Jogging & Running/piriformis

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QUESTION: Happy new year Nick.

I have been having a pain in my butt. LOL. Unfortunately, for real. Right side only. Maybe related to poor sitting posture at work idk. I have been stretching, rolling, tennis ball massaging and even icy/hot ointmenting my ass off. Luckily the one thing that makes it feel better is.....running. During and after a run it feel fine. Other than everything I am doing and other than going to a Dr or therapist ($$) would you suggest cold or heat or anything else other than more of what I am doing already?

I had a painful glute once before and stretching did the trick. So far this time it has not.

ANSWER: Happy New Year Len.

I know this may sound odd, but I need to know if lying on your stomach and then pressing your hands into the ground to lift your torso off the ground makes it better or worse or no different. My guess is that it'll make it better due to the fact that running makes it feel better and it sounds like sitting may make it worse. This is something commonly seen and heavily researched. It would classify you as an extension directional preference client. If lying on your stomach and lifting your torso off the ground for 5 mins doesn't change it at all then write me back. Also, please tell me more about when it hurts and when it doesn't.

Good luck and I look forward to hearing how this goes.

---------- FOLLOW-UP ----------

QUESTION: Lying on my stomach and lifting my torso does cause increased pain while I am doing the stretch and it feels better after the stretch is released but that lasts for only a short time. Not that I know yoga but I have incorporated a few yoga stretches into my daily stretching including something I think is called a cobra pose which seems similar to this.

I can feel a knot or discomfort pretty much all day at work. I try to get up from my desk as many times as possible doing stretches. It feels better right after the stretch and within 10 minutes its back again. I put a heating pad on my glute for a few hours last night with some stretching during the time. It felt better and looser after. I just cannot seem to stretch or kneed it out permanently this time. Maybe this cold weather is contributing to a tight muscle. I did notice that shoveling snow aggravated the hip component of the discomfort last week. I am a righty and the right hip bothered me during shoveling.

I used to do squats and dead lifts after running and stopped a few months ago. This past week I started those up again hoping it would help this. Good or bad idea? Nothing too heavy - same weight I curl.

Thanks

Answer
Len, The low back/hip/butt is a fun area to work with because there's so much that we can do. However, it can be tricky to do without being in person. I'll give you a few things to do below. One may help more than another, but none should make it worse.

1. Continue lying on your stomach with your torso lifted. This is is basically "Upward Facing Dog" from Yoga. The goal of this movement is to have the pain centralize and feel better the more it is performed.

2. Perform clamshells and bridges. I'm pretty sure I've given these to you in the past. If not then google them or write me back.

3. Keep performing squats and dead lifts so long as it isn't making your pain worse.

4. A principle of this type of pain is to find things that feel good. Often I just help clients to figure this out for themselves. If you find something that makes it feel better (normally a movement, position, or exercise) then keep performing it until you are better or it stops working.

Good luck and don't hesitate to write with more information or an update.

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Nick Rainey

Expertise

I can answer questions about pain and training program. If there is a question about running that I don't know then I'll do some research and make sure I provide you with an answer.

Experience

I'm a Doctor of Physical Therapy. I'm a track and cross country coach. I train clients throughout the year. I've helped prepare athletes for their NFL Pro Days. I've written articles on running. Finally, those that I work with have less pain and run faster.

Organizations
American Physical Therapy Association- Sports Section

Publications
The 6 Week Workout Program- I'm the author of this book Research Made Simple for Physical Therapists- I'm the author of this Kindle book

Education/Credentials
Board Certified Clinical Specialist in Orthopaedic Physical Therapy Doctor of Physical Therapy BS in Exercise Science NSCA- CSCS and CPT USA Weightlifting Level I NPI- Certified Posture Specialist Total Motion Release Level II Certified Dry Needling

Awards and Honors
National Posture Institute's International Perfect Posture of the Year Award 2011 Clinical Excellence Award- Rocky Mountain University of Health Professions Aegis Therapies Scholarship recipient

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