Save Your Buns! How to Reverse Dead Butt Syndrome with Andrew Bang, DO

Podcast Transcript

John Horton:

Hello and welcome to another Health Essentials podcast. I'm John Horton, your host. Statistics show that most of us spend six and a half to eight hours a day sitting. That's a reality that can quickly become a pain in the, well, you know. Something called Dead Butt Syndrome has become a byproduct of our increasingly sedentary lifestyles. Yeah, I know. It's a funny name, but the condition is no laughing matter. It can truly cause serious aches and numerous physical issues. So today we're going to try to revive dead derrières with a little help from chiropractor, Andrew Bang. Dr. Bang is one of the many experts at Cleveland Clinic who pop into our weekly podcast to offer guidance so we can live a little healthier. With any luck, by the time we're done chatting, you and your buns will feel a little more lively. Dr. Bang, it is so great to have you back on the podcast. I always know that we're in for an informative and fun chat when you stop by.

Dr. Andrew Bang:

Thanks so much, man. As we were saying earlier, it's been too long. I've been waiting by the phone for a call, John.

John Horton:

Well, we finally got you on and that's a good thing. Let me start by saying, with what we're talking about today, I really wanted to figure out a way to do this whole show while standing or walking. I'm sitting for a discussion focused on how spending too much time in a chair can lead to Dead Butt Syndrome. Just seems kind of wrong.

Dr. Andrew Bang:

I know. It's kind of ironic, huh? It seems ironic that we are sitting for such a discussion that it's all about not sitting. But if we can just think of the great words of the late Richard Simmons, may he rest in peace. He has three rules to live by, which applies totally this. Rule number one, of course, love yourself. Rule number two, eat healthy. And rule number three, you know what he said? Squeeze your buns. So John, even though you can't stand, you can just squeeze your buns all throughout the podcast today.

John Horton:

I will try to do that. You're going to make me blush. That's too funny.

Dr. Andrew Bang:

I know, right? I was like, I'm sure when I was looking up this topic, I'm sure Richard Simmons has some wise advice for us, and sure enough he did.

John Horton:

He's very sage. So we're talking about Dead Butt Syndrome, which is a pretty descriptive and colorful name and definitely more memorable than, I think it's Gluteus Medius Tendinosis, which is the official medical diagnosis. Can you walk us through what this condition actually does to your rump?

Dr. Andrew Bang:

Yeah, sure. So understanding what the glute medius is, it's one of three muscles of the glute muscles, your buttocks, okay? The big one is the glute maximus, and you have two smaller ones that are on the side of your glutes out on the edge, and one of those glute medius as we were discussing, it helps to really stabilize your pelvis. And it does a lot of important things specifically with walking, standing position, rising from sitting. And so when we don't use it, we use the word, dead butt, because it's just not engaging like it's supposed to because of inactivity. And then that leads to a whole snowball of other issues that come along with it.

John Horton:

So is that why, I mean, your butt just starts feeling numb if you sit for long periods?

Dr. Andrew Bang:

Yeah, so typically when nerves, we learn about what nerves do, they give not only muscles to contract, they're like, I don't know, a wire that goes to an outlet into a switch and the nerve energy from your brain, it gives an impulse down the nerve and makes the muscle contract and fire. So you can move and stand and run, but the nerves also do some important things. They feel stuff, hot, cold. When the nerve gets compression on it, it can get a sensation of electricity, burning, numbness, tingling. And so people who start experiencing this numbness from sitting too long, it's probably because there's some sort of compression in the sleeve of the nerve because you're not contracting your glutes enough or you're putting too much pressure from sitting in one position for too long. In fact, someone really smart, smarter than me, said it only takes the weight of a dime on a nerve where the nerve starts to have irritation. That's not very much. That's not very much pressure before it's going to be getting irritated.

John Horton:

I have a lot of dimes above my butt, so that's putting way more weight on there than what that is. So while that numb dupa, to use a word that my Slovenian grandmother used all the time, isn't the best feeling in the world, it's more of a nuisance than anything. But as I understand it, the real concern is that Dead Butt Syndrome affects far more territory than what the name suggests.

