We’ve probably all used, or at least thought of a phrase, which describes the type of pain and the exact location we’re describing here, but buttock pain really can be a pain in the butt and it’s not funny as it can make walking, sitting or even sleeping painful and difficult, so we’ve identified three of the most common causes of buttock pain and what you can do to about it.
Lower butt pain
This pain is normally experienced right in the crease of the buttock at the back of the thigh and can give you some trouble while walking, but is especially uncomfortable when bending forward with legs straight.
Normally, this buttock pain indicates an injury to the tendon(s) which attaches your hamstrings to your pelvis and is often as a result of pulling on the hamstrings too enthusiastically before a proper warm up. Yoga practitioners often insist on keeping the legs straight in forward bends and then force themselves into a pose which can sometimes end up injuring the tendon. (1)
The solution is to give your tendon(s) a chance to heal, which means contracting the hamstrings to increase circulation to the area, rather than stretching them, even if that does feel like the best thing to do, bending the knees generously in the forward bends and only very, occasional mild stretching, if any. Once the worst has passed and healing has progressed, you can begin to add gradual stretching.
Outer/upper butt pain
This buttock pain is normally experienced in the hip or upper or outer buttock area and can resonate down the side of the leg. It usually gets worse during walking and while lying on the affected side at night. Often, depending on the exact location and symptoms, this can be due to weakened abductor muscles, which can cause a displacement of the pelvis and a host of muscle compensation patterns. A tight IT band can also be a contributing factor.
This pain is often due to some sort of an asymmetrical movement pattern which can go on for an extended period of time, and whilst it can be remedied by stretching the IT band or using the roller to apply pressure to it as this symptom is often perceived as an IT band issue, it does not address the root of the problem which is weak abductors. Strengthening those will normally alleviate the problem. Strengthen your abductors by using them in the stabilizing role (standing on one leg) and moving role (moving the leg out to the side, preferably against gravity).
Central butt pain
The sciatic nerve is the longest nerve in our body and is quite big in places, which means it can get pinched at various locations causing sciatic pain. Two common places are the lower back (between the lumbar vertebrae) and underneath the tight piriformis muscle, which is a small muscle that sits deep within your hip and helps rotate your hip externally. This can cause a lot of trouble if it gets tight and can cause the buttock pain, but the situation will worsen if it presses on the sciatic nerve that passes underneath (and for some people right through) the piriformis muscle.
The pain can manifest itself as numbness or weakness in the leg and can appear in the middle of the buttock, in the lower back or anywhere along the pathway of the nerve. This is normally due to herniated disks, bone spurs on the vertebrae or tight piriformis muscle and can be caused by sitting or driving a lot and degenerative changes in the spine with age.
If due to a herniated disk, you need to see a specialist, most likely core strengthening under physical therapist supervision would be the best solution. If the buttock pain is due to the tight piriformis muscle, Yoga is a good solution and can help by releasing the muscle tension. The most commonly recommended pose for the tight piriformis is the Pigeon pose, although for many people with this type of pain this is too much, too soon.
A better solution would probably be to use a Contract-Relax-Stretch principle which your local Yoga therapist should be able to help you with.
It’s also a good idea to relieve chronic contraction in the adductors, since tight adductors can internally rotate the leg which places additional stress on the piriformis muscle. Tight hamstrings can also irritate the sciatic nerve, so it is useful to relieve tension there as well. Bear in mind though that even the simplest hamstring stretches can be very painful to someone with sciatica, so it’s best to follow the same principle for hamstring pain that’s outlined above in 1.
So there are three possible solutions for buttock pain which can be a very painful situation, but do consult your physician or work with a qualified yoga instructor, especially if the pain persists.