When serious problems like infection, cauda equina syndrome (compression of the spinal nerves), or major hip fracture have been ruled out, movement is usually safe and one of the best ways to treat buttock pain.
For gluteal tendinopathy and greater trochanteric pain syndrome (inflammation and wear of the gluteal tendons with or without irritation of the adjacent fluid-filled sac), a large clinical trial showed that education plus specific hip strengthening led to better long term improvement and satisfaction than a single corticosteroid injection or “wait and see.” 1 2
Strengthening the hip abductors and extensors helps the tendons handle daily loads like walking, stairs, and standing, which can reduce pain on the outer hip and buttock.2 3 8
For proximal hamstring tendinopathy proximal hamstring tendinopathy (back thigh tendon issues) and sacroiliac joint pain, progressive tendon loading and lumbopelvic strengthening are key parts of care. These programs build capacity around the sit bone, hip, and pelvis, helping you sit, bend, and walk with less pain over time.4 5 11
The goal is not to stop moving completely, but to reduce painful positions, improve strength and control, and then slowly return to the activities that matter to you.
Effective exercises for buttock pain
Not every exercise is right for every person. If a movement causes sharp pain or new symptoms, stop and consult a medical provider.
These examples are commonly used for gluteal tendinopathy, proximal hamstring tendinopathy, and sacroiliac joint related buttock pain. Your own plan should be tailored by a clinician.
1. Side lying hip abduction
Why it helps: Strengthens the gluteus medius muscle on the side of the hip, which is often weak and irritated in gluteal tendinopathy and greater trochanteric pain syndrome.1 2 3
How to do it: Lie on your side with the sore hip on top and a pillow between your knees if needed. Bend the bottom leg for balance. Keep the top leg straight in line with your body and gently lift it toward the ceiling without rolling your pelvis back. Pause for 2 seconds, then lower slowly. Start with 2 sets of 8 to 12 repetitions, stopping if pain rises above a mild, tolerable level that settles by the next day.
2. Bridge
Why it helps: Strengthens the glutes and hamstrings near the sit bone, important in proximal hamstring tendinopathy and sacroiliac joint support. 4 5 11
How to do it: Lie on your back with your knees bent and feet hip width apart. Walk your feet a little farther away from your body so you feel the back of your thighs work more. Gently tighten your buttocks and press through your heels to lift your hips until your body forms a line from shoulders to knees. Hold for 3 to 5 seconds, then lower slowly. Start with 2 sets of 8 to 10 repetitions. If sitting is painful, this exercise can be a good starting point to load the tendon without compression.
3. Side lying clamshells
Why it helps: Targets the deep hip rotator and abductor muscles, which help control hip position and reduce strain on the outer hip and sacroiliac joint.2 3 5
How to do it: Lie on your side with your hips and knees bent and your heels together. Keep your feet touching and your pelvis still. Gently open the top knee like a clamshell, then close it slowly. Avoid rolling your body backward. Aim for 2 sets of 10 to 15 repetitions on the sore side. If this feels too easy, you can later add a light band around your knees, if your clinician agrees.
Helpful stretches for buttock pain
Stretches can help reduce stiffness and ease tension around the hip and pelvis. They tend to work best when they are gentle and combined with strengthening.2 4 5
1. Figure four glute stretch
How it helps: Eases tightness in the deep buttock muscles, which can feel sore in gluteal tendinopathy, sacroiliac joint pain, or deep gluteal syndrome.3 7
How to do it: Cross one ankle over the opposite knee, creating a figure-4 shape with your legs. Gently press down on the knee and lean forward from your hips as far as comfortable, keeping your back straight. You should feel your hip and glute stretching. Hold for 20 to 30 seconds, then relax. Repeat 2 to 3 times.
2. Hamstring stretch in long sitting
How it helps: Reduces tightness along the back of the thigh, which can contribute to discomfort at the hamstring origin in proximal hamstring tendinopathy.4 11
How to do it: Sit on a mat with one leg straight in front of you and the other bent for comfort. Keeping your back fairly straight, gently lean your chest forward over the straight leg until you feel a stretch in the back of the thigh. You should not feel sharp pain at the sit bone. Hold 20 to 30 seconds and repeat 2 to 3 times per side.
3. Hip flexor stretch in half kneeling
How it helps: Opens the front of the hip, which can ease strain on the buttock and sacroiliac joint, especially in people who sit a lot. 5 6
How to do it: Kneel on a soft surface with one knee on the ground and the other foot in front, as if in a gentle lunge. Keep your torso upright and gently shift your weight forward until you feel a stretch at the front of the hip on the kneeling side. Avoid arching your lower back. Hold 20 to 30 seconds, then switch sides. Repeat 2 to 3 times.