Dr. Andrew Bang:

Totally. I mean, it implies that it's no big deal because it's kind of catchy and funny, but when you mentioned the medical term earlier as Glute Medius Tendonitis and Tendinosis, that turns into an irritation that can last for so long. If any one of your listeners have ever had tendonitis of an elbow or a knee or shoulder, oh my gosh, that can be months. It plagues you. And so again, thinking of the mechanism, what the glutes do, especially this glute medius, it really helps your gait, meaning when you walk, go up and downstairs, et cetera. When you walk, when you raise up your one leg to take a step, your glute medius on the other side actually hold your pelvis in place so you don't fall down like this, right, when you walk. You're walking like this instead of boom boom boom . Well, so as we get tendonitis in there, now every time you contract that muscle to hold yourself up, you feel pain, discomfort. That can lead to walking irregularly, which then that leads to other problems like knee, hip, ankle pain.

It can lead to back pain because now you're really being careful not to use certain muscles while you're walking. Your lower back does all the work and now it causes pain. Now you got pain maybe down the leg or sciatic symptoms that some people are familiar with the term. That just means the sciatic nerve, which is the five lumbar nerves in the low back, they come together as one giant rope called the sciatic nerve. It gets irritated. So Dead Butt Syndrome is way more than just this benign, funny term we use. It can turn into some serious complicating health issues.

John Horton:

And it's amazing to me as to how far-reaching that is because you think of your butt, it's pretty central. It's just that one spot. But when you sit there and you, like you said, flatten those nerve endings out or irritate them, the fact that it can radiate into your hip, into your back, cause, I mean, problems up and down your torso because you're at that central kind of junction where everything's kind of coming together.

Dr. Andrew Bang:

Yeah. And let's talk a little bit more about, let's break it down, really what's happening physiologically. Because I think that really helps understand why it travels to so many spots instead of staying right in your buttocks. Another term for this would be called Lower Cross Syndrome, and what that essentially means is the muscles across from each other in a diagonal pattern are either too weak or too tight. So let's take the glutes. So the glutes are a lower muscle and its opposite muscle in the front would be the abs. And then we think the muscles that are directly above the glutes are your low back muscles and the muscles diagonal from and down from those are your hip flexors.

So what typically starts to happen is when you sit for long periods of time, your knees and hips are flexed, so your hip flexors get really tight. And then your lower back gets really tight, and then what happens is then you get a lot of weakness in the abs because you're not using them, because you're not standing erect and your glutes get really weak because they're just being stretched all day from being, when you sit, they kind of stretch. So you have two weak muscles, two overly tight muscles, and this cross pattern creates a world of havoc once you get up and start moving. That's really what Dead Butt Syndrome is. We're focusing in on the glute weakness part, but it's a combination of all these muscles that really gives us our problems.

John Horton:

And that's why we feel so awkward after we've been sitting for a long time and you get up and you kind of have those, you can have those Frankenstein steps and you get up because you're like, oh. You've been in the car for a long drive or something like that. It's like it takes you a few steps to get everything synced up and working again.

Dr. Andrew Bang:

That's so true. I love how you put that because as your muscles are super tight, they got to let go of that tightness, and that's why it takes a couple steps to get going. The muscles that haven't been contracted in a moment, they got to start contracting again. And so you're right, it takes a few steps to get moving and then you're starting to slosh around the blood and then this slick fluid that's in the joint, it starts lubricating again once you start moving. So yeah, sitting too long is a huge culprit of this because it just tightens everything up or makes things too loose because of inactivity.

John Horton:

Now obviously we just mentioned that and we're all familiar with that feeling when you've been sitting too long and you get up and you have those weird steps. If you continually do that, I take it it's not just a temporary effect where you walk it off with two or three steps. It's something that's going to linger and become, almost create some chronic weaknesses in those muscles.

Dr. Andrew Bang:

For sure. I'm thinking of a patient that I've been working with for the last several months, or approaching that six months to a year. It's tough. She has tendonitis because of this same thing we're talking about, and that tendonitis has now turned into bursitis. Bursaes are these cool little water pillows in her body, usually covering bony areas to create cushioning and for muscles and ligaments and fascia to slide on. So if you get Dead Butt Syndrome and your tendons are irritated and inflamed and now you're walking abnormally, that irritates these bursaes.

