 times per day.

1. Seated piriformis
2. Supine piriformis with and without cross over
3. Opposite leg assisted supine piriformis 

Progress over 4-6 weeks: perform 10 to 15 reps progressing from 1-3 sets, 1 time a day.

1. Bridge with abduction
2. Sidelying clam shells with resistance
3. Sidelying leg lift
4. Modified side plank with hip abduction
5. Full plank with hip abduction
6. Mini squats with resistance
7. Monster walks
8. Single leg squats
9. Single leg squat step down
10. Front and diagonal lunges
11. Plyometrics

Now, get that butt moving! You won’t get the butt you want by sitting on it 😜.