Your glute max
It extends the hip and gives you power off the floor. Strong in most athletes when they are pushing straight ahead.
Glute & Piriformis Self-Assessment
Deep Glute Or Piriformis Pain? Start Here.
You feel it deep in the buttock. A dull ache, or a spot that will not release, sometimes with a niggle down the back of the leg.
Here is the part most people miss. Deep glute pain is rarely about a tight muscle you need to stretch harder. More often the glutes and the deep rotators have stopped controlling the hip, so the load piles onto whatever is left. The piriformis included.
When the side and the back of the hip share the load and fire in the right order, the hip feels stable. When they go quiet, the pelvis drops and twists, and the deep tissues take strain they were never built to hold.
The Basics
Meet The Team Around Your Glute
Keep this simple. A few key players decide how your hip feels from behind.
Your glute medius
It controls the pelvis when you stand on one leg, so the hip does not drop. When it goes quiet, the side of the hip and the ITB take over.
Your deep rotators, including the piriformis
They control how the thigh bone turns. When they cannot handle the load, they get overworked, and they sit right next to the nerve that runs down the leg.
When these share the work, the hip is quiet and stable. When the glutes switch off, the deep rotators and the ITB pick up slack they cannot hold. That is when the deep ache and the niggle down the leg show up. Most of this page is about getting the side and the back of the hip controlling the hip again.
Find Your Issue
Where Do You Actually Feel It?
Pick the one that fits you best. It points you to the right checks below.
01Check First
Deep ache in the buttock
Worse sitting, driving, or after a run.
Start with the pathology checks 02Check FirstButtock pain with a niggle down the leg
Pins, needles, or a line of pain down the back of the thigh.
Start with the pathology checks 03CoordinationPain on the outside of the hip
Worse lying on that side, or standing on one leg.
Go to coordination
Pathology Assessments
Glute & Piriformis Assessment: Signs You Need A Professional
Is It Something To Get Checked?
Before anything else, we rule out the things that need a professional eye. Deep buttock pain can be a local muscle, or it can be the nerve nearby. These checks do not diagnose anything. They tell you whether it is sensible to get it looked at before you load it.
The Figure 4 Check
A simple way to load the deep glute and see how it responds.
- Lie on your back, both knees bent.
- Cross the sore side ankle over the opposite thigh, just above the knee, so your legs make a figure 4.
- Reach through and gently pull the bottom thigh toward your chest.
- Go slowly. You are looking for pain, not a big stretch.
Just a stretch
A normal stretch feeling, no sharp or familiar pain. Deep gluteal irritation is less likely. Move on to the coordination check.
Your deep pain reproduces
A deep, familiar ache in the buttock points to the deep gluteal muscles or piriformis. If it sends symptoms down the leg, get it screened properly. This is a screen, not a diagnosis.
The Red Flag Check
Deep buttock pain sits close to the nerve and the lower back. Some signs mean stop and get it looked at. Tick any of these and book an assessment.
- Pain that shoots or travels down the back of the leg.
- Pins and needles, numbness, or weakness in the leg or foot.
- Symptoms that flare with your lower back, not just the hip.
- Pain at rest or at night that is getting worse.
- Any change in bladder or bowel control. This one is urgent. Get seen the same day.
A word on the nerve. The deep rotators sit right beside the sciatic nerve. A bit of local ache in the buttock is one thing. Pain, pins and needles, or weakness travelling down the leg is a signal the nerve or the lower back may be involved. That is a get it checked, not a train through it.
When in doubt, get it checked.
These checks are for peace of mind and understanding your body. They are not a diagnosis and they do not replace medical advice. If you have pain travelling down the leg, numbness, weakness, or any change in bladder or bowel control, stop training and get seen.
If nothing above fits you, your deep glute pain is far more likely about coordination and control. That is good news, and it is exactly what the next part is for.
Coordination Assessments
Is Your Body Sharing The Load?
No red flags? Then the question changes. It is not "what is damaged". It is "who has stopped doing their job". This check shows you whether your glute medius controls the hip on one leg, or whether the pelvis drops and everything else compensates.
