What is Gluteus Medius Syndrome a.k.a. Runner’s Butt

The Gluteus Medius muscle is a very important muscle found deep to the Gluteus Maximus and overlying the Gluteus Minimus.  Its primary function is to contract isometrically and help provide support to your hip during weight bearing. When we walk or run we put all of our weight on one leg at a time as our foot comes in contact with the ground.  The Gluteus Medius muscle contracts on the weight bearing hip during full joint loading at this time.  Most runners’ feet will collide with the ground 1000-2000 times per mile.  That means their Gluteus Medius Muscle will have to contract 1000-2000 times as well multiplied by how many miles they run…..5 miles would equal 5000-10,000 Gluteus Medius muscle contractions!  Imagine if you were to do 1000-2000 bicep curls……do you think you biceps would be sore?  Now multiply that by 10.  Can you even come close to imagining what your arms would feel like after doing 10,000 bicep curls?  Oh yea I left one thing out.  When you run you are landing with 100% of your body weight multiplied by 3x due to the impact!  If you weigh 150 lbs you are impacting 1000-2000 times per mile time’s 450 lbs!  Now go back to my gym analogy.  Try doing bicep curls with just 10 lbs 1000-2000 times.  The fact that our skeleton can absorb these types of impact forces is truly a testament to the fabulous engineering of the human body.  It is no wonder then that the Gluteus Medius sometimes can get overworked and spasm and when it does it can cause you a very real pain in the butt or as we jokingly call it “Dead Butt Syndrome” or “Runners Butt Syndrome”.

Gluteus Medius Syndrome Causes and Symptoms

Gluteus Medius Syndrome is often misdiagnosed as Sciatica, Ischial Bursitis and Hamstring sprain/strain otherwise known as hamstring tendonitis or tendonosis.  There are some obvious signs and symptoms that can help accurately diagnose Gluteus Medius Syndrome while differentiating it from the others.  Gluteus Medius Syndrome is an overuse injury which is why it is so common in long distance runners.  But did you ever wonder why it sometimes affects only one side?  If it is from overuse and you ran on both legs shouldn’t it be on both sides.  The answer lies in that we are not normally symmetrical beings.  This means that you can have one foot larger than the other, one arch flatter than the other, one leg longer than the other, one hip higher than another or other type of misalignment such as “Knock-knees”, collapsed arches or spinal scoliosis.  These asymmetries can lead to muscles imbalances and asymmetric loading of joints resulting in injury on one side.  It is important to not only diagnose the injury correctly but to figure out why you suffered from the injury and then correct that.  This is easily done by addressing the asymmetry using whatever means necessary to bring your body closer to neutral symmetry.

Gluteus Medius Syndrome is characterized by pain that radiates deep into your glute region and may even radiate into your thigh.  Often the patient will describe an increase in pain while running, especially uphill or running faster.  On occasion the neighboring Piriformis muscle may be affected and cause the person pain when sitting.  The reason we call it a “syndrome” is because it is a multi-symptom condition but not everyone that has it has all of the symptoms.

Gluteus Medius Syndrome Diagnosis

In order to diagnose Gluteus Medius Syndrome a thorough and proper examination must be performed.  Orthopedic testing can rule out similar conditions such as Sciatica, Piriformis Syndrome, Ischial Bursitis and High Hamstring Tendonopathy.  Special testing such as X-ray or MRI are not useful in diagnosing Gluteus Medius Syndrome but may prove useful to eliminate a bulging disc that could cause Sciatica or a MRI of the Hamstring would show a High Hamstring Tear.  Gluteus Medius Syndrome can be diagnosed by eliminating those other diagnosis, history and location of the patient’s pain, provocative testing and manual palpation of the trigger points.

Treatment for Gluteus Medius Syndrome

First let me describe the typical  scenario.   You start with a visit to your primary and tell him/her that it hurts when you run.  “Stop running”, they say.  Then they take an x-ray of your back and/or hip and say “nothing’s wrong”.  Next they prescribe you Ibuprofen and if you are really lucky a visit to the PT.  Unfortunately for you they did not know what was wrong so you have no diagnosis.  The PT does not know what to do so they tell you to strengthen and stretch your tight and weak Glutes using stretches you already knew and exercises that your grandmother would say are too easy.

At San Diego Running Institute we accurately diagnose your condition and then provide you with treatment options and interventions that are effective and make sense.  We also address the root cause of your injury and will outline for you how to get your body closer to symmetry if you desire it.  By having your body perform and function in anatomic neutral by being symmetrical you will reduce your chance for further injury.

For this injury we typically offer runners two options.

  1. Treatment – This would entail receiving direct therapy to the injured area using sports medicine modalities that you might find in a professional sports locker room. Modalities such as Ultrasound, Electrical Stimulation, Kinesiotaping, joint manipulation, muscle work similar to ART or Myofascial release.  A home program is also taught consisting of specialized stretching and a very specific foam roller routine.
  2. Home Treatment/Therapy Program – If the person desires to “DIY” we will show you the home program that will consist of specialized stretches and a specific Foam Roller routine. This course of action will take longer than receiving treatment in our clinic but it is your body to do with as you wish.

When the patient has faulty foot posture or poor foot mechanics that might be causing their Gluteus Medius Syndrome we can also prescribe custom orthotics.  Our custom orthotics are hand crafted on site in our in house lab.  The orthotics are molded by Dr. Allen D.C. to your feet then are customized within 7 days.  The cost is $367 per pair or $500 for two identical pair.

Get an accurate diagnosis by making an appointment at our clinic.  If you have any insurance you would like checked please email DrAllen@sdri.net He will verify any coverage/benefits you