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Dead Butt Syndrome

Dead Butt SyndromeIn 1990 while dancing professionally, I sustained a hamstring injury during a dance performance. I was running backwards heading toward a “controlled fall” that was to be broken by another dancer. The other dancer missed the catch, and I fell earthbound with great velocity. Immediately, I felt pain near my ischial tuberosity on the right side of my pelvis.

After 6 weeks of rest, gentle stretching, and mild strength training, I thought my recovery was complete.

Fast forward to 1996. I was teaching a Modern dance class at Arizona State University. During the class while coming across the floor in a running combination, I heard a pop at my right hamstring insertion when I rapidly accelerated, then decelerated the run. There was immediate excruciating pain.

I stopped dancing, iced, took anti-inflammatories and employed assisted stretching to help with the spasm and pain. Once again, I rested, used stretching and mild strength training to overcome my injury.

2009-2011. Over the last few years I developed a “piriformis” type syndrome with pain and spasm in my buttock. At times, my iliotibial band became tight. On rarer occasions, my right calf became tight, and on rarer occasions my right ankle and foot demonstrated a plantar fasciitis. My right knee felt as though it was “out of joint” when kneeling and sitting on my heels. My right hip rotated forward. My right inner thigh became tight and tender.

My symptoms exacerbated when running, standing, or balancing on one leg.

This is the story of my journey to recovery of a common injury pattern for athletes, dancers, and runners. Whether it is called Piriformis Syndrome, Dead Butt Syndrome, Glutues Medius Tendonitis, Sacrotuberous Ligament Syndrome, of Sacro-iliac joint dysfunction matters not to those who wish to get back in their game (sports, dance, running). All they want is information essential to recovery and resumption of activities of their daily lives.

The cause and treatment of the above imbalances varies. Each individual should consult a medical professional to determine the exact etiology of their imbalance to receive the best remedies for their particular case.

Here is what I learned about my body, my injury, and my rehabilitation.

Dead Butt Syndrome is a combination of improperly trained lower abdominals, a hypertonic iliopsoas, a tight anterior hip capsule, and an inhibited gluteus muscle. It can present with any of the above listed conditions. In order to determine its existence, lower abdominal testing is done. For a high level athlete exercises such a Roll Over, Jackknife, Long Spine, and Corkscrew are difficult to execute with Dead Butt Syndrome. Dynamic lower abdominal strength is not sufficient to create these movements without difficulty and recruitment of additional muscles. Inhibition of the gluteal muscles does not allow them to fire properly when doing the above exercises. For the non-athlete exercises such as Coccyx Curl, Breathing (on Trapeze Table), and Pelvic Press are a challenge.

My rehab started with simple buttock exercises such as Rock n Roll of the pelvis, Coccyx Curl, and Pelvic Press. I focused on working my pelvic floor muscles, as well as my lower abdominals. As I was able to better articulate my spine, pelvis, and hips as independent and contiguous units with stability, my condition improved.

Due to my hamstring injury, my iliopsoas on the right side tightened up, and became hypertonic. It always seemed to be in a shortened position, causing a feeling of tightness in my anterior hip capsule. Eve’s Lunge, preparation for Front Splits (on the Reformer), and Arabesque helped to open up this tightness.

My gluteal and piriformis muscles on the right became tender, and at times, in spasm. Rolling out these muscles with a foam roller and tennis ball alleviated muscle congestion and contraction. Stretching my piriformis (single leg stretches across the midline, and my #4 stretch) helped greatly. Ice, heat, and anti-inflammatories helped, but what helped the most was this…

Squats. I began doing exercises like the Russian off the end of the Trapeze Table. I focused on leading back into the squat with my pelvis, coming to a deep squat, and pressing my weight into my heels when straightening up to the start position. My legs were externally rotated 30 degrees, and I kept my knees over my toes during the exercise. I paid attention to the alignment of my hips, knees, and ankles one to the other. Once I mastered squats without issue, I began to work on more buttock exercises such as Front and Sideward Lunges on the Wunda Chair.

Posture. I had an anterior tilt of the pelvis that created tightness of my psoas muscle, and a weakness of my abdominal and buttock muscles. This, as well as some ligamentus laxity (sacrotuberous ligament) associated with my prior injury and anterior tilt contributed to dysfunction of the sacro-iliac joints at times. The laxity in my sacrotuberous ligament referred pain to the front of my right thigh. To help me through the acute phase, an S/I belt was valuable for stabilization of my pelvis.

