‘Dead Butt Syndrome’ – SAY WHAT?! There are more and more articles coming out, especially in recent months in light of our global pandemic, about a supposed ‘dead butt syndrome’, or ‘gluteal amnesia’. This condition is thought to be characterized by a person’s body ‘forgetting’ how to ‘turn on’ or ‘fire’ a gluteal contraction due to extended periods of time in a seated position. But can this actually happen? If it does happen, how does this actually happen anatomically? Can our glute muscles actually ‘forget’ how to activate properly? Do long periods of sitting actually have an effect on our muscle mass, appearance, and strength? In this article, we explore the validity of gluteal amnesia about how to turn on your glutes as well as provide you with exercises that will actually target your glutes!

 

What are the glutes?

The gluteal muscle group, known as the “glutes” for short, is actually composed of three muscles, the gluteus maximus, gluteus minimus, and the gluteus medius. These muscles make up our buttocks region and are responsible for hip extension, abduction, and internal and external rotation. They originate on the ilium (rounded portion of the hip) and extend to the greater trochanter (rounded upper portion of the femur).

Gluteal Muscle Anatomy

From West Coast SCI

 

Functionally, the glute muscles are responsible for keeping us in an upright stance and position and help us to perform functional activities such as the squat, lunge, walk, and climb stairs. They are often directly or indirectly linked to a person’s overall strength and fitness and are common muscle groups that are trained in a gym setting.

 

Looking For Help With Your Hips?

The Hip [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your hip health. This program will expose you to various hip and lower body strengthening and stabilization exercises supported by science. Learn more HERE!

 

Nerve supply to the glute muscle group is the superior gluteal nerve. This nerve helps the muscles stabilize the pelvis, especially during walking and physical activity. When unloaded contralaterally, the muscles contract to help prevent hip drop, also known as the Trendelenburg sign. Learn more exercises to fix Trendelenburg gait HERE!

Superior Gluteal Nerve Muscle Anatomy

 

Is Glute Amnesia Real? – Nerve Injury Anatomy

Have you ever sat so long that your legs start to ‘fall asleep’? What you are experiencing is a compressive type nerve injury, and there are a few reasons why this can happen. Sustained pressure on an area causes what is known as neuropraxia. In this scenario, there is a small amount of focal damage to the myelin sheath, or the ‘outer covering’ of a nerve. The electrical supply remains intact, and the nerve is still able to conduct impulses to contract our muscles. The sensation usually subsides when we shift positions to alleviate pressure or get up and move around. The myelin sheath has the ability to repair itself over time, causing no symptoms or issues with muscle bulk (4).

Nerve Injury Grades

 

If there is sustained pressure on a nerve over a period of several hours or days, or worse, a direct traumatic injury to a nerve, more significant damage can occur. Examples of these are a crush injury, double crush, or palsy. In these examples, the electrical supply (axon) of the nerve is damaged, and the person will be left with longer-lasting symptoms such as chronic numbness and tingling, gait and mobility issues, or inability to use their damaged limb.

Why do we mention this? What we experience when we sit for extended periods of time throughout the day is a mild insult to the nerve and not sustained damage that is irrecoverable. We have the ability to naturally shift and change our positions to alleviate sustained pressure. We naturally do not sit perfectly still unless we have a pre-existing condition that forces us to do so. Therefore it is unlikely that we are providing enough sustained pressure to our superior gluteal nerve at any given time to impair the electrical supply from the nerve to the muscle, which causes muscular atrophy (muscle wasting).

Great news! Youre glutes cannot simply turn off!

Now, this is just one factor when we consider all of the potential adverse effects that prolonged sitting can have on our bodies. We examine a few of these factors below.

LISTEN: TALKING GLUTES WITH BRET CONTRERAS

 

Does posture and desk setup matter?

Especially in light of a global pandemic, more people are working from home than ever before. Also, in light of an ever-increasing digital world, there are more and more people who are sitting doing computer work for large portions of their day. In one study by Daneshmandi et al (3), it was found that study participants (office workers) spent 6.29 hours in a seated position during their 8-hour work day shift. Health outcomes tracked over time showed that half of the participants were uncomfortable with their workstation, ¾ of them were exhausted throughout the day, 6.3% suffered from high blood pressure and high cholesterol, and ½ of the participants reported neck, back, and shoulder pain after their workday was completed. The musculoskeletal changes that can happen when we sit for prolonged periods of time can be profound, to say the least.

Is Sitting The New Smoking?

 

Does age matter?

