No, your butt isn’t really dead (thank goodness!), but it is inflamed, says Pamela Peeke, M.D., fellow with the American College of Sports Medicine and the author of Body for Life for Women. The technical name for this problem is gluteus medius tendinopathy, and it’s common in runners who do a lot of forward motion without much lateral, or side-to-side, movement. When combined with endless hours of sitting, which most of us do at work and home, our glutes—especially the gluteus medius—get weak.
“The gluteus medius is that middle muscle in your butt that you need for stability and support,” Peeke says. “When it’s weak because you haven’t done enough cross training or strength training and you go for a run, it can tear.”
The good news is that the problem is fixable, says Peeke. Depending on the severity of the pain, you might need to back off your typical routine and embrace the R.I.C.E. protocol—rest, ice, compression, and elevation.
Once the acute phase has passed, introduce some cross training by hopping on the elliptical machine or swimming laps in the pool. Getting a deep tissue massage can also help by breaking up scar tissue. To keep dead butt syndrome from becoming a recurring problem, incorporate specific glute-strengthening exercises into your workouts.
The following routine was designed by Dat Quach, DPT, a physical therapist at Anne Arundel Medical Center in Bowie, Maryland. The exercises are grouped into phases that become progressively harder. Start with phase one exercises, focusing on perfecting your form and completing the series with minimal fatigue. Once you can do the phase one exercises without pain for a week, move on to phase two, and, ultimately, phase three.
These movements could be integrated into your strength-training routine, but doing them before a run to fire up your glutes is a great idea, too. Aim to get through these exercises three times a week.
Phase One Exercises:
Side-lying clamshells: Lie on your side with one hip stacked on top of the other. Bend your knees to 90 degrees. Keeping your feet together, lift your top knee away from your bottom knee without rolling your body. Work up to being able to complete 50 on each side.
Side-lying hip abduction: While in the same position as the clamshells, extend your top leg while keeping your bottom leg bent. Lift the top leg away from the ground while pulling your toes toward your nose. Do two sets of 20 repetitions on each side.
Side plank: Lie on your side with your legs straight. Prop your body up on your elbow and raise your hips until your body forms a straight line from your ankles to your shoulders. Hold for 60 seconds. Repeat on the other side.
Phase Two Exercises:
Side-plank clamshells: To get into the starting position, push yourself up into a modified side plank with your body resting on your knees and forearm and with knees bent at a 90-degree angle (your weight will be on one elbow and your bottom knee). From here, perform the clamshells as described above. Do two sets of 20 repetitions on each side.
Side-plank hip abduction: Start in the same position as the side-plank clamshell. Perform the hip abduction exercise as above (you can either keep the bottom knee on the ground or you can raise into a full side plank). Do two sets of 20 repetitions on each side.
Phase Three Exercises:
Side walks: With a medium to light resistance band tied around your ankles, walk sideways for 10 feet, pause, then walk the other direction. Repeat.
Lunges with a single dumbbell: Hold a single dumbbell in one of your hands, step forward with one leg, and lower your back knee to the ground. Alternate legs and repeat for 10 reps.
Split squat with a dumbbell: Stand on your left foot and prop your right foot behind you on a chair or bench. Maintaining control, bend your left leg and lower your right knee toward the ground. Do two sets of 15 repetitions on each side. Once you get the hang of the exercise, do the single-leg squats while holding a dumbbell in the hand opposite of the leg being worked.