Not a day goes by that Ido not see a runner with severe butt pain. Often the condition is misdiagnosed as either Sciatica, Piriformis Syndrome or Bursitis. It is not that it is never one of these but much more often than not it is Gluteus Medius muscle strain. In runners Gluteus Medius muscle strain is far more prevalent than any of the other conditions. The Gluteus medius is one of three Gluteal muscles that work to stabilize your hip joint and sacroiliac joint. The Gluteus medius is crucial during the landing phase of gait. When your foot strikes the ground and you are putting all of your weight on one leg the Gluteus Medius on that side contracts to stabilize the hip and give you balance and support. The problem? Your foot impacts the ground up to 2000x per mile. That is 2000 Gluteus Medius contractions per mile! Try doing 2000 biceps curls and see what your biceps feels like!
I saw a women today who was suffering from “Sciatica”. She explained how she has been to all of the “top” orthopods and sports doctors. She told me the grim details of her encounters with physical therapists who tried to”strengthen” her hips. I heard tales of Chiropractors who “cracked her back”. She also had heard that shoes caused her problem so she started running barefoot. Not only did that not work but now she had Achilles tendonitis too! Why couldn’t all of these doctors and therapists help her? Because they were all playing the game blindfolded. In the dark. They were all operating under the wrong diagnosis. She had Gluteus Medius strain not Sciatica!
We directed the therapy at her Gluteus using mostly ultrasound and myofascial release. I instructed her on proper stretching (how much and how often…how long to hold the stretch and how many times to do it a day). I introduced her to her new best friend, Mr. Foam Roller. As I demonstrated how to properly use the foam roller she came to have a love-hate relationship with Mr. Roller (“it hurts so good”!). She emailed me tonight to let me know that her butt was feeling better for the first time in months! I promised her it would be 100% better in a couple of weeks and she would be running again…..far. She asked why the other doctors and therapists did not know what she had. I explained, “They simply do not understand running injuries because they are not runners. I run far and I run often. I have had every running injury there is. I have treated runners with every running injury there is for 12 years. When you do the same thing over and over again for 12 years you get good at it. I’m good at it”.
It is not arrogance that makes me so confident. It is my desire to help people, runners especially. I do not want to be “average”. I want to be excellent. I have strived to learn as much as I can about running and running injuries to better serve my patients and the San Diego Running community. Unfortunately it is true that most doctors and therapists are fine with mediocrity and being average. For this reason they misdiagnose and mistreat runners and patients. Sad but true.