Pete! What's wrong with my butt?

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  • #42243
    Anonymous
    Inactive

    🙂

    Lately, I’ve been having post-training session pain medial to, and slightly higher than, my left sitz bone. It never hurts during a training session, only after sessions that include sprints or if the session is longer-than-average in duration.

    What usually triggers the pain is some type of lateral adduction. For example, the idea of standing on ice with my legs wide, trying to stop them from going out, would probably be painful.

    The following may or may not be relevant:

    * My left leg has always been my “dumb” leg. For example, I can jump around single-legged with my right leg without much thought, but with the left, I have to be aware of how I’m moving to land correctly, keep my knee in line, etc. Another example is that on a ski lift, with my legs hanging, my left ski is rotated outward to a greater degree than my right.

    * Several years ago, I felt a twinge in my upper inner thigh (hamstring), and then the next day, a short run triggered enough pain in my left SI joint that I was on the couch for a week.

Posted In: Injury & Rehab

  • Participant
    Pete Dickinson MS,PT on #42259

    Well, your butt looks fine to me:) OK, excellent question. This is an interesting area, the sit bone, perineal, hamstring region. We have to differentiate between a soft tissue tendinous injury, or local nerve involvement, proximal spinal referral, training error, or a musculofascial consideration. Lots going on. Your discomfort can give us some indication, do you have pain sitting, driving? I would take you through some neural tension tests to see if one side is tighter than the other. Hows your gross strength on a single leg step down left compared to right? Is your fascial tissue mobile through the glut med/posterior hip/ischial tuberosity/hamstring (posterior line)? Zoomie sessions are helpful to sort this out!! Its all treatable with some combination of fascical mobilization, single leg strength, neural mobilization, spinal mobility.
    Cheers,
    Pete
    pete@worldcup.physio

    Inactive
    Anonymous on #42306

    You mean I can’t just take a pill or something? 🙂

    * PAIN: No pain sitting or driving;
    * STRENGTH: Single-leg pistol squats are straightforward with my right, but harder and less stable with my left;
    * NEURAL: If I do a downward dog yoga pose, I feel a nerve-like pull near my left glute med, but not on the right;
    * MOBILITY: Digging into my glutes with a lacrosse ball hurts on both sides, no noticeable difference.

    I’ll email you and we can set something up. Thanks!

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