Man, it's been plaguing her. And she's had to not only use some of the techniques we've taught her, we've incorporated some physical therapy by working with some great physical therapists, and unfortunately we had to send her to get even some advanced treatments, including injections and another therapy that some providers use called TenJet to help clean out scar tissue and to clean up the tendons where they've kind of frayed away because of this kind of chronic tendonitis and tendinosis on these tendons. It can become unfortunately very painful and a very time-consuming diagnosis to overcome and get back to the way you were prior to this.

John Horton:

And it's so hard to believe. You think you just sit and you don't think you're doing that much damage. It's hard to think that you're hurting your body that much just by doing it, but I think over time, it just gradually gets worse and worse and worse. And by the time you really realize it, you're probably literally in a world of hurt.

Dr. Andrew Bang:

Oh, I mean, it's like anything. Even, I always love using the analogy of cars because it makes sense. Most of us have driven a car or experienced it. If you're not watching your tires, you could wear them out until they would explode one day. And it's just very gradual over time. Slow micro tears in our body and our muscles from lack of use that it eventually turns into a major problem. So yeah, it's frustrating because you don't notice all along the way. That's why it's so important to do podcasts and listen to things like this and get informed because you can do a lot and this is one of these conditions that's pretty much preventable. There's a lot of things you can do on your own to then not be in this world of hurt as you age and as you get further on in life.

John Horton:

All right, well, Dr. Butt. Oh, Dr. Butt, Dr. Bang, that is exactly why we have you here. Let's save some butts right now.

Dr. Andrew Bang:

Let's do it. I should have been a proctologist.

John Horton:

Let's start with how long is too long to be sitting?

Dr. Andrew Bang:

Okay, so that's a great question. I don't know if anyone scientifically said, "Let's do a study and try to figure it out." But using my rationale reasoning and all the training and my degree in applied kinesiology, the study of movement, your body loves to move. It hates being stuck in the same position. I mean, we all get it. If you went to the gym, John, which I know you do, you're buff. I see it. You never-

John Horton:

I'm not quite buff. I'm working on making sure I don't have quite as much of a dad bod as what I do.

Dr. Andrew Bang:

I love it. I love it. So when you're at the gym next time working on your dad bod, you wouldn't spend all 60 minutes doing biceps or ab curls or squats. Because we all know our muscles need breaks in between these demanding exercises. Well, we've got to think of that. Even though it's not demanding to sit, one group of muscles is overworking, because it's holding you upright and one group of muscles isn't working. So we just got to think, how long do I really want that to happen? I try to tell patients, think of the, when you make change depending on your age and your level, maybe you're experiencing pain, it's less time for you. But a rule of thumb where you're spending 40 minutes sitting, 20 minutes kind of up and moving, that doesn't have to be 20 minutes all at once. But where you're moving and sitting and moving and sitting and throughout the day. I love standing desks and that would be one that people often ask me, "Hey, I just stood up for eight hours at my job and now my ankle hurts."

I'm like, "Well, yeah. You changed all the stress from sitting to now you stand all day." So we got to find that happy medium of not sitting too long and also not standing too long, just motion is lotion, movement is key and changing the position. So start with that 20 and 40 minute kind of interval and then adapt as necessary. If you can sit a little bit longer and it's not causing you discomfort, maybe you push it to 50 minutes and then you're up for 10 to 15 moving around and that will probably be a good thing. If it's causing you pain, you're going to really shorten that to maybe you're sitting for 25 to 30 minutes and you're up for five or 10. Then back down and then back up and back down. Does that give you some guidance on how much you should be moving?

John Horton:

Yeah. Yeah. So if you're in an office and you're emailing somebody. Walk over and talk to them, instead of just sending the email. Just make some excuses to get up and move around because it sounds like a short walk just kind of engages those muscles again and kind of breaks that cycle where they're just sitting in one spot.

