A pain in the butt! But what exactly causes your buttock pain?
This article looks at the common causes of buttock pain and will explain the anatomy, symptoms, treatment and exercises that you can be doing for the pain to go away.
Understanding the anatomy and function of the buttocks and glutes is key to becoming more knowledgeable and preventing/reducing any pain.
Once you have a good basic education in regard to the gluteals, then this can help you to prevent future episodes of buttock pain or even self-manage buttock pain.
The glutes are the largest muscles within the human body. They are key to everyday function and even more important to sporting performance.
The glutes are not only responsible for the movement of the hip but also help with back and knee movements.
Let’s take a look at what makes up the buttocks and the exact functions.
The buttocks sit on and attach to the pelvis and the thigh bone which make up your hip.
This is the lower part of the trunk and consists of 2 hip bones that connect to the lower parts of the spine which are the sacrum and coccyx.
The pelvis has 2 openings called acetabulum – which is more commonly known as the hip socket and this is where the head of the femur fits in to form the hip joint. The upper parts of the pelvis are known as the iliac crests and these also act as attachment points for the gluteal muscles.
This is more commonly known as the thigh bone and sits tightly within the hip socket and offers a good range of movement to the hip and also various attachment points for a lot of the buttock muscles.
Gluteus Maximus – this is the largest of the buttock muscles and is the most visible muscle of the buttocks. The glute max – inserts on to the upper edges of the illac crest at the back of the hips, runs around to the lower section of the back and its insertion points are on to the femur and also merging in to the illitobial band (ITB) which runs down the lateral aspect of the leg.
Functions: extension and lateral rotation of the hip, and also to extend the trunk and back.
Gluteus Medius – this is much smaller in comparison to the glute max muscle. It originates on the iliac crest also and sits underneath the glute max. It attaches down on to the outside surface of the greater trochanter, which is an attachment point of the femur on the outside of the hip.
Function – The anterior section works alone to flex and internally rotate the hip. The posterior section helps to extend and externally rotate the hip. The anterior and posterior parts working together abduct the hip and stabilize the pelvis – especially in one legged standing / balance.
Gluteus Minimus – a small fan shaped muscle which again attaches to the outer part of the illium and attaches to the greater trochanter
Function – its main purpose it to abduct the hip (taking away from the body) but also helps with assisting flexion and rotation of the thigh. It also has a big role to play with one legged/balance type stability.
These are the main muscles of the buttocks and there are other smaller muscles which assist these to do their jobs.
Important notes to mention regarding the buttocks and gluteals – there is a main branch of nerves running through the glutes. These can be responsible for causing some buttock pain such as sciatic type problems. The sciatic nerve and superior gluteal nerve run through the buttocks.
The tendon attachments of the buttocks which are at the outer part of the hip are also a common source of pain and dysfunction. This is due to poor blood supply and poor conditioning due to modern day lifestyles. Take a read of the causes of buttock pain to gain a better understanding.
Buttock pain can vary in the way that it onsets but here are a few examples of how it can affect you:
- Pain to touch or pressure – pressing in to the soft tissue of the buttock can be tender but also compression of the buttock can result in pain developing.
- Pain on movement – using stairs and walking, because they are highly hip dependent can cause pain.
- Night/bed pain – when lying on to the buttocks or moving around in bed, the compressive nature of doing that can cause irritation of the glutes.
- Poor balance – because a lot of the gluteal muscles are key to balance and stability of the pelvis, you may find a loss of balance when performing one legged stance movements
- Loss of muscular power – when pain is present in a muscle it can mean a reduction in power so this can affect the performance of the buttock.
- Nerve pain – this can vary in how it feels but it can often be intense and difficult to manage. Nerve pain is common in the buttock due to the nerves that run through it.
Hip OA – osteoarthritis of the hip is when the head of the femur and socket of the hip lose their smooth surface and cause a rough surface to develop which can cause pain and stiffness. Pain from this typically radiates through the groin and in to the back of the buttock.
Piriformis Syndrome – this is caused by the tightness of a small muscle in the buttock region which can cause dysfunction, pain and even nerve compression. This can be common in runners and can restrict your running performance and sitting comfort.
