What to Do About Dead Butt Syndrome (Read This if You Sit All Day)

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“Dead butt syndrome” might sound like a quip from a cantankerous high school track coach — “Why weren’t you at practice yesterday? Develop a case of dead butt syndrome?” However, while it’s not a medical term, dead butt syndrome, also known as gluteal amnesia or more scientifically, gluteal tendinopathy, does describe a potentially painful medical issue that can actually be caused by too much sitting around on your butt. “The terms dead butt syndrome and gluteal amnesia have no strict medical meaning and loosely describe selective weakness of the buttock muscles,” particularly the gluteus medius muscle, says Evan Johnson, DPT , director of Och Spine Care Outpatient Physical Therapy at NewYork-Presbyterian in New York City. “Weakness and inhibition of the gluteus medius and other gluteus muscles is a common finding and can contribute to many painful conditions.” Usually, the main cause of dead butt syndrome is lack of exercise . “When you sit for very long hours at work and then you come home and sit, for meals and to watch TV, the gluteus medius is one of the muscles that tend to get lazy,” says Medhat F. Mikhael, MD , medical director of the Spine Health Center at MemorialCare Orange Coast Medical Center in Los Angeles and Orange County, California. RELATED: Just 15 Minutes of Exercise Can Help Counteract the Health Risks of Sitting All Day While neither dead butt syndrome nor gluteal amnesia is a medical diagnosis, gluteal tendinopathy, the preferred term, is a medical condition and refers to disorders of the gluteus medius tendon, explains Johnson.
What Causes Dead Butt Syndrome? Causes There are three muscles that make up the gluteus muscle group, explains Johnson. The largest is the gluteus maximus muscle, which is commonly referred to as your buttock (it’s the muscle you sit on). The other two gluteus muscles are the gluteus medius and minimus muscles. As a group, the gluteus muscles are responsible for hip extension (when you lengthen the front of the hip, as in walking) and hip abduction (when you move your leg out to the side). They are important for pelvic stability and lower limb (thigh and leg) alignment. “Weakness of these muscles may occur due to a sedentary lifestyle and may contribute to [less than ideal movement] patterns, stressing the hip and spine,” says Johnson. Too much sitting, for desk work or other reasons, can also play a role. “Someone who sits for an extended period of time or frequently and does not stretch, exercise, or walk briskly may develop tightness of the hip flexors,” explains Johnson. “This can result in inhibition and weakness of the gluteus maximus muscle over time,” and can lead to fatigue and injury. This is because if the hip flexors are tight, the hip extensor (gluteus maximus) has to work much harder to accomplish hip extension, he adds. The gluteus medius, meanwhile, is primarily responsible for hip abduction. When this muscle is weak (due to a sedentary lifestyle or other factors), it can affect your ability to hold the pelvis level when standing on one leg, says Johnson. When the pelvis isn’t held stable, it can drop on one side. This can cause stress and pain on the hip and spine as well as down the leg on the knee. “It is not so much that the muscle forgets (or gets ‘amnesia’), it is more that the muscle fatigues due to weakness and tendinopathy and cannot bear the load,” explains Johnson. RELATED: Is Too Much Sitting Bad for Your Health?
How Dead Butt Syndrome Feels How It Feels Gluteal tendinopathy typically manifests as chronic lateral (side) hip pain and tenderness, notes a review published in the Orthopaedic Journal of Sports Medicine . In some cases, it can cause debilitating hip pain. Siddharth Tambar, MD , a rheumatologist based in Chicago, says at his practice, people affected by gluteal tendinopathy “usually present with pain in the hips or having more fatigue,” which may cause them to think they have a pinched nerve. “Lateral hip pain may also sometimes be difficult to differentiate from a pinched nerve in the lower spine, but a thorough clinical evaluation and magnetic resonance imaging (MRI) can help clarify the pain generator,” adds Johnson. Gluteal tendinopathy can interfere with sleep (side lying) and common weight-bearing tasks, according to a review published in Sports Medicine . The condition’s hallmark hip pain is often dull and achy, according to a clinical commentary published in the International Journal of Sports Physical Therapy . Dead butt syndrome can also cause pain with walking and climbing stairs, according to the Orthopaedic Journal of Sports Medicine review. “Weight-bearing activities from walking to climbing stairs can be quite painful, as the gluteus medius muscle needs to work hard to perform these tasks,” says Johnson. “Pain with lying on the side is often a sign of bursitis of the hip. The greater trochanteric bursa lies directly below the gluteus medius tendon and is often inflamed with tendinopathy. Any direct pressure on this area may be painful, such as lying on that side.”
