A sharp pull in the buttock while sprinting, lunging or slipping? That may be a gluteal strain. Here is how to tell it apart from other buttock pain, how long it usually takes, and how to get back to full strength.
Your gluteal muscles, the glutes, are some of the largest and strongest in the body. They push you up stairs and hills, drive you forward when you run, and hold your pelvis level every time you stand on one leg. Because they work so hard, they can be overloaded, and a sudden effort can strain them.
People often call this a "gluteal sprain". Strictly speaking, a muscle is strained and a ligament is sprained, so the correct term is a gluteal strain, but you will hear both. More important than the name is working out whether the pain really is coming from the muscle, because buttock pain has several common causes.
At a glance
- What it is: an overload or tear of one of the gluteal muscles in the buttock
- Common causes: sprinting, hill running, jumping, deep lunges, a slip or sudden twist
- Symptoms: a sudden pull, then pain with stairs, hills, rising from a chair or stretching
- Look-alikes: pain referred from the lower back, gluteal tendinopathy, hamstring injury, nerve irritation
- Treatment: a short period of protection, then early, progressive strengthening
- Recovery: days to a couple of weeks for a mild strain, longer for a significant tear
The gluteal muscles
There are three main glutes on each side:
- Gluteus maximus, the big outer muscle, which extends the hip: climbing, sprinting, standing up
- Gluteus medius, on the side of the pelvis, which keeps the pelvis level when you stand on one leg
- Gluteus minimus, a smaller, deeper muscle that helps gluteus medius
Underneath them sit smaller hip rotators, including piriformis, with the sciatic nerve passing nearby. That is one reason buttock pain can come from more than one place.
Strain or something else? Grading muscle injuries
An international consensus on muscle injuries in sport, the Munich consensus, separates two broad groups:
- Functional muscle disorders: the muscle is tight, sore and overworked, or not working properly, but there is no actual tear
- Structural injuries: a partial tear, or in more severe cases a near-complete or complete tear
Most "pulled glutes" in everyday life sit in the milder end of this range. A significant tear is less common but takes longer and needs a more careful plan.
Symptoms
- A sudden pull, twinge or sharp pain in the buttock during an activity
- Pain walking up stairs or hills, standing up from a chair, or getting out of the car
- Pain when the muscle is stretched, such as pulling the knee towards the chest
- A tender spot in the buttock
- Sometimes bruising a day or two later, if a tear has bled
- Gluteus medius strains often hurt on the side of the hip when standing on that leg
Common look-alikes
A good assessment matters here, because several other problems produce pain in the same area:
Pain referred from the lower back
The lower back very commonly refers pain into the buttock. Clues include back stiffness, pain that changes with bending or sitting, and pain without a clear moment of injury. See our article on disc bulge and sciatica.
Gluteal tendinopathy
Pain on the outer hip, especially lying on that side at night, standing on one leg or climbing stairs, often building up gradually. It is common in women around and after menopause and is now understood as the main source of what used to be called "trochanteric bursitis". It is a tendon problem rather than a muscle tear and is treated differently. Read more about gluteal tendinopathy.
Hamstring injury
Pain low in the buttock, near the sitting bone, especially after sprinting, may be the top of the hamstring rather than a glute. See hamstring strain.
Deep gluteal syndrome
Irritation of the sciatic nerve as it passes through the buttock can cause deep buttock pain, often worse with sitting, sometimes with pins and needles down the leg. A detailed review describes how careful history and examination help to pin down where the nerve is being irritated.
Sacroiliac joint and hip joint
Pain right over the back of the pelvis may come from the sacroiliac joint, and deep groin or buttock pain with stiffness may come from the hip joint itself.
How it is diagnosed
Most gluteal strains are diagnosed from the story of how it happened and a hands-on examination: where it is tender, which movements hurt, how strong the muscle is, and checks of the back, hip and nerves. Scans are not usually needed for a straightforward strain, but an ultrasound or MRI may help if a significant tear is suspected, if it is not improving as expected, or to rule out other causes.
