Dead Butt Syndromes and other fairy tales affecting those who run

A few weeks ago, I read an article that was posted on the NY Times web site regarding something called Dead Butt Syndrome (http://well.blogs.nytimes.com/2010/12/21/when-the-diagnosis-is-dead-butt-syndrome/).  Apparently, this is a problem with the gluteus medius (one of the larger muscles in the butt) which as this person. The person who wrote this article is a veteran runner and as she said “For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.” 


The problem with this all encompassing diagnosis of Dead Butt Syndrome is the same with many of the attempts to globally diagnose and then come up with a cure without fully understanding the mechanisms involved.  


Over the past year, I have been reading and reviewing Thomas Meyers book on Anatomy Trains (available through Amazon.com) which shows the myofascia actually controls motion, not the muscles making this diagnosis a part of the problem rather than the solution. 

 As many of our patients know, I diagnose through active evaluation, treat the fascial restrictions and then retest the firing patterns involved.  Sometimes my first impressions are right on but I do a number of maneuvers until I figure out how to restore a more normal firing pattern.  Often, tight hip capsules (fibrous tissue surrounding the hip) can cause this problem, as well as foot overpronation and gait asymmetry.  It does not just happen to nice people like this author.  The Fascia surrounding the muscles tighten, cause the gluteus medius to recruit in other muscles such as the obliques , hamstrings, other gluteal muscles, erector spinae and even affect the upper back as the problem worsens.  

My concern is the piecemeal type of diagnosis this is, only addresses the symptom, which is really a gait issue.  This person was over and under striding (one leg is tight in back, the other tight in front causing a short stride one one side and a longer stride on the other) way before the symptoms appeared and likely ran and stretched through it.  Like most things mechanical, you can run it until it dies or fix it so it wont. The net effect is it torques the pelvis, causing a loss of leverage and your legs tighten.  Your stride shortens, you pull muscles, have problems in the calves and you mechanically have some real issues.  To fix this, you need to understand that this diagnosis of dead butt is just a symptom, rather than the problem.  You cannot, as many our runners know after visiting many practitioners who were not effective enough, fix this with a quick itis or osis diagnosis which sounds medically intelligent but hardly will lead to a solution, because of the lack of understanding of the gait mechanism that created it.  Enough said.


There is no such thing as a dead butt.  There is a thing called foot overpronation or supination or asymmetric gait which will cause this type of a problem. For those looking for a solution, you can email me directly at backfixer@aol.com.  I would be most happy to give you cost effective guidance on problems like this.


What do you think?  As always, I value your opinion