Preventing buttock pain

Why prevention matters

Buttock pain can make simple things feel like hard work. Sitting at your desk, walking up a hill, sleeping on your side, or going for a run can all become uncomfortable. You might find yourself avoiding long walks, side sleeping, or certain exercises because you are worried about setting your pain off again.

Many buttock pain problems come from how the muscles, tendons, and joints around your hips and pelvis are loaded in daily life. Gluteal tendinopathy (hamstring tendon pain), sacroiliac joint pain, deep gluteal syndrome (sciatic nerve compression), and proximal hamstring problems are common and can often be managed without injections or surgery when they are caught early and treated with the right exercises and activity changes.^{1 2 4 5}

Prevention is about giving these tissues the capacity to handle your usual loads. Building hip and trunk strength, avoiding long periods of compressive positions, pacing your training, and paying attention to early warning signs can all reduce the risk of flare ups and help you stay active. ^{1 2 3 8}

Managing buttock pain: what can trigger flare-ups?

Different causes of buttock pain have different triggers, but some patterns show up often.

• Long periods of side lying or hip “hanging”: Lying on the sore side, crossing your legs, or leaning into one hip while you stand can compress the gluteal tendons against the bone and irritate them over time.^{1 2 3}
• Sudden spikes in walking, hills, or running: Big jumps in distance, hills, or speed work can overload the gluteal and hamstring tendons, especially if they were not well prepared. This is a common pattern in gluteal and proximal hamstring tendinopathy.^{2 4 11}
• Prolonged sitting on firm chairs: Sitting for long periods on hard surfaces can irritate the hamstring tendon at the sit bone and can also worsen deep gluteal syndrome by putting pressure on the sciatic nerve in the buttock^{4 7 11 16}
• Positions that put the hip into deep flexion or twisting: Figure four sitting, deep hip flexion, or repeated twisting can aggravate deep gluteal syndrome and some sacroiliac joint problems. [3][5][7][16]
• Weak hip abductors and poor trunk control: When the hip and trunk muscles are not strong enough, the pelvis may drop or the knee fall inward during walking or running, which increases strain on the outer hip and buttock.^{1 2 3 8}
• Ignoring early, mild symptoms Pushing through pain that is slowly getting worse, instead of adjusting activities early, can turn a small tendon irritation into a longer lasting problem.^{1 2 4}

Learning to notice these triggers early helps prevent small irritations from turning into full flare-ups.

Habits that help prevent flare-ups

You do not need a perfect routine to protect your hips and buttock. These simple habits can add up over time.

• Support your gluteal tendons in daily life Avoid long periods of lying on the sore side, crossing your legs, or leaning into one hip. Try side lying with a pillow between your knees and stand with weight shared more evenly between both legs.^{1 2 3}
• Strengthen your hip abductors and extensors Exercises like side steps, bridge variations, and single leg hip work two to three times per week can build tendon capacity and support your pelvis. A major trial showed that education plus specific hip strengthening led to better long term results than a steroid injection alone in gluteal tendinopathy. ^{1 2 8}
• Pace your walking and running Increase distance, hills, or speed gradually, especially if you have had hip or hamstring issues before. Sudden changes can overload tendons at the outer hip or sit bone. ^{2 4 11}
• Take sitting breaks and use softer surfaces If sitting bothers your buttock, try a cushion, vary your posture, and stand or walk for a few minutes each hour. This can reduce pressure on the hamstring tendon and sciatic nerve. ^{4 7 11 16}
• Train your trunk and pelvic control Simple core and lumbopelvic control exercises help you keep your pelvis steadier during walking, lifting, and running, which can reduce stress on the sacroiliac joint and gluteal tendons. ^{3 5 6}
• Notice and respond to early signs If lying on your side, standing on one leg, or running starts to cause new or returning buttock pain, cut back slightly, adjust positions, and gently restart your strength work. Early changes are easier to reverse than long standing pain. ^{1 2 4}

How Sword supports ongoing strength and mobility

Move is a guided movement program designed to help you stay active by building strength, improving mobility, and supporting stable movement patterns over time. It’s often used after recovery from a flare-up to help maintain progress and support long-term movement health.

Sword offers movement support that fits into daily life, helping you continue building strength and mobility over time. Programs are guided by expert insight and supported by technology designed to help you stay consistent.

• Focus on strength, mobility, and stability
• Designed to support movement between flare-ups
• Guided programs you can follow on your schedule
• Non-invasive, evidence-informed approach

Clinical insight

Deep gluteal syndrome reminds us that not all sciatica like leg pain comes from the spine. Sometimes, the sciatic nerve is pinched in the deep buttock by muscles or fibrous bands, even when lumbar scans are normal.^{7 16} Recognising this pattern can help direct care toward hip and neural interface rehabilitation, rather than unnecessary spinal procedures.