Dr. Andrew Bang:

Yeah, thanks for bringing that up because I was thinking, and I would want to do it right now, I just will mess up my camera view, but if you, next time you stand, John, or the listeners, next time you stand, actually hold your glutes and you'll know they fire or they turn on, they get hard as you go from sitting to standing. Once you're standing, they're soft again. So the act of standing doesn't necessarily work out your glutes. It doesn't at all, in fact. But the act from sitting to standing or standing to sitting is where glutes turn on or fire. So if you're really trying to avoid Dead Butt Syndrome or you have it or you don't want to get it, what you need to do is more than just standing and working, is when you go for that walk, your glutes really activate when you do some walking lunges is a big thing. Walking, let's see, squats. So maybe you stand up and down, up and down, up and down. Using the stairs, that's another really great one that also works.

John Horton:

Dr. Bang, you mentioned standing desks and I know those have become way more popular. Are they really that effective at kind of fighting Dead Butt Syndrome?

Dr. Andrew Bang:

So my colleague and I were talking about this the other day. Unfortunately it's not the standing desk problem, it's the operator error. They often get purchased and then just don't get used. You use them for the first day or two and then they just don't, they just don't get used anymore. So it's the operator. You must use your standing desk, okay. And again, as I mentioned before, it's the act of standing that engages your glutes and makes them fire. So what you could do is once you're standing, you could do some very simple exercises to keep firing those glutes to stop Dead Butt Syndrome from happening.

John Horton:

Clenching, you said, right? I've been sitting here clenching mine, so.

Dr. Andrew Bang:

That's right.

John Horton:

I've been following your advice.

Dr. Andrew Bang:

No, it's not mine. That's Richard. That's a Richard Simmons. We got to give that man the credit. Squeeze those buns.

John Horton:

Squeeze them. Yeah, all episode.

Dr. Andrew Bang:

Yes, yes. Like Kegels, the OBs will be thanking us for also promoting the squeezing of buns or Kegel exercises. But yeah, so once you're standing, and I know we'll probably talk about exercises. I don't know if we want to jump in now, but maybe I'll just do a little teaser. Any kind of lateral leg movement, like standing on your left leg, raising your right leg out to the side, fires the gluteus medius specifically, which is that dead butt muscle. Now we're talking about you want to fire those on a regular basis to keep them activated. Did you ever, John, did you ever break a bone as a kid?

John Horton:

I did not. I drink a lot of milk. I'm thinking that's going to help me out.

Dr. Andrew Bang:

You're not helping me here, John, come on. So if you were to break your arm and you put it in a cast, by the time you take off the cast, your arm is teeny compared to the other one because you get muscle wasting, right? You're not using the muscles. They stop. The body says, oh, we don't need them. I guess we're not using them. Let's not put energy into keeping them big. Motion is essential to keep your muscles big and plump and robust. So that's another reason why Dead Butt Syndrome happens. You're sitting literally eight to 10 hours a day, combination of work, driving, eating meals, et cetera, entertainment. They just literally evaporate away. And that's another problem.

John Horton:

We're going to have to make that sound. We're going to have to use that somehow and for evermore, I love that.

Dr. Andrew Bang:

As long as I get a kickback, anyone can use it.

John Horton:

So with standing desks, and you mentioned earlier, if you put it up and just stand all day, that's going to cause problems. So the idea is to build variety into it where you're standing, you're sitting, you're up, you're down. And if you do that, then your muscles are always, they never get bored. I mean, they're always doing something different. And they're happier.

Dr. Andrew Bang:

Yes, they are happy and they are not getting bored. You got it.

John Horton:

So what about posture? I mean, does that also play a role in Dead Butt Syndrome? Just how we're sitting, how we're standing?

Dr. Andrew Bang:

Yeah, I think so. And I'll tell you why. The idea of perfect posture, let me explain the theory because some guys and gals, physician, chiropractors, PTs, they're like, the perfect posture doesn't exist. And I like their rationale. But then there's this other camp that says, yes, perfect posture, it exists. So let me talk about this rationale first. Perfect posture exists in the fact that when you're standing or sitting, you're getting gravity to go through the body equally the way it's meant to be. So it can be dispersed. So your spine is like an S, think of it like a spring. So when gravity is pushing down on you, if your spine was straight, all the forces would hit the very last vertebral body and the jelly disk and it would get worn out super fast. But because it's like an S, the gravity actually gets kind of pushed and bounced and dispersed evenly through your spine and you can live a great life with a healthy spine.

