Gluteal pain or butt pain is common for runners to develop. What makes gluteal pain difficult to fix is that it is often confused as sciatica, hip conditions like bursitis and muscle weakness . Those that suffer from gluteal pain are commonly misdiagnosed by undertrained or misinformed doctors and therapists, well intentioned friends, family, loved ones and the internet (Dr. Google). Dr Allen has specialized in treating gluteal pain for over 13 years. The reason this is important is that there is more learned “in the trenches” than can ever be taught in school. It is also called “being in practice” because every day we come to work we are “practicing” on patients. When you do the same thing over and over for 13 years you get much better at it. What I know now after 13 years dwarfs the knowledge I had when coming out of school. Couple that experience with all of the “tricks of the trade” regarding running shoes, orthotics, Braces, Taping, modalities, running injuries, foam rollers, etc and what you have is a highly specialized doctor with intricate and intimate knowledge of running injuries and how to fix them. So how do you know what type of back, hip or gluteal problem you have? The answer is to list them all out and then in a fashion similar to what a crime detective might do, eliminate the usual suspects.
There are 7 major issues that affect the posterior, upper 1/3 of a runner’s lower body. I will list them from high (superior) to low (inferior).
- Symptoms – Pain that will radiate from the back or gluteal region past the knee and down to the foot. It is caused by a swollen, bulging or herniated lumbar disc. The pain will typically be made worse if trying to stretch your hamstring. The runner may also notice weakness in the foot, calf or ankle and or numbness.
- Differentiation – If you DO NOT have pain shooting past your knee into your foot you probably DO NOT have Sciatica or Piriformis Syndrome. However, pain that radiates past the knee and down to the foot is almost always indicative of Sciatica with Piriformis Syndrome also a small possibility.
- Testing – Manual orthopedic/stress testing can be performed that can differentiate between Sciatica and Piriformis Syndrome. X-rays are not useful in differentiating these. An MRI would be the appropriate special test to help diagnose the conditions.
- Treatment – Both Sciatica and Piriformis Syndrome can be treated effectively without surgery. San Diego Running & Sports Injury Clinic treats both of these conditions regularly with excellent results.
- Symptoms – Pain that is diffuse throughout the gluteal region and may radiate into the upper hamstring but DOES NOT radiate past the runners knee. Often the pain will hurt worse if running uphill or sprinting and may even hurt some while sitting.
- Differentiation – If you have pain shooting down your leg past your knee and into your foot you DO NOT have Gluteus Medius Syndrome but most likely either