It appears as though these metabolic and musculoskeletal changes from prolonged periods of seated time can affect any individual, regardless of age. In one study by Reid et al (6), community-dwelling older adults (ages 65-84) were studied. Total daily sitting time was associated with a lower percentage of lean mass and a higher percentage of body fat, as well as higher blood markers for inflammation. Students and younger individuals were examined in a study by Yoo et al (1). A similar trend was found, namely that increased smartphone use was associated with linear decreases in physical activity and general fitness, as well as increases in body fat percentage.

In short, ANYONE is susceptible to posture-related musculoskeletal changes!

 

Effects on muscle mass and function

It has been shown in recent research (2, 5, 7) that sitting is correlated with lower body muscle mass, composition, and function. A few factors that have been studied include:

• Deconditioned workers and those with sedentary jobs have impeded blood flow to the glutes and other musculature that prevents blood vessels from dilating fully. Nitric oxide builds up in the muscles, leading to early fatigue and feelings of exhaustion. This can also manifest as PAIN, and fatigued muscles are more likely to be subject to overuse injuries and strains.

 

• Due to a lack of vascularization, muscles start to lose their mass and size. The mitochondria, cells that act as a ‘powerhouse’ for the muscle, actually start to shrink, leading to overall muscular weakness.

 

• Lack of muscle elasticity and stretch can occur as well. The sarcomere, which is the cellular material that allows the muscle to have its shape, shortens during activity, which contributes to stiffness.

 

It is no secret that increased amounts of sitting is on the rise, and therefore, so is the risk for musculoskeletal impairments and pain. More good news – WE ARE HERE TO HELP!

 

The Prehab membership is the anti-barrier solution to keeping your body healthy. Access state-of-the-art physical therapy, fitness programs, and workouts online in the comforts of your own home or gym! Taking control of your health with exercise & education from the palm of your hand has never been easier. Get access to 50+ programs, 100+ unique workouts, and 3000+ exercises to build your own workout routines. Trial it for free, and learn how to get out of pain, avoid injury, and optimize your health with [P]rehab!

 

What can we do to help?

Physical therapists, healthcare providers, employers, trainers, and others can help their patients, friends, and coworkers “STAND UP!” to better health and decrease their sedentary lifestyles. We know that movement, activity, and exercise are the best prevention against chronic disease and metabolic issues that can arise from far too many hours in a seated position. What’s important to understand is that sitting itself may not be the actual bad guy – but the sedentary behaviors associated with sitting are to blame! Here are a few helpful tips from us!

 

To better feel your glutes, move & EXERCISE!

Motion is lotion, as they say, and there are extensive benefits to a personalized and safe exercise program. Here is a free, glute-focused exercise program to help that muscle group be strong and stable!

Seated Glute Stretch

Sample Hip [P]rehab Exercise Video

• HOW: Start in a seated position with your feet flat on the ground. From here, lift one knee off of the ground grabbing onto it with both hands and pulling it towards your chest. Perform x3 each side, 30 seconds hold, 3-4 days a week

 

• FEEL: You should feel a stretch in your glute.

 

• COMPENSATION: Don’t lean back as you stretch, stay upright.

 

Hip Thrust

Sample Hip [P]rehab Exercise Video

Begin by placing your upper back on an elevated bench surface. Your shoulder blades should be just above the edge. Have your feet shoulder-width apart and flat on the ground. Your knees bent with your feet slightly behind your knees. Push into the ground lifting your hips straight up. Stop when your hips are in line with your knees. Hold that position for a few seconds and then slowly return to the starting position. Perform 3 sets, 15 reps, 3-4 days a week.

 

Rear Foot Elevated Squat

Face away from the high TRX anchor and place one foot in both of the loops. The loop should be around the middle of your foot. Keep all of the weight on the standing leg. Bend the knee as you slightly bend your chest forward putting all of your weight into the knee. Push into the ground and return to the starting position. Perform 3 sets of 10 reps each leg, 3-4 days a week can hold a dumbbell or kettlebell to progress

 

Side Lying Clam

Sample Hip [P]rehab Program Exercise

Begin by lying on your side with your leg together. Slightly bring your knees up towards your chest. From here, rotate the top knee up while your feet stay together. Bring that knee up as far as you can until you start to open up your hips and rotate back.  Perform 3 sets of 10 reps each leg, 3-4 days a week, can add a resistance band if desired.

Want to improve your glute med strength? Look at this infographic that shows the best 3 glute med exercises based on EMG!