So then you apply that principle when you stand or sit. And the same is true with other joints involved, like when you're standing, your hips, knees, ankles, if those are in good posture, gravity will be equally dispersed. They don't wear out as quickly. The other camp says there's no such thing as perfect posture. Because even if you are standing with perfect posture and gravity, you don't stand there very long or sit there very long because we get muscle fatigue, we have bad posture. And they also complain, as we've been saying, you need movement.

So their idea of there's no such thing as perfect posture is also rational because you got to move. Even if I sit perfectly straight like this, some muscle that's holding me up is going to get fatigued. It's my back. I can feel it right now because I need to sit with good posture to be in the camera view. But I wouldn't keep this up all day. I mean, I might do it for the 30 minutes we're doing this podcast, but then I'll trust me, I'll be all over the place moving to get my back back where it needs to be.

John Horton:

And that's where we get into the variety. So your best thing is to kind of shake it up and do different things, different movements, and while you're doing those, make sure then that you do keep some of the good posture things and you're not in awkward positions.

Dr. Andrew Bang:

Precisely.

John Horton:

All right, well Dr. Bang, every time you visit us you talk about the importance of stretching. So I'm guessing you have a few suggestions and stretches that can help keep Dead Butt Syndrome at bay.

Dr. Andrew Bang:

For sure. So let's think back to that cross syndrome. Usually we got, our low back is super tight, our hip flexors are super tight. So those, we've got to stretch those and then we got to strengthen the weak ones. So first let's talk about stretching. So there's so many easy low back stretches you could do. I love the simple one of even just grabbing your chair and twisting your low back and stretching the lumbar paraspinals both ways.

John Horton:

Just to the side. So you just kind grab and just kind of turn?

Dr. Andrew Bang:

Yeah.

John Horton:

Just like that. All right.

Dr. Andrew Bang:

Yeah, exactly. The hip flexors, there's a couple of different titles, but I think the idea behind a lunge is the best way to kind of describe it over the podcast. So for instance, I would kneel on my right leg, excuse me, kneel on my right knee with my left foot kind of forward and then just bend forward so that my hip flexor is stretching. My right hip flexor would be going behind my body and I would be feeling that stretch. It's called a runner's lunge or a seahorse, depending if you are familiar with those, you could look those up on YouTube.

John Horton:

I need do it more because I have very tight hip flexors. They're a mess. So just doing that a couple of times a day just loosens it up a little bit.

Dr. Andrew Bang:

Exactly. And then once you get those stretches going, and one more tip, when it comes to stretching, it's hard to go wrong with stretching, but where people do go wrong is that they don't usually do it long enough. And the example I give is your muscle needs so much force input into it directly for it to actually want to change. John, if you went to the gym to work on your dad bod and you used one pound weights, even though you're working out, you're not going to get any change in your muscles. You have to apply a heavier weight and with enough resistance for your muscle to say, okay, we're going to get bigger, stronger. And the same is true with stretching. If you do a five or ten second stretch, it does nothing. It feels good. It does nothing for your long-term stretch and benefit. So there's some research out there that says two minutes is the magic number.

John Horton:

Two minutes?

Dr. Andrew Bang:

I know that's an awful long time.

John Horton:

Yeah, I'm happy if I get to one.

Dr. Andrew Bang:

I know. Well, so that's kind what I'm trying to say is if you get towards that one minute mark, I think you're doing pretty darn good because most of us stop at about five to 10 seconds. So if your listeners just said, "I'm going to make it to a minute." Man, I think that would be huge for them. And if they're not getting the relief they need, then they should go a little longer and try to get to that two minute mark per stretch. So yeah, so a simple lumbar twist, lumbar twist, and then do that runner's lunge or seahorse lunge to get the hip flexors loosened.

Then we go tighten. We want to tighten our abs and we want to tighten our glutes. Those are the weak ones. A great glute tightener is like a lunge. You could even do a standing lunge where you get down into the lunge position and just hold it. While you're on a conference call or doing a podcast. Or you could even do a standing plank against your desk. You just lean your hands against the desk and make your body rigid so your abs contract while you're there.

John Horton:

Okay.

Dr. Andrew Bang:

Two easy ones to do.