4. Open books
How it helps: Gently mobilizes the spine and pelvis, which can reduce stiffness contributing to sacroiliac or lower back related buttock pain.5 13
How to do it: Lie on your side with your hips and knees bent and arms straight out in front of you. Keeping your knees together, reach the top arm up and over to open your chest toward the ceiling, turning your upper body while your legs stay stacked. Go only as far as feels comfortable. Hold for 5 to 10 seconds, then return. Repeat 8 to 10 times each side.
Did you know?
Exercise plus education can outlast injection based care. In a large trial, people with gluteal tendinopathy who did education and targeted strengthening had better global improvement and satisfaction at 52 weeks than those who only had a corticosteroid injection.2 8
Exercises to avoid with buttock pain
You do not need to fear movement, but some positions and activities can aggravate sore tendons, nerves, or joints, especially early on. These are guidelines, not strict rules, and many of these activities can be reintroduced later in a graded way.
Things that often need to be limited or adjusted include:
Long periods of side lying on the painful hip. This compresses the gluteal tendons against the bone and mattress, which can worsen gluteal tendinopathy. Using a pillow between your knees, lying on the other side, or briefly lying on your back often feels better while the tendon calms.1 2 3
Standing with your hip “hanging out” to one side. Leaning on one leg with the pelvis pushed sideways increases compressive load on the outer hip and can flare greater trochanteric pain syndrome. Learning to stand with weight more even and the hip stacked over the foot is usually more comfortable.2 3 8
Deep forward bends and aggressive hamstring stretching into sharp pain at the sit bone. Strong stretching loads the proximal hamstring tendon under compression, which can aggravate proximal hamstring tendinopathy. A focus on controlled strengthening first, with gentle stretching only in a tolerable range, is recommended.4 11
High load impact or sprinting when buttock pain is severe. Sudden high speed running or hill sprints can overload gluteal and hamstring tendons before they are ready and may slow recovery. A gradual return plan works better.4 8 11
Remember, the goal is to keep moving in ways that feel manageable, not to stop all activity. A clinician can help you decide which exercises are “not yet” versus “go ahead but in a smaller dose.”. Most people can reintroduce any exercises gradually with proper guidance.
Clinical insight
Guidelines remind us that some buttock pain is linked to the sacroiliac joint or nerve entrapment in the deep gluteal space. These conditions respond better to targeted lumbopelvic rehabilitation, hip strengthening, and, in selected cases, image guided procedures, rather than routine spine focused treatments or long term medicines. 5 7 13
Brunker P, et al. Greater trochanteric pain syndrome: review of diagnosis and management. Br J Gen Pract. 2017;67(663):479-480.
2
Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection versus wait and see for gluteal tendinopathy: randomised clinical trial. BMJ. 2018;361:k1662.
3
International Society for Hip Preservation (ISHA). Physiotherapy agreement on assessment and treatment of GTPS. J Hip Preserv Surg. 2023;10(1):48-56.
4
Woodley SJ, et al. Proximal hamstring tendinopathy: systematic review of interventions. Int J Sports Phys Ther. 2021;16(2):305-333.
Manchikanti L, et al. Systematic evaluation of prevalence and diagnostic accuracy of SI joint interventions. Pain Physician. 2012;15:E305-E344.
7
van der Windt A, et al. Deep gluteal syndrome (editorial). Br J Gen Pract. 2019;69(687):485.
8
Grimaldi A, Mellor R, Nicolson P, et al. Education plus exercise is cost effective for gluteal tendinopathy versus corticosteroid injection and wait and see. Physiotherapy. 2022;114:1-11.
Orthopedic Reviews Editorial Group. Cluneal neuralgia: an under recognised source of low back and buttock pain. Orthopedic Reviews.
11
Rich A, Ford J, Cook J, Hahne A. Physiotherapy vs shockwave for proximal hamstring tendinopathy: randomised controlled trial. Am J Sports Med. 2025; epub ahead of print.
12
Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N. ESWT in common lower limb tendinopathies including GTPS and PHT: systematic review. Br J Sports Med. 2018;52(6):387-395.
13
National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). 2016-2024.
14
Feki W, et al. Infectious sacroiliitis: diagnostic contribution of CT/MRI and long term follow up. Eur Spine J. 2025;34:4758-4765.
15
Biondi NL, et al. Radiological insights into sacroiliitis. Clin Pract. 2024;14(1):106-121.
16
Sun G, Fu W, Li Q, Yin Y. Arthroscopic treatment of deep gluteal syndrome and peri operative ultrasound utility. BMC Musculoskelet Disord. 2023;24:742.
