Sit bone aches for months, what is it about?

Some additional info:

It feels worse going uphills. And the harder the surface is, the tougher my run feels.

I can do interval training, but tempo and long run are out of question.

I even have issues with easy runs too, if it lasts longer than 15 mins, and as mentioned above, it gets worse and worse (feeling tighter) until I stop running.

I injured the same spot back in 2014. After the sharp pain was gone, I resumed my training. There has been some tightness that comes up once in a while on my long run. I kinda get rid of it through weight training. But when I bumped up my mileage last June, going from 40 to 70-80 miles, I started to slack on the strength work. And it came back and has got progressive worse since September.

Bump.

How much sitting do you do?

I sit quite a lot in the office.

There may be some dull ache, if I sit on the tender spot.

Not that painful though (1-2 on a pain scale).

I had very similar symptoms and was later diagnosed (MRI) with upper hamstring tendinopathy. For 1.5 years, I tried everything from time off, stretching, no stretching, PT, cross training. I could train, but running faster was not comfortable. Ultimately, I had PRP injections in both upper hamstrings. I took 4 weeks of down time with only easy cycling. I haven't had issues since. It was a very frustrating process.

Likely to be a medial hamstring problem. Those two friends, semimem and semiten. Get a good sports massage on them and if no immediate change the at least you can rule it out.

Mikey B wrote:

I had very similar symptoms and was later diagnosed (MRI) with upper hamstring tendinopathy. For 1.5 years, I tried everything from time off, stretching, no stretching, PT, cross training. I could train, but running faster was not comfortable. Ultimately, I had PRP injections in both upper hamstrings. I took 4 weeks of down time with only easy cycling. I haven't had issues since. It was a very frustrating process.

Was the 4 weeks off after the injections? My PT guy chasing a similar issue suggested it may be time for me to go that direction. Was working on hammy's prior to a marathon last month that grabbed my butt late in the race, guess it wasn't cleaned up. I've had only easy running since then as running (and sitting) is uncomfortable.

Yes, four weeks after injections. I cycled a little just to move some, but the key is allowing the hamstrings to heal after the injections. It was difficult to take that much time away from running, but one of the best decisions that I've made.

Ischial bursitus or high hamstring tendinopathy. Graston and ART with eccentric dead lifts or try injections. If the first injections don't work, do the graston route before going back for more injections because cortisone is catabolic.

Thanks so much everyone, there has been lots of good replies thus far.

For high hamstring tendinopathy and ischial bursitis, I have performed some tests myself, and all turned out negative.

And it the pain is kinda deep in the bone and just lies in one particular spot somewhere in the lower buttock.

I wonder if it is stress reaction, but as far as I know it shouldn't be that chronic, should it?

Anyway, I have scheduled a pelvic MRI, hopefully with a more definitive diagnosis.

Injection as in cortisone shot, or prolotherapy?

During that 1.5 years period, did you try to run through it or just took time off completely?

Bump.

Sidelined runner wrote:

I wonder if it is stress reaction, but as far as I know it shouldn't be that chronic, should it?

I had pain in that area for close to a year. It seemed to be at the insertion of the hamstrings. I could still run to some extent; I even won a pretty competitive half-marathon with it. But it seemed to limit my ability to stride out normally. It was, as I recall, worse late in a run or after a run, and it got very uncomfortable when I had to drive significant distances without stretching out my leg. I assumed that it was a soft-tissue injury -- muscle or tendon -- and went to various therapists, including Michael Leahy, who developed (and patented) active release techniques (ART). After no noticeable improvement, I saw an orthopedic surgeon, who thought it might be a stress fracture of the ischial tuberosity. That sounded nuts to me, but he ordered a bone scan, and he turned out to be right. Ultimately, the problem resolved, but only after I rested completely for at least two months.

The cause is very simple.

Your clothes are too tight in the butt, and as you sit down they get tighter.

The same thing happened to me and I tried various remedies.

My regular clothes were loose enough as this had happened previously and I made sure that they were. That is the first thing to check. However the cause last time turned out to be my running shorts being too right. They were made from nylon but the nylon in this case was stiff and unforgiving, not flexible.

I've worn quite roomy, flexible running shorts since then and the pain and soreness went away.

Thanks for the input.

By "complete rest", do you mean stopping all athletic activities (including cross-training) at once, and even keeping walking to the minimum?

Anyway, I have just taken a Pelvic MRI, hopefully with some finding.

If not I might go for a bone scan as you did.

Btw, more additional info:

I have found that doing this glute stretch (

https://i.ytimg.com/vi/2zMMjowsfB0/maxresdefault.jpg

) sometimes creates pain in the hamstring/the back of the thigh), and the pain is a bit different from the dull ache in the sit bone I experience while running.

Add to that, I have a very weak right hip and tight IT band, so my right abductor don't respond to exercises like clam shell as well as my left hip does, Also, I somewhat have an extra-articular snapping hip (again, on the right side), even though my hip MRI (with arthrogram) is normal.

Bump.

Sidelined runner wrote:

Thanks for the input.

By "complete rest", do you mean stopping all athletic activities (including cross-training) at once, and even keeping walking to the minimum?

Anyway, I have just taken a Pelvic MRI, hopefully with some finding.

If not I might go for a bone scan as you did.

I had been doing treadmill running on a steep incline, which had gotten me through some nagging injuries in earlier years. I'm not sure whether I could have successfully cross-trained with pool running, stationary cycling, or various other things that I would have turned to during my younger years. After dealing with the problem for so long, I finally decided that it made little sense to try to retain some level of conditioning. Better to just let it heal entirely. I don't recall if I did any weightlifting during that time, but I doubt that I would have done anything that would put any significant stress on the lower body.

I had been doing some stretching exercises, but gave up all of that after I received the diagnosis of a stress fracture. Although some stretching of the hamstrings and glutes may be worthwhile to prevent such injuries in the first place, I don't think it makes sense to create any tension near the insertion of the hamstrings after the integrity of the bone has been compromised.