John Horton:

Those are two easy ones and the nice thing is you can do them in an office or at your desk and maybe not draw a ton of attention to yourself while you're doing it too.

Dr. Andrew Bang:

You don't look so weird when you're doing them, yes.

John Horton:

No, and like you said, you're on calls a lot, you're on meetings a lot. It's easy just to take a minute and do some of this stuff.

Dr. Andrew Bang:

You just mute your camera. I have people do it all the time. They darken their camera and do other little exercises because, man, John, I know you love numbers. Maybe sometime you'll have to figure out how many, what's the average amount of meetings we do now as society virtually. And I would guess, plenty, right?

John Horton:

Whatever the number is, it's too many.

Dr. Andrew Bang:

How often, it would be easy just to literally mute your camera for five to seven minutes during that meeting while you, maybe you're not the key speaker and do your stretches. In fact, this is kind of cool. Our department started something called, Our Wellness Minute, and at every meeting we actually do a wellness minute and that's been carried over to some of our higher-up meetings, which is pretty neat. We take a minute and usually have a, it's led by a yoga therapist or some other type of therapist and they do a little bit of stretching and mindfulness while we're sitting. It's awesome. So I think that could be a standard of care for every meeting. That would be a world of difference right there.

John Horton:

Well, I have to say, I have literally spent 15 minutes at meetings stretching on the floor.

Dr. Andrew Bang:

Awesome. I love it. You're the poster child.

John Horton:

I'm trying. It's something that I'm working toward. So we have our stretches now that we can do a couple of main ones that, like you said, tighten and loosen.

Dr. Andrew Bang:

Yes.

John Horton:

So what kind of exercises can we do to kind of keep your butt from going dead?

Dr. Andrew Bang:

Okay, so like we mentioned before, walking or the act of standing from your desk is huge. So you could even do where you practice literally standing up from your chair. That's an easy one. Let's say you like to walk. It doesn't really engage the glute muscles that much unless you're doing stairs. But what you could do is on your walk, still do the walk, but then take time to do some walking lunges while you're out there. That will really contract the glute muscles and get them to be stronger. The other ones I really love, let's say you're stuck at work. You can't go for a walk. You don't feel like you want to stand up and down, up and down from your chair. When you're standing there at your desk, and this could be brushing your teeth, standing at the microwave, waiting for your coffee to get hot or your lunch to get hot. You're going to do lateral leg raises to the side and to the back.

John Horton:

To the side. Like kick them out to the side?

Dr. Andrew Bang:

Yeah, just kick them out. That works the glute medius, which is that one that's really important for stabilizing those who walk and run. And the glute maximus, the big huge glute muscle, when you're going backwards, your legs are going back away from your body, that strengthens the gluteus maximus. Those are so easy to do. You can do them with gravity, your own leg weight. You can add an ankle weight, you could do a band, a resistance band and tie it to the bottom of your chair or wrap it around your other leg. So it's wrapped around and you're just going out like this. There's so many options and it's not hard to grab a YouTube video and have someone walk you through it if this doesn't make sense, what we're trying to describe.

John Horton:

And are those more repetition, so if you're going to kick your leg out to the side, just kind of one, two, three, just kind of keep doing it and knock out 10 or whatever feels comfortable and then alternate legs?

Dr. Andrew Bang:

Exactly. Usually that's what I recommend. You start with 10 and if, sometimes what I'll say to patients, if you're busy and you're like, I can't do what I'm doing and count, that's fine. You do reps until fatigued, because let me tell you, that's not a very big muscle, the glute medius and it burns pretty quick if you're doing the exercise right. You're just raising your leg up to the side, keeping your toes straightforward. If you deviate your toes, you're going to use your quadriceps, which we don't want to do. Keep your toes forward, laterally raise your leg and you'll feel that little sucker start burning right away, which tells you, okay, that's enough, switch to the other side. And that's a great way to do it without needing one more thought process of like, oh, how many reps did I do? I'm just going to fatigue and then switch.

John Horton:

And you had mentioned always doing steps, which I know it's something people try to dodge them a lot, but just you want a flight or two or whatever. It engages them and gets them going again.

