Sitting Too Much? You May Have Dead Butt Syndrome

Dead butt syndrome is caused by a combination of weak and tight muscles. The symptoms usually come on gradually over time, including numbness, soreness, and pain; they are made worse with prolonged sitting, poor posturing, improper stretching, and certain activities. There are several treatments, the most important being strengthening and stretching exercises.

Key takeaways:
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    Dead butt syndrome is also known as gluteal amnesia, lower cross syndrome, gluteus medius tendinosis, and lower cross syndrome.
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    It involves the gluteal muscles of the butt “forgetting” to work properly, hence the word amnesia.
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    Symptoms are numbness, soreness, and pain in the gluteal area. However, there can also be pain radiating to the hips and legs.
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    Conservative treatments are usually highly effective, including strengthening and stretching exercises.

Dead butt syndrome is also known as gluteal amnesia. The gluteal muscles fail (forget) to function properly, hence the addition of the name amnesia (a condition that results in forgetting). It has two additional names, gluteus medius tendinosis and lower cross syndrome. For this article, we will use the term dead butt syndrome to refer to all these conditions.

What happens in dead butt syndrome?

Viewing the diagram below helps in understanding dead butt syndrome. Two areas of tight muscles (gray line) are the thoracolumbar extensors and hip flexors. In addition, there are two areas of weak muscles (purple line): the abdominals and gluteal muscles.

If you notice, the gray and purple lines cross in the lower body; thus, the name lower cross syndrome. In addition, the posture created with lower cross syndrome causes anterior pelvic tilt, seen in the side view segment (on the left).

Lower crossed syndrome

What are the anatomical structures involved in dead butt syndrome?

As you can see in the diagram below, there are three gluteal muscles: the gluteus maximus, gluteus medius, and gluteus minimus, with the gluteus maximus being the largest of the three. As a side note, there are additional muscles in the pelvis and hip area, including the piriformis and obturator internus.

The hip is created by the femur (thighbone) and the pelvis (hip bone), attaching at an area called the acetabulum, which is not shown in the image. The sacrum is the large “shield-shaped" structure below the lumbar vertebra between the hip bones.

glutes posterior view

What causes dead butt syndrome?

The condition is mainly caused by prolonged sitting, such as sitting at a desk. Since the pandemic, there has been an increased number of people who sit for most of the day. Many of these people are no longer at an office where they frequently get up, move, or walk around.

In addition to office workers, dead butt syndrome is also seen in recreational gamers and drivers. Poor posture and an increasingly sedentary lifestyle are additional causative factors.

Even though dead butt syndrome is usually seen in sedentary people, it can also be seen in passionate athletes, especially runners, for several reasons. First, they do not do other exercises to strengthen their core (abdominal) and gluteal muscles. Second, they do not adequately stretch the hip flexors and thoracolumbar muscles (low back muscles). Third, they develop inflammation of the gluteus medius muscle, the middle of the three gluteal muscles, stabilizing the hip and pelvic area.

In addition to passionate athletes and runners, sedentary workers who engage in frequent brisk walks can develop dead butt syndrome.

What are the symptoms of dead butt syndrome?

The most common symptoms of dead butt syndrome include numbness and soreness of the gluteal and hip area that can develop slowly over time but can progress to pain. In addition, most people feel the symptoms after prolonged sitting.

Our gluteal muscles are engaged in our daily activities, including standing, walking, and climbing stairs. However, with dead butt syndrome, there can be weakness and difficulty performing these activities.

In some severe cases, pain can radiate to the hips and legs, as seen in more serious conditions, such as neuropathy and radiculopathy.

How is the dead butt syndrome diagnosis made?

Like any other musculoskeletal disorder, a diagnosis is made by similar methods, including:

History is taken into consideration to learn about prolonged sitting, along with sports and recreational activities.

A physical exam to evaluate muscle tightness, tension, and strength, in addition to a complete neurological exam to assess for neuropathy and radiculopathy.

A lateral visual inspection for anterior pelvic tilt.

Laboratory tests to evaluate for infections, gout, or rheumatoid arthritis.

Plain x-rays to assess the underlying bones for fractures (breaks), spurs, or osteoporosis (thinning of the bones).

Computer tomography (CT or CAT) or magnetic resonance imaging (MRI) scans to view soft tissue structures, including the muscles, tendons, and ligaments.

What is the treatment for dead butt syndrome?

The good news is that dead butt syndrome can be treated conservatively.

Frequent position change helps. If you have a job that requires sitting all day, it is good to get up and move around several times an hour. Standing desks are also an excellent alternative for people to change positions while working on their computers.

If driving a car, try to get out of the car every 15 minutes, if possible.

Ice and heat help muscle tightness and inflammation.

Medications. For inflammatory purposes, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Bayer, Ecotrin, Anacin), ibuprofen (Advil, Motrin), or naproxen (Aleve), can be used at a higher dose.

Exercises are the most crucial treatment for dead butt syndrome and are usually the most effective, including:

  • Stretching of the hip flexors and thoracolumbar areas
  • Strengthening of the abdominal and gluteal muscles
  • Stretching of the leg muscles before walking and running

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