The Single Leg Stance Check
Start here. It is the clearest look at whether your glute medius is doing its job.
- Stand tall next to a wall or a counter, one hand resting on it for light balance only.
- Lift the good leg so you are standing on the sore side.
- Watch your pelvis in a mirror, or feel it. Try to keep it level and stay tall.
A good result
Your pelvis stays level. You feel the side of the stance hip working. You can hold it without swaying or leaning.
A poor result
The opposite hip drops. You sway or hitch to the side. The work goes into your lower back, or you cannot hold it at all. That is the glute medius not controlling the hip.
Second check. The Midfoot Bridge Check from the knee and hip pages shows whether the back of the chain accepts load. Shared assessment, defined once.
Get The Basics Right
The Drills
These are the exact drills we use in our clinics to get the side and the back of the hip working together again. Do them in order. Each phase earns the next. Keep everything pain free.
1
Isometrics
Wake it up.Hip External Rotation Holds
Wakes up the deep rotators so they can control how the thigh bone turns, instead of getting overworked and irritable.
Cue. Sit tall, or lie on your back with knees bent. Turn the thigh outward against light resistance from your own hand or a band. Build tension slowly, hold, ease off. Keep the pelvis still and keep it pain free.
2
Load Tolerance
Share the load.Lateral Hip Loading with Kettlebell
Loads the side and back of the hip with a bit of rotation, building the control you need to decelerate and change direction.
Cue. Reach across, let the hip travel toward the corner of the room, and keep contact through the ball of your big toe even as your weight loads the heel.
Glute Medius RDLs
Takes lateral hip control into a hinge. Reaching across the body forces the deep rotators to work.
Cue. Do not let the knee bend further, keep pressure through the big toe, and drive the hip forward to stand.
Single Leg Reverse Plank
Loads the back of the hip, the calf and the hamstring together in high tension, where they have no choice but to work.
Cue. Only an inch of clearance, hold pressure through the heel.
3
Deceleration Tolerance
Control it.Box Lateral Hip Loading
Puts the side of the hip on an elevated surface so your nervous system has to trust it. That builds the frontal plane control you need for cutting and deceleration.
Cue. Heel off the edge, weight through the midfoot, reach and let the hip travel outside your base, then control it back.
Slouch Walking Lunges
Takes the control and adds movement through space, the way real sport demands.
Cue. Stay low in the tunnel, do not stand up between steps, keep the upper body relaxed.
Progress
Glute & Piriformis Pain Recovery: How To Know The Drills Are Working
The deep ache in the buttock eases, and any niggle down the leg settles.
You can stand on one leg and keep the pelvis level without thinking about it.
You feel the side of the hip working, not the lower back.
Sitting and driving stop flaring it up.
When to progress
When a drill feels easy and clean, move to the next phase. Easy is the signal. If it still feels like a fight, stay where you are.
When to get help
If the pain is not settling after a couple of weeks of honest work, or anything shoots down the leg or you lose strength, get it assessed.
Your Sport
Glute & Piriformis Pain By Sport: Running, Hyrox, CrossFit, Court Sports
Running and endurance
The glute medius controls the hip every time your foot lands. When it is late or weak, we see lateral hip pain, ITB symptoms and a deep gluteal ache that builds over the miles.
Hyrox and CrossFit
Lunges, step ups and single leg load hammer the side of the hip. When the glutes do not control the pelvis, the deep rotators and the ITB take the strain.
Field and court sports
Cutting and change of direction need control from the deep rotators in the transverse plane. When they cannot handle it, the load dumps into the lateral hip and the lower back.
Next Step
Where To Go Next
01One To One
Book A ProSport Online Assessment
Want certainty, or ticked a red flag? We find the root cause with you, online or in person.
Book now 02RehabGo To The Rehab Drills
The full library of drills we use in clinic.
Open the library 03ReadWhy Hip Pain Keeps Returning
The coordination story in full.
Read the article 04BrowseBack To All Body Parts
Something else bothering you? Pick another area from the full list.
All self-assessmentsYour glutes are not weak so much as switched off. Wake them up, give them the hip to control, and the deep ache settles.