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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Dormant Butt Syndrome

Published June 2, 2016 10:12 AM by Dillon Stickle

There are many reasons a person might be experiencing chronic pain - improper posture, poor work ergonomics and repetitive stress, and recurring injuries to name a few. But a less obvious reason is making its way into the spotlight: Dormant Butt Syndrome (DBS). In an article from the Washington Times, Dr. Chris Kolba, a physical therapist at Ohio State University's Wexner Medical Center, claims that DBS, a condition in which weakened glute muscles do not perform the way they should, may be the cause of chronic pain in anyone from professional athletes to office workers.

In the article, Kolba stresses that "The rear end should act as support for the entire body and as a shock absorber for stress during exercise. But if it's too weak, other parts of the body take up the slack and often results in injury." He said that the main causes are sleeping in the fetal position and sitting for long periods every day; after all, sitting is the new smoking.

So, what do we do about our weakened, inefficient gluteus Maximus? Kolba has two suggestions: keeping our hips mobile with stretching and flexibility exercises, as well as strengthening our glutes with strength training exercises like squats or lunges.

PTS, have you had any patients with chronic pain who might have DBS? What treatments would you recommend? Do you think DBS might be the underlying cause of chronic pain in millions of Americans? Do you disagree with Kolba's claim? Let us know in the comments!

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I agree with the above post, that glut weakness may be a contributing factor to movement dysfunction, along with many other impairments resulting from faulty movement patterns. It is important for us to address these movement patterns which will be individual to the patient and train these muscles in a functional way. However, for a large majority of patients with chronic pain a lack of physical activity in general could be a larger culprit, or contribute to this "dormant butt syndrome". Additionally, repetitive stress or prolonged abnormal postures are more likely to correlate with chronic back pain than glut strength alone. Current evidence and clinical outcomes are supportive of general exercise and repetitive movements in addition to traditional core stabilization, stretching, strengthening, and manual therapy. Another supported adjunct to traditional therapy includes clinical pain science education/cognitive behavioral therapy, which may prove more beneficial to address those patients dealing with chronic pain.

Blaire, SPT April 18, 2018 4:36 PM

Although while I agree clinically that the glutes tend to be weakened in most patients, particularly those with low back pain, they often times are strong functionally. By this I mean a patient may present with weak hip abduction/external rotation/extension on manual muscle testing, yet they are able to adequately perform exercises such as sit to stand, stairs, etc. This leads me to question our muscle testing positions, but that is another topic. Perhaps we need to rethink that “Dormant Butt Syndrome” is more than just isolated weakness or decreased flexibility and more of a neuromuscular problem associated with faulty movement patterns. We can prescribe all the squats, lunges, hip flexor stretches, and any number of other exercises for our patients, but this will not necessarily fix their chronic pain if they continue to move in a pattern that is faulty. We must retrain people’s movement patterns. In other words, we must find the root of the patient’s problem, which is often times more than decreased strength and flexibility, or purely a “dormant butt.”

Eric Kosco, SPT February 25, 2017 4:33 PM

I deal with dormant butts all the time.  I use exercises from "Make All of the Right Moves"  to re-educate the gluteal muscles BEFORE trying to do any kind of strengthening.

Brian Lambert, PT - PT, Owner June 10, 2016 12:54 PM
Charlottesville VA

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