Right Glute/Leg Pain

Training Injuries
1

I am new to the forums here but I came here from the discussions I have seen in other threads so I figured I would give it a shot of posting. Until now I have been looking into runners forums because the kind of injury I think I have seems to closely match a running injury, but I am definitely not a runner and wanted to see if I could get better information here.

I have whittled this down as much as I can, but I want to include as much information as I can so if there is an off chance anyone can help out I want them to see the whole story.

In early fall of 2011 on the second day after a grueling squat session I had very serious DOMS, nothing out of the ordinary for me, but I did want to stretch it out, so I went into what I would call a standing hamstring stretch similar to this http://www.topendsports.com/image/clipart/fitness/stretching/standing-hamstring-stretch.gif.php except with the rear foot rotated away from lead foot. I went deep too fast with my right let leading and felt a strong pop in my right glute and/or hamstring, hard to tell it was just extremely painful really fast (worst pain I ever felt), and had pain from my glute to my knee with a sensation feeling like someone stabbed me in the back of my leg, and passed out shortly after it started.

I was convinced I had at least a grade 2 hamstring tear, but there was no bruising at all. I saw a general doctor, but was told with no bruising that I had a minor tear and that aggravated my sciatic nerve and to see how I felt in a couple days.

Two days later I was completely pain free and was able to continue working out as if nothing happened. I now know I should have gone to a sports medicine doctor then, but I felt fine and trained just as hard before the initial occurrence.

As time went on I would have periodic aggravations of the condition. At first it would be every month or so after heavy squats, then every few weeks after squats, and then finally any time I pushed it like trying to move not even close to what I would have previously called heavy boxes when moving from my old to new location.

Originally it never hurt during the event or exercise, always the next day when I should be sore but instead I have the pain. Now it does hurt a bit when lifting/pushing it, but the real pain still comes the next day. Also the in between occurrence period used to be pain free but now it is not; I have pain in my glute on sitting, and pain/tightness in my glute and hamstring when bending over, stooping down, kneeling, lunging and any activity that requires my leg to bend and/or contract in a dead lifting or squatting motion.

Shortly after re-aggravating the injury my hamstring just about mid way between the glute and the knee is extremely sensitive to the touch (this is the same area as the original pain I think), and a week or so after I have pain in what feels like my piriformis and my gluteus medius.

And now I no longer get soreness in my right leg or glute when they are pushed, just pain. Again this is all in the right side.

I went to a sports doctor specializing in leg injuries back in Jan 2012 and was diagnosed with a hamstring tear. I have recovered from fairly severe hamstring tears before on my own, so I followed an at home program, but with little improvement.

I was not able for various reasons able to make it back to the doctor again until May 2012 and then started a guided program for 2 months, again with very little improvement. I went back in Jan 2013, again could not make it back for multiple reasons, and demanded an MRI. I got one, without dye, and everything in my glute and hamstring turned out OK, with no evidence of any difference from left to right. The doctors best educated guess was that I had something going on in my hip or lower back, so he sent me to the back and hip doctor in the same office.

This doctor did a differential diagnosis and said it was either a nerve compression issue in my gluteal region (maybe piriformis) but in his opinion most likely an issue in my lower back. I had an MRI, again with no dye, and the only thing he could find suggested a lower back problem (not for sure but this was the only possibility from what he saw) but that the problem should have been far worse on my left and that this was a degenerative concern not a specific incident that caused this. I was adamant that it was a specific injury that happened on my right side but he would not listen and said I needed to go to Physical Therapy again to correct muscular imbalances causing the concern, so I did.

I have been going for months now and had some improvement. This week I was feeling much better, or so I thought, so I tried an exercise, lying hamstring curl, with very little weight that previously I could have easily done with 1 leg but did it with both, and got a slight aggravation out of my hamstring. A year ago this would not have done anything. It is possible that just because I have not done this exercise in awhile it elicited such a strong response, but regardless it is disheartening.

I will say my current Physical Therapist really listens and evaluates me every time and he is very confident I will be back to full strength eventually, but does admit he has not seen anything quite like what I have.

Right now I am looking at going back to another doctor, this time getting imaging that will give a better view of the nerves, from what I have read I need an MRI with contrast, and possibly a guided needle injection near my sciatic nerve with cortisone and a slight numbing agent to help relax any muscles constricting nerves in the area but not to actually numb the nerve itself.

Again I apologize for how long this is and anyone who can provide insight I appreciate any and all help. Of course I want to lift and train with full intensity again as anything that requires stabilization of my body can aggravate the situation so now when I do lift it is much lighter than before, but more importantly I really just want to be able to pick my son up and run around with him and not worry I might pass or have high levels of pain that requires me to limp around for weeks on end.

I have searched hundreds of questions through dozens of forums, and posted in many and got varying degrees of insight. From what I have seen in the response to other injuries this looks like my best place to find guidance online. I am not looking for a medical opinion on how to fix what I have exactly, though if someone can give it I would not say no haha, more just on what condition/conditions to read about so I have an idea of what to try next with the next doctor.

