Life can be complicated.
“What did we have for dinner last night, Honey?”
Who hasn’t had someone roll their eyes at them as they struggled to pull a simple fact from their short term memory, and failed? Our brains suffer temporary amnesia on occasion – I get that.
It was a bit of a shock, however, to learn that the same thing can happen at our other end. Call it what you wish: gluteal amnesia, gluteus medius tendinopathy, or the most recent trendy label, “Dead Butt Syndrome” (DBS). Even Stephen Colbert took notice this week:
Simply put, if we spend too long at one time sitting—think driving for a couple hours, watching a long movie, or, most commonly, hunched over a computer screen—our glutes become lazy and unfocused, and forget what their main function is, namely to support our pelvis and keep our body in proper alignment.
Both are critical to dynamic movement and upright stability. This inactivity causes our gluteal muscles to lengthen and weaken, and our hip flexors to tighten.
Gluteal amnesia has been known and understood by the medical profession for years. Long-distance trucking and office jobs that require sitting at a desk poring over spreadsheets forever aren’t new. However, the quickly growing number of us that spend our time sitting, for work and entertainment, has changed, making recognizing and understanding the potential dangers of DBS important to all of us.
The major gluteal muscles are the gluteus maximus, medius and minimus, with some including hip flexors.
The gluteus maximus is thick and fleshy, and being the bulkiest of glutes, provides most of the shape and form of our buttock area.
The gluteus medius works with our hip flexors to control the rotation and flexion of the hip, such as motions that bring the knee closer to the chest like climbing stairs or making a soccer-style forward kick.
The gluteus minimus is our hip stabilizer and abductor, responsible for moving our hips and legs laterally out to our sides. The minimus is also the primary conduit for the superior gluteal artery and superior gluteal nerve, both critical to keeping our lower half functioning properly.
Hip stability, a healthy gait, better balance, improved athletic performance and injury resistance if we fall are all benefits of a strong gluteal minimus.
At the connection points to various skeletal joints, tendons and other muscles, our glutes are integrated with bursas, the thin, lubrication-filled sacs which reduce frictional wear and tear.
The thing is, these muscles only work as above when force is necessary, such as straightening from a bended position, getting out of a chair, a vehicle or from other seated positions, walking, running or climbing stairs, etc.
The thing is, these muscles only work as above when force is necessary
If gluteal muscles sit or lie down for too long, they get amnesia. You will notice this as stiffness or even temporary imbalance when arising after sleeping, or first standing after extended periods of sitting.
Initial symptoms that you need to move or stretch because of gluteal amnesia can include numbness or soreness in your butt after a long sit. Ignoring these signs may lead to more serious symptoms, including pain in your hips, lower back and knees, and a shooting pain down the leg similar to sciatica.
In the worst cases, painful tendonitis of the gluteus medius tendons and bursa inflammation (bursitis) can set in.
Counter-intuitively, distance runners, cyclists, and other athletes who attempt long bouts of strenuous exercise after prolonged periods of sitting or inactivity are at especially high risk. Without extensive cross-training and resistance exercise to balance their bodies, gluteal amnesia is possible.
For most of us, gluteal amnesia is a health issue to be conscious of rather than worried about, given that preventive strategies are generally simple and effective for mild cases. Movement that will stimulate blood flow and nerve action in the tight areas is key, and there’s no shame in setting a reminder alert on your watch, phone or computer to do so every hour or less.
Climbing stairs is effective, and also provides cardiovascular and weight-bearing or resistance exercise at the same time. Simply squeezing your butt, or cheek, muscles while standing with your legs hip-width apart 15 or 20 times can be done in the office or mixed company, and is useful. Lateral leg kicks, stationary marching and squats will attract a bit more attention, but engage your gluteus minimus and thigh muscles beneficially. If you have the time, a short walk works too.
For those who are especially active in certain sports, dance, hiking or want more protection from dead butt, specific exercises designed to maintain the strength and flexibility of glutes and hip flexors are recommended. Glute or back bridges, hamstring stretches, leg and high knee lifts, more intense lateral kicks and Sumo squats will all help.
Beyond exercise, for those who can’t avoid extensive computer time, alternating between sitting, standing and even a kneeling chair can help avoid glute problems.
As we age, there is an additional reason to avoid gluteal amnesia – its impact on hip surgery and hip replacement.
The American National Library of Medicine states, “The gluteus maximus muscle has importance in surgical approaches to the hip joint.” When the time arrives for a hip replacement, the options of choosing a posterior, lateral or anterior surgery may be impacted by the strength of our various glute and hip flexor muscles. (The specific advantages and disadvantages of each type of surgery are debated, and are well beyond the scope of this column.)
At the most basic level, good muscular and tendon health contribute to speedy and satisfactory recovery.
How ahead of her time was my mom when she told me 60 years ago that I needed to get off my butt and do something.
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