“Bottom line…sit and occasionally stand like a man.”
There’s really no better word for butt pain than “butt pain.” Gluteal pain? Hip bursitis pain? Sciatic pain? Piriformis pain? They all have more syllables, and they each refer to a different problem. But they’re all butt pains.
Now I’m talking about one specific form of butt pain; gluteal tendon pain, which might be the hardest to treat, the most painful, and it’s on the rise. I’m referring to the various forms of disease involving the gluteal tendon, which attaches the bulk of our butts to our hips. And in women, it’s under a lot of lifetime duress because of the way we’re put together and the way we use our hips. I think it’s on the rise, because women in their 60s and up have been more active in their lifestyles than women of previous generations. Some of us…exercise more, work and take care of grandkids longer, do more laborious work, and live longer than our predecessors. We just wear out that ridiculously crummy tendon.
Those of you who have read my blogs, know all about the way we gals are put together, and the rest of you can get caught up by reading my Sit Like A Man post. Mechanically speaking, we’re different than the guys, and it matters. There are several conditions discussed on that post, which are almost exclusively suffered by women, and this pertains to the mechanics of our lower extremities.
Gluteal tendon disease (repetitive strains, tendonitis and tears) is one of these conditions. It’s painful and hard to treat. So, in keeping with the rest of my posts, it would be best to prevent it, and prevention starts early. Suffice it to say, I truly believe if we start sitting and getting in and out of chairs like men, at a relatively early age, we might be able to prevent this condition. But it is also affected by our somewhat sashaying gait, and standing with our hips cocked to one side. We do this more than men.
We probably can’t change the way we walk. Except in the most exaggerated cases (runway model walking), most of us walk this way because of the mechanics of our legs. We simply can’t walk like men, even if we tried. So, don’t try.
But we can try not to stand with our hips cocked to one side, and if you begin to develop any lateral or posterolateral hip pain as you age, you should try to avoid standing in any way which causes discomfort. I tell my patients with gluteal tendon pain to stand like Mr. Clean. This condition usually affects women over 60, and most of us remember Mr. Clean and his stance…legs akimbo.
Repetitive strain to the gluteal tendon, eventually results in chronic tendonitis, partial tears and eventually, even complete tears. The gluteal tendon is crucial to the function of your lower extremities and the balance of your pelvis as you take one step after the other. Loss of function results in a painful, exaggerated limp. It can be life altering.
Physical therapy, anti-inflammatories, injections of cortisone and biologics (platelet rich plasma, stem cells, exosomes) can help, but often don’t. It usually does not resolve spontaneously, unless you really catch it early. Surgery is an option as well. But before you ever consider surgery, you may go through a long course of resting and pain. You will often be misdiagnosed with more common conditions around the hip, like sciatica and hip bursitis. An MRI can confirm the diagnosis.
As always, the best thing is to catch it early. Be mindful of butt pain, and take steps to stop the pain. Stop exercises which cause the pain. Don’t work through the pain. Find positions of comfort, and get to those positions more often (like sitting and standing with the legs slightly apart). Use hiking sticks when you walk. This takes tension off the gluteal tendon and muscles. Try over-the-counter NSAIDS, if you have no contraindications to taking them. If these things don’t help…see your favorite orthopod or physiatrist.
Bottom line…puns always intended…sit and occasionally stand like a man.