A Friendly Guide to the Running Butt

Bunanza! Image via midwestnerd

As my training ramps back up and as my butt injury seems to be fading far into the background (please no jinx!) I want to look back upon my experience to create a guide for all future pain in the butt* havers. So without further ado here’s Salty’s Guide to the Running Butt, FAQ style.

1. Why Does a Butt Injury Hurt Like a Mofo? The butt is made up of many muscles, but the most problematic for many runners is the piriformis, a lesser butt muscle that lies underneath the gigantic glutes deep inside your butt cheek.  The piriformis is a long skinny muscle that attaches at the sacrum, base of the spine and extends all the way across the cheek over the sciatic nerve to the hip. That’s why it hurts. It literally hits a nerve when it’s irritated. When mine is really po’d and kicking up the sciatica it causes me to want to jump out of my chair or driver’s seat and sometimes even causes numbness in my foot. While the muscle is long and skinny, mine always hurts in the same spot:

The spot is the location of my piriformis pain. (Wish I had purple bunz!)
You can kinda see the wonky arms here.

2. How Does One Go About Injuring a Butt? As I said above, the piriformis is a stabilizing muscle. You can irritate it when you run on mud, ice or other slippery conditions necessitating extra balance. I wish that’s how mine became irritated. I’ve always had a touchy right piriformis and it’s related to my arm-swing. My arm swing is super wonky: my right arm swings perpendicular to my body and the left arm swings way out away from my body. The theory is that the arms are compensating for my weak or over-used right piriformis. On top of that after a couple of pregnancies the muscles in the right side of my pelvis got out of whack which likely caused lower crossed syndrome. LCS in turn caused my right glutes to not work properly which then added even more stress to the piriformis which tried to pick up the slack from the lazy glutes. Basically, my piriformis was doomed!

That being said, the piriformis is used in running all the time. One need not have a funky wonky arm or messed up pelvic muscles to have a cranky butt. Excessive hills and speed work or simple overtraining can be enough to piss off any butt.

3. How Do I Know If I Injured My Butt? When a piriformis is hurt it often feels like pain at the top of the hamstring or right at the point where your rear meets the seat of a chair. It can be anywhere in there.  You might first notice the pain, not while running, but when sitting. I remember one of the first times I noticed my cranky butt. I did a long run and then went to brunch at a place with wooden benches. I was sipping coffee and all of a sudden, “OWEEE!” Woo baby. It was like someone stabbed me in the @$$ right in the spot (see diagram above).

The thing with the piriformis is that it’s a touchy muscle with a big nerve next to it. If it hurts it might not be injured in a debilitating sense, but even mildly irritated and you’ll probably know it. It’s like a lot of other “injuries” in that there’s a fine line between a runnable annoying pain and a real injury necessitating modification or cessation of training. Ultimately, it’s something only you can know. When I couldn’t sleep because of the spasms in my butt back in July my pain in the butt crossed over the injury line. On New Year’s Eve when I couldn’t open up my stride it did it again.

4. Say I Have a Pain in My Butt, But I Ignore It. What Will Happen? If you can tolerate the pain, you can probably get away with running with a pain in the butt for a while. Eventually you might end up with night spasms or a real strain like me. If you have sciatica related to your butt pain you could permanently damage the nerve and have constant numbness in your feet or shooting pains up and down the back of your leg. That’s no fun. I do have to admit that I have struggled with butt pain for a long time and most of the time it comes and goes. Sometimes I’ll have a really bad week where it hurts on every run and then out of nowhere after a good tempo or something the pain disappears for a while. Again, it’s really a judgment call on when you need to do something about it that only you can make.

Massage in Frankfurt, Germany
A super 60 minute massage should cost less than a pair of trainers. Image via Wikipedia.

5. How Can I Take Care of My Butt and Avoid Injuring It? To prevent a pain in the butt from developing I recommend a few things. First, if you’re a stretcher, incorporate a butt stretch into your stretching routine. The pigeon pose is a great stretch. For a how-to video go here. Second, keep your core strong. Keep up with your planks and crunches and this will help your butt immensely! Finally, if possible I highly recommend seeing a massage therapist regularly for deep tissue massage. A good masseuse can spot problems in your muscles before they become injuries. Getting a massage once a month to once every 6 weeks is probably sufficient.

