Buttock Pain in Athletes: a Narrative Review

Purpose of Review The goal of this review is to provide a guide to systematically evaluate and diagnose sport-related buttock pain. Since buttock pain is a common yet challenging complaint for sports medicine clinicians, we have developed an overview of the common diagnoses in athletes presenting with buttock pain using an anatomical framework to illustrate the complex anatomy and multiple pain generators that may refer to this area. Recent Findings The differential diagnosis for buttock pain is large; the most common causes of buttock pain in athletes include myofascial pain, referred pain from the lumbar spine, proximal hamstring tendinopathy, and sacroiliac (SI) joint dysfunction. Relatively novel nonoperative treatments for hamstring and gluteal tendinopathy include platelet-rich plasma (PRP) and extracorporeal shockwave therapy, although the current literature is limited. Summary A strong understanding of sport-specific biomechanics, mechanisms of injury, and the complex interactions of the lumbar spine, pelvis, and lower extremity is essential in the evaluation of the athlete with buttock pain. Ultimately, treatment should be determined utilizing a multidisciplinary, evidence-based approach to optimize athletes' clinical outcomes and facilitate return to sport. Future research should focus on the development of large, randomized control trials to investigate the efficacy of emerging nonoperative treatment options for sports injuries in the posterior hip.