Butt gripping and low back, SI joint and hip pain

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Butt gripping is a common unconscious habit that may be at the root of low back, SI joint and hip pain.

Do you have chronic low back or hip pain? If you are female, did you notice that you developed your back pain during pregnancy or after giving birth? Maybe a fall or car accident triggered the back pain and now it is ongoing? Whatever the initial cause it may be worth checking yourself to see if you are a butt gripper. Butt gripping is a term coined by Diane Lee and Linda Joy Lee, used to describe a back stabilization strategy that involves squeezing the buttocks together. This habit is completely unconscious, and is a common strategy the brain uses to try and stabilize the spine if the muscles that are supposed to do the job are not functioning as they should, or if there are significant digestive issues that may be causing gas. Butt grippers are easy to recognize in other people – not only do they look like they are squeezing their butt cheeks together, but they also frequently walk like a duck with the toes pointing out.

Sometimes it is more challenging to recognize the habit in oneself. If you are not sure, have a friend help you. Lie on the floor on your back, completely relaxing your leg and buttock, and have your friend pick your leg up and hold it bent to 90 degrees, at the knee and at the ankle. Your friend can then try and move your upper leg side to side. It should swing completely freely with no movement in the pelvis at all if you are not butt gripping. If the leg moves stiffly as if one were churning butter, or if the pelvis moves with the leg, that means the buttocks are hanging onto the leg and you are indeed a butt gripper. Check both legs, because occasionally the problem can be one-sided.

Why would this habit increase low back and hip pain? Try squeezing your butt cheeks together hard, and walk across the room. Notice how your legs cannot swing freely, and how you need to rotate your spine in order to move a leg forward. This puts extra wear and tear on the vertebral joints – not good. Contracting the piriformis, a deep rotator muscle in the buttock that runs from the sacrum (triangular bone at the bottom of the spine) to the big bump on the outside of the upper leg bone (greater trochanter), puts a strangle hold on the bottom of the sacroiliac joint, compressing it and creating pain. Furthermore, because the sacrum is a triangular bone and butt gripping squeezes the bottom part of the joint, the top of the SI joint opens up making it unstable. And with the sciatic nerve being so close to the piriformis muscle in the buttock, occasionally overuse of this muscle will create sciatic pain.

Although not in the right place to mimic piriformis properly, the bungee cord in the photo simulates a butt gripping strategy, and one can clearly see how this opens the top of the SI joint. This might also destabilize the joint between the top of the sacrum and the lowest vertebrae, and possibly the lumbar spine further up. Also, the piriformis might pull the front of the lower sacrum forward, unlocking the SI joint, destabilizing it. Massaging the external hip rotator muscles will help temporarily, but until one stops using a butt gripping strategy the pain will not go away permanently.

transversus strategyIn order to stop butt gripping permanently, one must replace the butt-gripping stabilization strategy with one that is more optimal. Ideally we want to create a ring of support around the top of the pelvis by using the deepest abdominal muscle called the transversus abdominis. Notice in this photo how the bungee cord simulating the action of transversus abdominis, closes the SI joint, and how using this muscle would stabilize the pelvis in a way that does not compromise the ability of the legs to move freely. This muscle, along with co-contraction of multifidus and the pelvic floor form the optimal way to stabilize the low back and SI joint.

Find transversus abdominis by getting onto all 4s, letting your belly hang out, pulling in the tissue just above the pubic bone, feeling a slight muscle contraction there, and holding it while breathing. The contraction should be well below the belly button. Drawing the navel to the spine activates the wrong muscle according to Real Time Ultrasound research, and therefore does not provide the needed stabilization to the spine. One should be able to hold this deep, low contraction and breathe quite easily. Once you can find this abdominal muscle, lean back so your butt cheeks open. Then try finding your connection to transversus in various positions including sitting and standing. Transversus should be on at very low intensities pretty much all the time, so build up hold times rather than contracting and relaxing it.

Frequently practice finding transversus abdominis in standing, and then practice letting go of your buttocks so your legs can swing freely. Teaching your brain to use your body differently can take a few weeks to a few months of diligent practice, so be patient. Best practice for a minute 6 times an hour rather than an hour a day, so set a timer to beep at you every 10 minutes. Over time as your brain learns a new way of stabilizing your back and pelvis your pain may very well dissipate. This is tricky stuff, so do find a good physio or CHEK practitioner to help ensure you are doing this correctly.

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Lee, Diane The Pelvic Girdle Churchill Livingston, 2004.

Lee, Diane and Lee, Linda JoyAn Integrated Approach to the Assessment and Treatment of the Lumbopelvic-Hip Region DVD, 2004

Lee, Diane and Lee, Linda Joy Postpartum Health for Moms – An Educational Package for Restoring Form and Function after Pregnancy
CD ROM 2006.

Lee, Diane Assessment Articular Function of the Sacroilac Joint VHS

Lee, Diane Exercises for the Unstable Pelvis VHS

Richardson, C, Hodges P, Hides J.Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain Churchill Livingston 2004.