Treatment: protect briefly, then load
The way muscle injuries are managed has changed. A major international review of traumatic muscle injury describes a shift away from long rest and protection towards early activation and progressive loading. It also notes that medications and injections are often used to try to speed recovery, despite very limited evidence that they do.
A practical framework many physios use is PEACE and LOVE:
- Protect the area for the first few days by avoiding the movements that sharply hurt
- Elevate and compress where practical (more relevant for limbs than the buttock)
- Avoid anti-inflammatories early on, unless advised otherwise, because inflammation is part of healing
- Educate yourself about the injury and avoid unnecessary treatments
- Then Load the muscle progressively, stay Optimistic, do pain-free cardio for Vascularisation, and Exercise to restore strength and control
Why starting early matters
In a Danish randomised trial of 50 recreational athletes with severe strains of the thigh or calf muscles, rehabilitation was started either early or after a delay. Earlier rehabilitation has been linked to a faster return to sport, and in this trial muscle strength and healing on MRI ended up similar in both groups. The muscles studied were not the glutes, but the principle that sensible early loading does not harm healing applies to muscle strains generally.
Exercises you can try
Only progress when the previous step is comfortable. Mild discomfort that settles quickly is usually fine; sharp pain is a sign to ease back.
- Glute squeezes (isometrics): lying down, gently squeeze the buttock for 5 to 10 seconds, repeat 10 times
- Bridges: lying on your back with knees bent, lift the hips, hold briefly, lower slowly
- Side-lying leg lifts or clams: for gluteus medius, slow and controlled
- Sit to stand: from a chair, without using your hands, gradually from a lower seat
- Step-ups: onto a low step, then higher, then with more speed
- Single-leg work: later on, such as single-leg bridges and single-leg deadlifts
- Return to running: walking, then jogging, then hills and faster running, before sprinting and jumping
How long does a gluteal strain take?
It depends on the size of the injury:
- Overload without a tear: often days to about two weeks
- A partial tear: typically several weeks of progressive rehab
- A large tear: longer, and occasionally a specialist opinion is needed
Rather than going by the calendar, a physio will usually use milestones: walking and stairs pain-free, normal strength compared with the other side, and sport-specific drills without pain, before full return.
Myths about buttock pain
- "Rest it until it stops hurting." Short protection, yes; long rest tends to leave the muscle weak and prone to re-injury.
- "Stretch it hard to loosen it." Aggressive stretching of a fresh tear can aggravate it. Strengthening matters more.
- "Buttock pain is always the muscle." The lower back, tendons and nerves are common sources too.
When to see a physio or doctor
See a physio if the pain followed a clear injury and is not settling within a few days, if you are unsure whether it is the muscle or your back, or if you play sport and want a safe return plan.
Seek urgent medical attention if buttock or leg pain comes with:
- Numbness around the groin, genitals or inner thighs
- New difficulty passing urine or controlling your bladder or bowel
- Weakness in the leg or foot, or a foot that drags
- Fever, feeling unwell, or severe pain at night that does not ease with rest
How UpPlus Physiotherapy helps
At UpPlus Physiotherapy in Seaton, our physiotherapists start by working out where the pain is really coming from: muscle, tendon, back, hip or nerve. For a gluteal strain, we set a loading program matched to the injury, progress it as you improve, and test strength and function before you return to running or sport.
Finding a physio near me for buttock pain
Look for someone who examines your back and hip as well as the buttock, explains what is and is not causing the pain, and gives you a progressive strengthening plan rather than passive treatment alone.
Our clinic is at 177 Trimmer Parade, Seaton, close to Woodville, Findon, West Lakes, Grange and Henley Beach.
Physio take-home message
- A gluteal strain is an overload or tear of a buttock muscle, often from sprinting, lunging or a slip.
- Buttock pain has several look-alikes, especially the lower back and gluteal tendons.
- Protect it briefly, then load it progressively; early loading is safe for muscle strains.
- Return to sport by milestones, not just by days.
- Numbness in the saddle area or bladder changes need urgent medical care.
If buttock pain is holding you back, our physiotherapists can assess it and build your recovery plan. Book online or call 0403 907 587.
This article is general information, not a diagnosis or a substitute for an individual assessment. If you are unsure about your symptoms, see a health professional.
