Have you ever noticed that if someone uses the phrase… “that (or it) was such a pain in the backside!” … that we all immediately know that whatever the subject matter, what that the person was trying to describe was excruciatingly horrible for him/her. I would suspect that we all understand the person’s amount of discomfort because we have all experienced that REAL level of pain that can be caused by a group of muscles and nerves located in the bendy, back-portion of our body (better known as the gluteal region)! Of course, there is also medical reasons that I will not go over today like herniated/bulging discs and sciatic nerve entrapment. Sciatic nerve entrapment is a very rare and is where the nerve is actually located in the belly of the piriformis muscle or is bifurcated (split in two) and runs either through the belly of the piriformis or on either side of it.
*Locating the source of low pain, gluteal or even leg pain usually starts with a group of muscles located in the low back, gluteal and upper leg. This is a huge area to investigate! It can include all of these muscles or more!
Typically, a physiotherapist, when investigating the source of your pain, will ask you a series of questions to try to pinpoint the primary source of your pain. Questions may include what you have been doing prior to the onset of pain, what types of movements elicits the pain and whether you feel pain in one general area or if (as in the case of some gluteal pain) it travels down your leg and if so, how far and which side of the leg. Depending on your answers, the practitioner will then palpate your muscles to feel for abnormalities (such as hypertonic/tight muscles or injuries/scar tissue), heat (sign of inflammation) or indicants of trigger points.
A trigger point is a hyperirritable locus or spot that is typically associated with a group or band of muscles that when compressed will mimic the pain patterns to a specific area or muscle. When this trigger point is pressed with even the lightest amount of pressure it will sometimes respond with a medium to large amount of pain. Please keep in mind that when we, as practitioners, are doing this palpation we are not trying to cause you pain, it is just what we have to do to help you feel better!
So where do those dang Trigger Points come from anyway?! Trigger Points are typically in areas where nerve and muscle fibers connect. They become irritated when an overload has occurred in that area. What the what????! Anything that over tires or overloads the muscles can cause a trigger point to become cranky. Have you have sustained a recent injury? Or did you become a weekend warrior, not remembering that it has been decades since your last PE class? Perhaps you can list, like most of us, inactivity, poor posture or a sustained stationary (desk or standing in one space) job as a source of your muscles to revolt against you?
*look for Travell trigger point charts on-line if you would like to see more photos or to do your own research on the subject.
Whatever the cause, there is help! After seeing a qualified professional (hopefully me!) and getting the proper physiotherapy, your body needs to recover to a state of health, rebuilding muscle strength and dexterity should be next on your list of things to do.
Remember that when recovering from an injury or accident, or even just trying to strengthen or start a corrective exercise program; it is very important to at least consult with a professional to ensure what you are doing will not further your pain or injury!
Simple starts are always the best when you are trying to change your health! Your body can be like a skittish wild animal! Any sudden quick changes in movement (think level of exercise or stretching) can lead to disastrous results!
When consulting with a trained professional; here is a few things you might consider….
Should you have a professional test your level of strength bilaterally (meaning both sides of your body)? YES! Any inequality in muscle strength or flexibility may have caused the problem in the first place. Imagine, if you will, a little scrawny guy getting picked on at school every day on the playground. That is, of course, until he decides to do something about it and he bulks up over the summer. The other guys all of a sudden leave him alone, thus reducing his incidence of injury on a daily basis!
Maybe you walk with your toes or knees in or out or with one hip higher or rotated forward and you have never noticed? Professionals are trained to notice such postures and know how to help you fix them! They may give you core, or external/internal hip rotator strengthening exercises or perhaps you need to relax and stretch your hamstrings, TFL/IT band or quads (for example) allowing for the proper hip alignment?
Do you have secondary pains/weaknesses that you do not think would possibly relate to your backside pain? I personally have left knee problems. It wasn’t until I consulted with Sports Medicine (and felt like an idiot because I should have known the answer) that I found out I have a severe unilateral (one-sided) weakness of my left medial gluteus muscle (outside of the gluteal muscles). It wasn’t even firing which lead to left knee valgus (inward collapse of the knee, or knock-kneed) and dominos into hamstring/TFL and quad/hip flexor tightness and weakness which caused knee pain when squatting or bending down. Again, I say… It is important to consult with professional when seeking out answers to your pain questions!
Always ask for ‘at home’ therapy, stretches or strengthening exercises you can do. Remember it only takes 2 weeks of consistency to form a habit!
What is the take away from this week’s blog?
There are many reasons why you may have a pain in the backside. I can’t help you with the emotional ones (like your fun neighbors), just the physical! But I AM here to help any way I can! Come in so we can talk about the pain you are feeling. We can work together to find ways to reduce it or take it away and keep it away! I can help with massage techniques, strengthening exercises and also advice on how to do home stretching to keep your muscles and YOU happy!
Sharon Coleman 