I've got what is diagnosed as an overly tight piriformis and glute
muscles. This has resulted in a "pain in the butt" for the past year
and a half. I haven't been running since I got injured, since running
aggravates it. I was doing a lot of speedwork when I got injured.
Other actions that aggravate this "butt pain" include sitting
(especially on hard surfaces or sitting on the floor Indian style with
legs crossed), biking, and fast walks. Other symptoms that came along
with the butt pain and are still present are the iliotibial band
snapping at my hip and some snapping, popping sensation in the hip
flexor, groin region. All the symptoms are on my right side. I also
get some popping in my lower back occasionally, particularly when I get
up from a seated position and twist my torso at the same time, like when
getting out of a car. Lately, I've been experiencing some numbness on
the outside of my right thigh that seems to come and go, but stretching
the piriformis and itb tend to bring the numbness back. X-rays and MRI
of the pelvis and hip didn't show anything unusual.
Two questions. First, does it sound like I am diagnosed correctly as
having a tight spasming piriformis muscle? Second, what treatment
should I seek for this injury? Things I've tried include NSAIDs,
stretching, ice, heat, trigger point injections, and lately deep tissue
massage with little relief.
Thanks for any suggestions you can provide. I look forward to hearing
from you.
Ron, whenever you have "pain in the butt", the first thing we think about is
Sacro Iliac Joint dysfunction (SIJD). It is typical to have several various
symptoms that mimic other conditions when this occurs. The reason for this is
that SIJD takes on several forms. you can have a posterior torsion of the ilium
on the sacrum (the most common in my experience), an anterior torsion, an up
slip, and a down slip. Osteopaths also describe several forms of dysfunction
that are relative to the rotational axis, and the position of the sacrum. My
advice is to seek the assistance of an osteopath, or a manual therapist who is
skilled at mechancal diagnosis and treatment.
The SI joint is rarely injured in men. Naturally, women are more subjected to
SIJD, especially during pregnancy, and often after. It is usually preceeded by a
trauma of some kind, and it is not uncommon for something as low level as bike
riding to be the chronic irritant. Also, it is usually the hypermobile side that
hurts, and treatment often has to be administered to the hypomobile side. I
would offer you some suggestions as to exercise, but the exercises differ
accorduing to the nature of the SIJD. Good luck in your