Who Is at Risk of Dead Butt Syndrome? Who’s at Risk Dead butt syndrome is an ailment of desk-bound white-collar workers, but usually the idleness goes beyond the workplace, says Dr. Mikhael. “You wouldn’t [typically] see this in a young person who is active during their off-hours,” he explains. Mikhael adds that the syndrome also affects people whose mobility is temporarily reduced due to illness, injury, or recovery from surgery. Strangely, the syndrome also plays out in a category of people who are highly active: Athletes, especially runners who neglect to focus on cross-training and strength training, according to the Cleveland Clinic . “ Running requires landing on a single leg repeatedly with great force exerted on the hip (up to 3 to 6 times your body weight),” explains Johnson. “If individuals have inherent muscle imbalances, poor foot and leg mechanics, or run repeatedly on uneven surfaces, they can over-stress the gluteus medius muscle and compensate with other muscles that contribute to greater imbalances and more stress. Over time the musculotendinous complex may become weakened and suffer small tears. This contributes to pain and increasing dysfunction.” Dead butt syndrome mostly occurs in middle age, and affects females more than males, according to the Sports Medicine review. Some insights into the typical dead butt syndrome patient can be gleaned from the Orthopaedic Journal of Sports Medicine review. Among 1,103 patients from 27 studies, the average age was 53.7 years. Women seem much more likely to develop the condition than men; the ratio of female to male patients was 7 to 1. The mean body mass index (BMI) was 28.3, which is in the “overweight” category of the BMI scale but not obese.
How to Prevent Dead Butt Syndrome Prevention Just as lack of exercise leads to dead butt syndrome, thoughtful, targeted exercise that optimizes muscle balance, core strength, and proper mechanics can prevent and reverse it, says Johnson. “There is no secret to it,” adds Dr. Tambar. “Move around more. Use a standing desk as opposed to a sitting desk. Get up and do some kind of daily exercise.” Johnson recommends performing exercises like clamshells, crab walks, side lying leg raises, squats , and step ups three to four times per week to strengthen the gluteal muscle group, but notes that “proper form is important to avoid perpetuating faulty movement patterns.” In general, you can begin with two to three sets of 10 repetitions for each exercise (increasing resistance as you get stronger), but Johnson recommends listening to your body and working at a fitness level that is appropriate for you. RELATED: The Best Leg Exercises for Stronger Glutes, Quads, and Hamstrings “Motion is lotion. Staying active is the best medicine for deconditioning and weakness,” he adds. “Getting up regularly from your desk is essential for good back and hip health.” Consider setting a timer to remind yourself to get up from your chair to stand up and move or stretch every 20 minutes or so. RELATED: 8 Ways to Sit Less and Move More Each Day
How to Treat Dead Butt Symptoms Treatment If you’re having symptoms of dead butt syndrome, a sports physical therapist may use several tests to diagnose or rule out gluteal tendinopathy, according to the aforementioned clinical commentary. MRI or ultrasound may also be used. Management of dead butt syndrome commonly involves corticosteroid injection, exercise, or shock wave therapy, with surgery reserved for stubborn cases, according to the Sports Medicine review. Most important to treatment is acting immediately. “Dead butt syndrome is a progressive problem,” says Tambar. “When the muscles are not being used as they should, the issues tend to add up.” Failing to seek prompt treatment can lead to issues like hip osteoarthritis , progressive tendinopathy, and chronic hip bursitis, adds Johnson.
Research Into Dead Butt Syndrome Research One study with 204 participants experiencing hip pain because of gluteal tendinopathy found that a mix of exercise and education was more effective in reducing pain than corticosteroid injections, and both were more effective than no treatment. Another study found that platelet-rich plasma injections offered better short- and long-term results than corticosteroid injections. A small Italian trial of 50 people found some effectiveness of shock wave therapy. Tambar says that, in most cases, the best course of treatment is to analyze your lifestyle. “I think if you have this condition or have these symptoms,” he says, “you should be aware of how you are living.”

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