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Researchers in Ohio have identified a potential primary source for knee, hip and back pain that can lead to injury and surgery: dormant butt syndrome (DBS).

Scientists at The Ohio State Wexner Medical Center coined the term DBS, which is marked by tight hip flexors and weak gluteal muscles— an effect that may place unnecessary strain on the muscles and joints around the gluteal muscles.

“The entire body works as a linked system, and a lot of times when people come in with knee or hip injuries, it’s actually because their butt isn’t strong enough,” Chris Kolba, a physical therapist at Ohio State Wexner Medical Center, said in a news release. “The rear-end should act as support for the entire body and as a shock absorber for stress during exercise. But if it’s too weak, other parts of the body take up the slack and often results in injury.”

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Exercising improperly but also not exercising enough, or even sleeping in the fetal position, can weaken the gluteal muscles and strain other parts of the core, Kolba said in the release.

Tight hip flexors can cause DBS, leading to meniscus injuries that often require knee surgery.

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Kobla said not sitting for periods of long time, but rather standing up and stretching can decrease the risk of DBS, as can doing exercises to strengthen the gluteal muscles.