I utilized Chiropractic adjustments, massage, and myofascial work to support my condition. However, the most important thing I did was re-training my gluteal muscles. I had always focused on the abdominals and spine, but had neglected the buttock. So, my new focus is on including training, strengthening, and stretching the buttock muscles in every session as well as strengthening the “core” in the usual manner.

By · Posted on October 8, 2011 · Topic Front Page, Sports Specific

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7 Responses to “Dead Butt Syndrome”

  1. Kristen Matthews on October 31st, 2011 3:48 pm

    Virginia,

    This is a great article! I seriously felt like you were talking about my body, minus your hamstring injuries, and a few other changes. The major point of dead butt syndrome is what I took away though. About a year ago I realized I had weakness in my glutes and started adding squats. I also started doing more glute work with my clients. For so long I stayed away, and realized it was the wrong thing to do. Thanks for the read!

    ~Kristen

  2. 7 Peculiar Ways Running Affects Your Body | Frugivore Magazine on March 14th, 2012 6:02 pm

    [...] called gluteus medius tendinosis — an inflammation of the tendons in the gluteus medius, one of three large muscles that make up [...]

  3. Sloan DeFilippo on May 3rd, 2012 3:19 pm

    Hi Virginia. I happened to find your blog while looking for releif of the same issues. The difference is I also had a labrum tear repair. I have been taking Pilates for a while now and have incorporated yoga as well as weights and biking. It seems that my left is constantly tight. I stretch and roll everyday. To date my hamstrings always feel like they r torn.
    I have added a 10 min low passive squat and that seems to just make the front of the hip worse, but everything else better.. and boy u r right about doing one legged exercises, as they flare my pain and locking up occurs after.. I have a reformer at home and have been offf and on it for a while as well. I would really love to find a routine to follow to get better but hav so much info and do not know where to start. And to top it off the left knee is also a problem. I have such a hard time doing any stretches where i put the left leg into a fig our four position. It has gotten better since I am aware of it but boy miss one day of stretching and it is like starting all over. SO to date I should say i am like what you were before you recovered. Any info would b so helpful. Thank you in advance.

  4. karen milton on September 1st, 2012 7:02 pm

    I dont know if i have dead butt syndrome but i have had ischial tuberosity bursitis and i had a cortizone injection for that it has taken nearly two months to get rid of all the inflammation in my bottom but i can finally sit so now my dilema is walking without a sharp pain in my butt. Every time i heal and i put a spring in my step i get this sharp pain my arse was so hard so i got down and did pilates exercises and i felt good so i did more and when i finially finished i got up and once again i put a spring in my step and the pain stopped me dead in my tracks but this time it felt different . I was standing when i realise i could not put weight on my left side so off i went to the physio and the next day i felt better so she said practice relaxed walking and i was going so good and then i must have extended my leg and this time i felt a throbbing in the top of my buttock and my hip so i immediately took a voltaren and went to bed . I have made an appointment with a orthapediac specialist to find out what is happening with the butt and the hamstring as i have had at least 10 episodes of sharp pain heal and then it does it again .

    To top it of i will tell you had i did this basically i had pulled a muscle and it hurt so off i went to the physio and it was healing and then i had a fall i went down this hill and i couldnt slow myself up until i pushed hrough with all my weight in to my body to stop me i felt pulls and twice in my sacrotuberous ligament and the jolt was so sudden it grabbed me and held me but the pain was so extreme i almost fainted i could not move my husband help me to the car and i sat down and i think i passed out in the car and i was wite with pain but after i collected my self i was able to get up on my feet and head to bed where i stayed with many voltaren and ice packs from then on i have had so many episodes of pulling and bursitis of hips and buttocks

  5. karen milton on September 1st, 2012 7:12 pm

    please remove this off your website as i dont want a community forum thank you

  6. Health Bits: Cause of Dead Butt Syndrome Is Lack Of Lower Body Muscle on September 24th, 2012 8:27 am

    [...] Butt Syndrome” is treatable by some physical therapy and a mixed regimen of muscle conditioning to encourage hip stability and [...]

  7. holly on February 13th, 2013 12:41 am

    I have clients with Piriformis Syndrome and generally work them on the reformer in “Neutral.” This article is very informative in working with the Anterior tilting of the pelvis with the Piriformis syndrome. I appreciate your sharing your experiments and the discovery of the various techniques in addressing the issues. It’s nice to hear this from a professional at your level with such clarity.

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