Sciatica – is a condition which stems from the nerve in the back but can produce pain in the buttock and the back of the thigh and run the whole length of the leg due to where the nerve is positioned. The buttock pain from sciatica can be quite intense.
Gluteal Tendinopathy – tendinitis or tendinopathy is when tendons become irritated and inflamed. This produces weakness and pain. The gluteal tendons can become sore at the outside of the hip but produce pain in to the main area of the buttocks.
Groin Injury – the groin when injured can produce an imbalance of the pelvic region placing more stress on the buttocks and this can make them overworked and tender.
Back Pain – whenever the back has pain in it, this can also produce buttock pain. This is due to the close relationship the buttocks have with the back. The buttocks help to assist with back extension and if the back is not working, the buttocks can be placed under stress causing them to develop pain.
Knee Pain – because some of the glutes extend down toward the knee and also help to stabilise and rotate the femur, when you have buttock pain this can actually affect the knee causing pain and poor control.
Physiotherapy – going to see a physiotherapist for buttock pain can help you to find the exact cause of your buttock pain and they can provide you with a rehab plan but also passive treatments and manual therapy techniques to treat your buttock pain.
Myofascial release/Foam Rolling – the use of foam rollers and soft tissue release tools can be a great way to take the tension out of your buttocks. This can be a foam roller, a hockey ball or a spikey ball. Rolling on to this can help to reduce pain temporarily and give reduction of tension of the muscle
Pain Relief – use of medication helps to reduce pain levels. This can particularly helpful for troublesome nerve pain which is sometimes difficult to manage. Consider pain relief when your symptoms are high and it affects how you are moving.
Heat – hot water bottles, heat creams, hot baths – all are great at relieving pain and relaxing the muscle and improving circulation to soft tissue.
Shockwave therapy – this is a great way to accelerate the healing of soft tissue, especially the tendons which can take longer time periods to heal and resolve.
Acupuncture – needles based therapies are good for reducing tension in muscles and improving pain.
Exercises and Rehabilitation
These are the best buttock exercises which can help to prevent pain in the glutes but also to treat any symptoms that you may be having.
These are all simple exercises that you can perform at home without equipment. If you are new to exercising this area then you should focus on bodyweight initially before progressing to further equipment or weight.
- Pigeon Stretching – this stretch applies to the outside of the hip and addresses the external rotation of the hip which can commonly be restricted due to excessive sitting.
This stretch involves coming in to a lunge position and placing your foot and outside of the shin to the ground and dropping your weight on top to stretch the outside of the hip.
Stretching is best when done for more than 2-0 seconds at a time.
- Hip Flexor Stretching – stretching the front of the hip can help to reduce the feeling of tightness and provide balance for the buttocks.
Place yourself in a long lunge position and lean in to your front leg until you can feel the front of the hip stretching.
Hold for a minimum of 20 seconds.
- Adductor Stretching – The adductors are the side of the thigh and groin and can also have an effect on buttock pain.
Stretching your adductor can be done in standing, with a wide stance. Simply transfer weight to one side and keep the other foot on the floor.
Stretch for a minimum of 20 seconds until you have a comfortable pull within the inside of the thigh.
- Bridging – one of the best exercises for the buttocks and lower back. Lying flat on your back, push through the feet and raise your hips as high as possible. Hold at the top for 5 seconds. This can be done as a double leg or single leg exercise.
- Hip Abduction – lying on your side – perform raises of your leg, hold for a few seconds and lower. This can be made more difficult with resistance bands.
- Adductor Strengthening – a simple way to strengthen adductors is to get a ball or cushion, place between your knees and squeeze for 5-10 seconds. Repeat until tired.
- Step Ups – using a stair or a box, simply step up and lower down. The hip extension in this movement helps to strengthen the glutes. The higher the step, the better it is for the glutes.
- Lateral Step Ups – stepping up on a sideways plane really helps to strength the outside of the buttock and supports healthy tendons – this is best done very slowly and in a controlled manner.
- Single leg balance – with a slight bend in the knee, stand and balance for as long as possible. This switches on the smaller muscles within the buttocks and stabilises the pelvis.
Thank you for taking the time to read our guide to buttock pain. If this has been helpful, please share it with someone you know.