DonTigny, Richard Pelvic Dynamics and the subluxation of the sacral axis at S3 The DonTigny Method.

Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Poise: Psoas-Piriformis Balance” Massage Magazine, March/April 1998.

Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Fans of the Hip Joint” Massage Magazine, Jan/Feb 1998.

Myers, Thomas Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists Churchill Livingston, 2001

Chek, Paul CHEK Level 1 Advanced Back Training Chek Institute.

Johnson, Jim
The Multifidus Back Pain Solution: Simple Exercises That Target the Muscles That Count
New Harbinger Publications Inc. Oakland CA, 2002.

Lee, Diane Understanding your back pain – an excellent article explaining the concept of tensegrity and its importance in stabilizing the pelvis and spine.

DeRosa, C. Functional Anatomy of the Lumbar Spine and Sacroiliac Joint 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Gracovetsky, S. Analysis and Interpretation of Gait in relation to lumbo pelvic function 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Dananberg H. Gait style and its relevance in the management of chronic lower back pain 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Online at www.kalindra.com A fantastic website devoted to sacroiliac dysfunction.

Copyright 2010 Vreni Gurd

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6 Comments »

  1. Robert Halili said,

    May 24, 2010 @ 9:01 pm

    Hi Vreni,

    Thanks for the informative articles. I’ve found them very useful and have changed my behaviour on the way I eat and treat my body. I just want to comment on the butt gripping article. I live in a fast paced city and stress tends to creep into my sleep. A few years ago I couldn’t figure out why my hamstrings were so tight, could barely run. I found out I was tensing my hamstrings during sleep, especially when I have a bad dream. Tried the normal stretches but they only worked temporarily as I continued to tense my hamstrings whenever I went back to sleep. I Googled Tight hamstrings and found a website by Somatic doctor Lawrence Gold. In his site are exercises that helped solve my problem. Butt gripping probably happens a lot more during sleep so chronic grippers need to train themselves to automatically relax their buttocks during sleep. Anyway, just my 10 cents worth. I figure butt and hamstring grippers are likely in the same pool.

    Thanks again for the articles.

    Robert

  2. Vreni said,

    May 24, 2010 @ 10:29 pm

    Hi Robert,

    Good to hear from you. Thanks for pointing me to Dr. Lawrence Gold. I’ll check out his exercises. I do agree that if one is in the habit of contracting muscles during sleep that this is something that would need to be resolved! And I also imagine that trying to stop yourself from doing something in your sleep is no easy task, so I do appreciate the referral.

    Vreni

  3. lynn said,

    June 3, 2010 @ 10:29 am

    Hi,
    If you want to strengthen your glutes with exercises like bridges and quadraped bent leg extension—will these increase SI symptoms? In a sense those exercises are shortening and tightening the glutes. I often hear trainers encourage clients to “activate” their glutes during certain exercises–even when walking up hill. Can one activate the glutes without contributing to more pain? Pilates instructors sometimes say “wrap your glutes” as I thought the glutes were part of low back stabilizers and protectors. So what is the best way to strengthen glutes if you tend to be tight in the piriformis and occasionally have SI symptoms? Thank you!

  4. Vreni said,

    June 3, 2010 @ 1:00 pm

    Hi Lynn,

    Great question. It is possible to do bridges by extending the hips and not squeezing the butt cheeks together, so that way you are biasing glutes over piriformis and the other deep hip rotators. Quadraped hip extensions like other unilateral work can sometimes increase SI symptoms if the joint is highly unstable, but I do use this exercise a lot. Unilateral quadraped hip extensions also bias glutes, and they also target multifidus, one of the key spinal stabilizers.

    The key is to not squeeze the butt cheeks together while strengthening glutes, and to also engage the local stabilizers like transversus abdominis, multifidus and pelvic floor to ensure good support for the SIJ. Does that make sense?

  5. James said,

    March 5, 2014 @ 5:02 pm

    Hi Vreni. I’m having a hard time getting the contraction of the TrA. Am I supposed to contract the PF at the same time? Or is it possible to contract the TrA without contracting the PF? I know you say not pull in the navel to the spine as this can activate the more superficial muscles, but it seems kind of hard to get something to happen without the navel moving at all. Lastly, there’s a lady by the name of Katy Bowman who believes that exercises such as kegels are bad to do. What is your opinion on that?

  6. Vreni said,

    March 6, 2014 @ 11:46 pm

    Hi James,

    Although one can contract the PF without TrA, that is not the ideal situation. They should both work together, along with multifidus.

    The navel will move a bit when activating TrA, but the bulk the movement should be originating below the navel, not at or above. So it is like a zipper going from the pubis to the navel, with the navel moving in at the end.

    I think PF is a very important stabilizer, but as with everything else, it is possible to over tighten this muscle which can be a problem.

    I hope this helps!

    Vreni

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