You Can do Side Bends or Sit-ups, But Please Dont Lose That Butt


Is one muscle group more important than another for athletes? Popular culture might lead us all to believe so. As it goes with most of the medical education we receive from pop culture, it turns out that this may not be the truth.


In 2010, the New York Times wrote this blog about Dead Butt Syndrome. Ever since then all I hear about is how someone’s weak glutes are the cause of all their lower extremity pain. It is a well-known fact among my friends and colleagues that I can and do talk about the glutes—i.e. the butt—all day long. Working primarily with endurance athletes, I have no choice.


As a physical therapist I often agree that weak or inhibited glutes are a component of the problem. Research has proven this; however, we cannot blame the glutes for everything. The glutes, otherwise known as gluteus medius, gluteus maximus and gluteus minimus, are pelvic stabilizers, hip rotators, abductors and extenders. Along with these muscles, it is the coordination of these muscles with other body systems that allows for standing, walking and running to be possible.


So if it’s not all about the butt, then the question remains: why then does your hip, knee, lower back, foot or hurt? If it is not just those pesky glutes, what else could cause your injury? The answer varies depending on the afflicted body part. What we do know is that it’s usually a combination of impaired motor control, spinal inhibition and dysfunctional movement patterns. These are all good answers.


Motor control is like human software: it’s essentially how a person is able to activate, coordinate and fine-tune the movement of the various pieces of their kinetic chain using the brain, nerves, and musculoskeletal system together. If a person has impaired motor control, the brain and muscles may not be properly communicating, which would lead to inhibition, or sleepiness, in the muscles. This then can lead to dysfunctional movement patterns and possibly pain.


The root cause of an injury can come from the top-down or the bottom-up. This means that the problem could come from dysfunctional patterns above or below the site of injury. Nothing in the body works alone. Each muscle, joint, ligament, tendon and bone relies on its surroundings—near and far--to do its job. They are all connected like a “chain.” The glutes are only one part of that kinetic chain


If you have been diligent about strengthening your glutes and the results are dismal, then don’t lose hope just yet. It may be that your glutes are strong, but have to be “re-trained” because they are sleepy and not working together well with the rest of your “chain.’ Or it could be that the root cause of your pain is somewhere else along the kinetic chain. Here are some scenarios that may depict these concepts. Do any of them sound familiar?

  • Maybe your hip flexors are too tight. This will make it difficult to extend your hip to properly push off while running. This could then cause your quadriceps to overwork and increased the stress and strain at your knee, hip or lower back. It also will keep your glutes from being able to do their job well.

  • Perhaps you have tightness or stiffness at the foot/ankle. This will make it difficult to dorsiflex your ankle leading to difficulty pushing off. As I mentioned above, the glute is integral in push off.

  • Ever heard of overpronation? No, I’m not talking about regular pronation (that’s a good thing!). Going along with the point above- if you cannot dorsiflex your ankle you may overpronate to compensate which can lead to posterior tibialias tendonopathy among other issues. And oh by the way-you guessed it, overpronation impairs your glutes’ ability to properly function.

  • Inhibited core muscles: Just like your glutes, your core muscle may be sleepy, too. If your posture or breathing pattern is less than optimal you may not be properly utilizing your core. And oh by the way- your glutes rely on proper strategy in use of the core muscles.

The list goes on and on! As you can see—it’s not all about the glutes, after all. All or some of these problems could contribute to your glutes not working properly. From one glute lover to the next, strengthening one muscle group will not completely rehabilitate an injury, prevent injury or optimize performance. The body is a complicated system that relies on coordination of movement, flexibly, mobility and strength.


Now that you understand it’s not all about that bass, you may be thinking “so what you’re saying is, it’s a lot more complicated than these squats I’ve been doing to strengthen my glutes.” Yes! Yes it is. So what do you do about it? Here are some general recommendations.

  1. Go to Pilates. You can learn to efficiently control your movement and improve some of your muscle imbalances with Pilates. Not only will it make you stronger and a more efficient runner, but it will also give the few overworked muscles some deserved rest, not to mention it counts as cross training!

  2. Participate in the Functional Movement Screen (FMS) by a certified practitioner. You may be able to find these experts at your local gym, running store, athletic training room or PT office. This will help break down typical movement patterns, identify “weak links” in your movement chain, and--if you are lucky--give you guidance for a more well-rounded and specific exercise program. You can find a certified practitioner here.

  3. Get a video gait analysis. Have an expert watch you run from all angles to see if there are any adjustments that could be made in your form to optimize performance, improve efficiency of movement and curb injury. Usually this can be done by specialized running coaches, performance consultants and physical therapists.


Now that you’re armed with some tools to help balance out your body, it’s time to get started! If you find that you cannot do it on your own, then see a physical therapist that specializes in treating runners and recognizes that one muscle group is not more important than another. Once you’re balanced, maybe then you’ll get that desired butt enhancement you’ve been longing for—but perhaps more importantly feel the results in your running.

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