2

My initial thought is that you have a piriformis problem, but I read the post you bumped about hamstring syndrome and would agree that this is probably a more specific diagnosis (you might also have a piriformis problem, but it came along after the hamstring problem).

I googled hamstring syndrome because I was unfamiliar with that diagnosis and found out that it may be one of the effects of lower cross syndrome, which I am highly familiar with since I had it.

Basically, the underlying cause of all these problems is lower cross syndrome, or tight hip flexors and tight back muscles and weak abs and glutes. I did not have the nerve pain you have, but when my piriformis tightened as a result of trying to compensate for my weak glutes, it pushed the head of my femur anteriorly and gave me anterior hip pain with any hip flexion movement.

I am guessing that your piriformis tightens up and clamps down on your sciatic nerve, causing pain down the back of your leg. The solution would be to strengthen your glutes so your piriformis won’t become overworked. Strong glutes will also tilt the pelvis posteriorly so the hamstrings won’t be pulled on constantly and become less prone to irritation.

The two exercises I found that helped my lower cross syndrome the most, in addition to stretching the hip flexors, were glute bridges and ab roll-outs. I did not treat these exercises like rehab exercises, with light weight and very high reps. Instead, I went heavy on the glute bridges (working up to 405x10) and progressed the ab rollouts to full range, with my weight on the balls of my feet at one end, my body horizontal, and my arms fully flexed overhead at the other end. It is important to progress the weight gradually or your piriformis will be aggravated (I made this mistake).

3

Thank you very much for taking the time to read and process my post, and even more for looking at the other thread I discussed. It is very much appreciated.

Before they injury I had spent years with various goals but more or less just having fun: trying to stay in good shape, add muscle, stay lean, have fun, whatever. A few months before my injury I had started to train with the intent to have goals for strength in size and actually was making good progress the first few months before the injury started. With the help of a friend I quickly realized my lower back, glutes, and hamstrings were very weak relative to the rest of my body and I was actively trying to improve and again I was making solid progress.

The lower cross sounds feasible for sure and I really appreciate the recommendation! The only problem is that the glute bridges you discuss even with just the bar would be enough to cause my hamstring to go ape and cause severe pain. The stretches I can and will do, but until I figure out what?s causing my hamstring to not respond properly even the most basic stressing motions have to be done extremely carefully. We are doing work in PT to strengthen my right glute (both actually).

I?ll respond in here when I have more news to report. I?m going to be the success story I?ve been looking for.

Again thank you for your help.

4

I looked at another website and it’s amazing the similarity between what I have going on and that condition, but right now any kind of stressful hamstring training is going to be limited. I’ll talk with my Physical Therapist and a new doctor soon and fill any information I can in here.

5

I’ve had similar issues, though they came about in another manner. I strained my quad tendon about 1.5 years ago. I did pretty much exclusively posterior work for the first 6 months before going to PT and eventually squatting again.

About a month ago I pulled my lower hamstring doing sprints (the quad issue feels resolved and strength is pretty much the same in both). I took it easy, slowly reintroduced the strength and began doing the hamstring rehab exercises from Running Mechanics, which I’ve built on over time from: 10 yd sprints at half speed, high knees, 20yd sprints at 80 percent, 30 yd sprints at 85 percent, and I’m supposed to begin flying 20s soon. I would massage and stretch the ham, calf, and piriformis between sets and focus on staying low and really pumping the arms during the sprints to take strain off the hams. However, during on of my between set stretches, I leaned over to stretch my right ham, grabbed my toe a little too hard, and I think I may have stretched a little too much, because I felt a sudden shock run up my ham. I stopped at that point and had no issues. I had been squatting and DLing low-moderate weights and doing my standard ham strengthening with no weakening since. I also do a version of the agile 8 pre workout that involves hip thrusts and flexor stretching.

About a week later, i did my sprints with no issues again and rolled everything out. I had soreness in both my glutes for a couple days, which I attributed to my focus on staying low, increasing intensity, and longer sprints. I also felt it might have been due to the thorough rolling I had given myself. My left glute returned to normal. My right one got kind of back to normal about a week later (though, still sore), but there is still acute soreness in the right piriformis and the right hamstring is fairly tight. The entire glute is tight when I sit, but not as much when I stand. I was going to sprint today, but not foam roll to verify whether it was the rolling or the sprinting.

However, in light of this thread, I took it easy and went for an easy bike ride and incline walk. As it turns out, my upper glute was also sore. I will focus on stretching the flexors some more and I will still roll out my quads, ITs, and hams, but stay away from glutes and piriformis. Does that seem sensible? Should I stop the ham strengthening even though strength hasn’t been effected? and the sprints even though they’ve been progressing and helping the ham? For abs, I’ve been doing slow leg raises, which are as much hip flexors as abs, should I try something else?