 

3 Best Exercises For The Glute Med

 

Deadlift With Kettlebell

Set up a kettlebell in between your feet closer to your heels than your toes. Hip hinge and grab the KB with both hands. While keeping your back and neck straight, push the floor away using your legs and stand tall while keeping your shoulder blades squeezed back. Then hip hinge again and lower the weight down towards the ground and repeat. Ideally, the kettlebell should move in a straight line up and down. Perform 3 sets of 15 reps, 3-4 days a week

 

INVEST IN A STANDING DESK

If you are an office worker or are currently working from home, it is a great idea to talk to your employer about a standing desk. Standing desks allow you to continue your work while having a break from being in a seated position, and help with offloading your joints and muscles from stress. Just as we don’t want to spend all day sitting, we don’t want to spend all day standing either, so you’ll want to be sure you move between positions frequently!

Do you find yourself sitting for long periods of time and getting sucked into the computer screen? Slumped shoulders and sore back? You are not alone! Our Posture [P]Rehab Program will help you learn the truth about posture, master your own posture, and help you feel great at work!

 

Closing Thoughts

As we have seen, there are a variety of factors that can contribute to overall glute muscular strength and function, with one of the biggest of these being a prolonged seated posture and a sedentary lifestyle. What Stuart McGill originally coined as “gluteal amnesia” can likely be better called “gluteal inactivation” or “loss of functional hip integrity”. It is not that the glutes “forget” how to fire, but rather it is likely that our posture, positions, and even low back pain are contributing negatively to our musculoskeletal function, leading to pain and other issues. We know that movement and activity are keys to keeping our glutes ALIVE and healthy, and to decrease the risk for other issues in the future.

 

Full Hip Programming At Your Fingertips

Our Hip [P]rehab Program puts a ton of emphasis on developing the glute muscles, as well as all-encompassing hip exercise programming. Click here to learn more!

 

References

1.Yoo et al. Relationship between Smartphone Use Time, Sitting Time, and Fitness Level in University Students. Exercise Science. 2020; 29(2): 170-177. https://doi.org/10.15857/ksep.2020.29.2.170

2. Keadle SK, Conroy DE, Buman MP, Dunstan DW, Matthews CE. Targeting Reductions in Sitting Time to Increase Physical Activity and Improve Health. Med Sci Sports Exerc. 2017;49(8):1572-1582. doi:10.1249/MSS.0000000000001257

3. Daneshmandi H, Choobineh A, Ghaem H, Karimi M. Adverse Effects of Prolonged Sitting Behavior on the General Health of Office Workers. J Lifestyle Med. 2017;7(2):69-75. doi:10.15280/jlm.2017.7.2.69

4. Menorca RM, Fussell TS, Elfar JC. Nerve physiology: mechanisms of injury and recovery. Hand Clin. 2013;29(3):317-330. doi:10.1016/j.hcl.2013.04.002

5. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–814.

6. Reid, N., Healy, G.N., Gianoudis, J. et al. Association of sitting time and breaks in sitting with muscle mass, strength, function, and inflammation in community-dwelling older adults. Osteoporos Int 29, 1341–1350 (2018). https://doi.org/10.1007/s00198-018-4428-6

7. Lurati AR. Health Issues and Injury Risks Associated With Prolonged Sitting and Sedentary Lifestyles. Workplace Health & Safety. 2018;66(6):285-290. doi:10.1177/2165079917737558

 

ABOUT THE AUTHOR

Taryn Everett, PT, DPT, CLT, CF-L1, CNC

[P]REHAB Writer & Content Creator

Taryn was born and raised in Maine and still resides there with her boyfriend and son. Taryn received her Doctorate in Physical Therapy from Husson University in 2010, and also carries a Bachelors in Kinesiology and Human Movement Science. She is a Lymphedema Therapist, Certified Crossfit Level 1 Trainer, and a NASM Certified Nutrition Coach. Taryn has 10+ years of experience in many different realms of PT, from the young athlete to the geriatric patient. Taryn considers herself a lifelong learner. She has special interests in oncology care and breast health, dry needling, and Crossfit training. In her free time, Taryn enjoys fitness, spending time with her family, continuing education, writing and reading, and is very excited to be a part of The [P]Rehab team to educate and empower others to take control of their own health and wellness.

 

 

 

 

 

DISCLAIMER – THE CONTENT HERE IS DESIGNED FOR INFORMATION & EDUCATION PURPOSES ONLY AND IS NOT INTENDED FOR MEDICAL ADVICE.