Dr. Andrew Bang:

Yeah. And it's again, such great easy, great stuff for your heart and your circulatory system. I mean, we all know the 10,000 step rule is literally, that is a huge indicator of health. If you get that 10,000 steps a day, man, it does put you light years ahead of other people who don't. And using the stairs is just the next level, as it were, of getting your 10,000 steps.

John Horton:

What about just yoga and doing things like that? I think any of those sort of stretches might help too. I mean, a lot of-

Dr. Andrew Bang:

Of course. I mean, and again, if you remember which ones are tight and which ones are weak, that can really guide your yoga practice. So for instance, your listeners may be familiar with the pigeon pose, right? Well, that stretches the glutes, feels great, but it doesn't combat Dead Butt Syndrome because it's stretching what's already overstretched from sitting. So what you may want to do in your yoga, if you're doing a 10-minute yoga during lunch, instead of doing the pigeon pose, even though it feels good, try to do a pose that would cause you to contract your glutes.

And you'll have to forgive me, I cannot think of one at the moment. There's a lot of, oh, I know one. Like maybe a triangle because you're forward on one leg and it's bent and you're holding yourself up. Your leg that's bent would be contracting the glute to engage. You have to do both sides, of course, but those would be great. And then of course, yoga is great for stretching. So you would isolate stretching the hip flexors and stretching the low back in your yoga session and then try to do any kind of Chaturangas are great for the abs because they're going to make you contract as you're in that Chaturanga position.

John Horton:

We'll have to have you on to lead a whole yoga session for us at some point too. So that could be a future episode.

Dr. Andrew Bang:

We need to bring in a specialist for that. I could just follow along.

John Horton:

You could be our yogi.

Dr. Andrew Bang:

I wish.

John Horton:

So Dr. Bang, bottom line on our bottoms, what's our best plan of attack to keep Dead Butt Syndrome from just causing a world of hurt?

Dr. Andrew Bang:

Again, let's review. It's not hard. First, let's return to our sadly departed Richard Simmons. Squeeze your booty or squeeze your buns. Let me get it right. I got to give him credit. So that's easy to do in the car. Let's say you're doing that long commute either to work or you're on a road trip. It's so easy just to just squeeze that baby, just contract them because you're going to keep the blood flow moving through there and you're not going to allow fatigue, or excuse me, you're not going to allow muscle wasting to set in because you're constantly contracting them, okay? Taking turns. That's so easy to do. Stand. Quit sitting for so long and engage those muscles by doing some lateral leg raises, some walking lunges. Incorporate a wellness minute into all your work meetings. I bet your boss will thank you because it will increase engagement, which everybody loves right now, and it will get your team a lot healthier.

Let's see, the other things I would do is just stretch the tight muscles, make sure that back, that low back and the hip flexors are loose so that your whole body works symmetrically and it's not fighting each other with having too tight and too weak muscles. And I don't know, turn it into a game. Remind yourself with some easy post-its or a funny text and maybe text with your wife or spouse or partner or coworker to have that support. And it's a funny thing, but the things that can prevent, again, I can't express to you how this can turn into a very painful and long recovery if you get into this gluteus medius tendon problem or Dead Butt Syndrome. So be proactive.

John Horton:

I like the buddy system. Message somebody and be like, "Hey, are you clenching your butt right now because I'm clenching mine?"

Dr. Andrew Bang:

Just don't send that to your HR leader.

John Horton:

You have to be careful who you do that with, right? Dr. Bang, I feel like we've been sitting here talking for so long and it's been fabulous, but I feel like I'm going to need to get up and start moving around soon.

Dr. Andrew Bang:

Me too.

John Horton:

Before we part ways, do you have anything else to add on Dead Butt Syndrome?

Dr. Andrew Bang:

No, John, just keep squeezing. Squeeze your butt.

John Horton:

Keep squeezing. The perfect sentiment to end on. So Dr. Bang, thank you so much for coming in. I haven't laughed this much in a while.

Dr. Andrew Bang:

Good.

John Horton:

If you've been sitting down while listening to this podcast, hopefully you now feel the urge to get up and move around. Breaking up your time in the chair is the best way to guard against Dead Butt Syndrome and the pain it causes. Consider it a stand worth making. If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.