If the pain is more intense I would recommend seeing an ART practitioner ASAP. The piriformis is usually highly treatable through this technique. If ART alone does not do the trick and you have reoccurring butt problems then you probably need physical therapy to remedy muscle imbalances and weaknesses.

So there you have it. If you have any more questions about your runner @$$ please leave them in the comments and I will add to the FAQ.

Cheers to happy pain-free rears!

*When I say butt or @$$ or rear I mean the piriformis unless I indicate otherwise.

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Salty Running boss and mother of 3 little ones with PRs of 3:10:15 (26.2), 1:25:59 (13.1) and 18:15 (5k). I love to write about running culture, mental training, and fitting in a serious running habit with the rest of a busy life.

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  1. Good summary Salty, these are valuable types of posts. When I had my injury last winter, I originally suspected the piriformis but I lacked the sciatic nerve sensations. It ultimately turned out to be a strained hamstring, so there may be a fine line between a high hamstring strain and piriformis issues. And I’d add hip thrusts to the list of core exercises useful for addressing either issue, one of the best exercises (along with bridges – also recommended, particularly one-legged) for addressing glute weakness.

    1. Strengthening the butt is good for those with no butt issues at the time they incorporate the exercises. Be careful if your butt is already cranky. Mine is so touchy, sometimes stretching or strengthening exercises can make it worse. One of the reasons the docs thought I had a herniated disk was because I screwed up my muscles from doing single-legged squats!

  2. Thank you for the great post, I just came across this as I googled “How to help the pain in my right butt cheek from running?” LOL I am new to running and am coming at this from an obese perspective too. I feel like every time I feel awesome about my running and everything I end up hurting something! First it was my left achilles (which still bugs me on my distance runs) and recently it has been the pain in my butt! Just when I thought it had subsided, I was out doing 3.5 miles and I think it was making me step different on my whole leg, about halfway through I could feel pain in my right knee and foot. The next morning my right arch was in lots of pain! Now I notice the pain in my rear every time I put the weight on my left side. Is this fairly normal? Does this sound like the same muscle you are referring to?

    1. An awesome post! However, what about rear SORENESS? It is in the same spot as you described, but seems seems to be running vertically up to the lower back and down to my hamstring.
      Another compensation issue?
      Usually is sore the day after a hard tempo or fartlek…
      Not too concerning (I hope I hope I hope)

      1. It’s hard to find a post with the exact same issue as you describe. Goes into the lower back and the top of the hamstring. Worse the next day after a tempo, speed session or Fartlek. Also hurts like hell doing a single leg bridge on the injured side. Can I please ask how long it took for your injury to heal and were you able to continue with your sore sessions? I’ve had 3 weeks off running so far, but have attempted 2 easy runs during these 3 weeks. Thanks

  3. Thank you so much for the info! I have been experiencing this pain in the butt on and off for months now which i never had before so it’s quite surprising to me. I have it again today after running/walking this morning. The pain is bearable but sometimes walking can be painful and i even feel it spreads down at the back of my knee. I will do the pigeon pose daily and other stretching you mentioned.

    Thank yu so much again!

  4. It’s reassuring to know other runners live with pain in the butt syndrome. I’d add one recommendation: keeping a “butt ball” (tennis ball, hackey sack, or special massage ball) in the car for drives lasting more than 4 minutes is also essential.

  5. My mother calls her butt pain “Hip-Butt-Itis.” Hers is actually Hamstring Origin Tendinopathy that was previously through to be piriformis. Apparently Tendinopathy is exclusively a running injury and often misdiagnosed as piriformis. How do you determine a correct diagnosis ?

  6. i have had this and its because its lack of stretching those muscles before a run and also from hill running too much,be careful on your mileage when enduring this and run on flatter even surfaces,ice that area when workout is over and build a routine that is a little easier on those muscles,as a runner there is not a pain I have not gone through,the only thing that wont heal is your ego,if you have to stop and walk while running do so and continue on a better day,working out and exercise is an on going program so you have plenty of time to what you love,don’t compete against your friends have fun and be proud of keeping fit

  7. Glute stretches do help but nothing does it like rolling your glutes with a tennis ball or lacrosse ball. Trust me the next time you have pain like this, just get out your tennis ball and do that (look up how to videos on YouTube to see how it’s done exactly). It makes glute-related pain disappear like a miracle. Put the tennis ball right on that spot you marked on your beautiful MS Paint drawing and just sit on it. It’s gonna hurt like hell but after you bear it for 60 seconds and get up you won’t believe how much better you feel.