Hip/Buttocks pain while running...what is it?

How could you even run with that sort of imbalance?!

^^

Go onto google and type in "marathoner" or "triathlete."

This type of imbalance is REALLY common and tends to manifest itself in subjects that do a lot of endurance training but are not functionally strong (such as a triathlete). It's probably one of the most obvious problems you can point out in someone's stride. You'd be surprised just how much strength and balance is required to have a healthy gait when running. In a sense, many people would probably test positive for Trendelenburg's sign. However, my guess is that the OP would see a dramatic difference from one side to the other, or just be terrible on both sides. The first goal would be to get symmetrical strength...then go from there and strengthen both sides so they are 100%.

Neliah,,

There are some interesting videos on hip biomechanics here:

http://recoveryourstride.blogspot.com/2011/10/gait-guys-on-hip-mechanics.html

is that drop in the hip the Tredelenburg sign that you are talking about? These are from the Gait Guys

http://thegaitguys.tumblr.com/

but more organized for the hip.

i definitely think that its pain in your Gluteus Medius, it is a trigger point, pretty much your muscle there is in a huge knot and needs to get broken up.

http://www.sportsinjurybulletin.com/archive/gluteus-medius.htm

http://blog.oregonlive.com/runoregon/2011/06/pain_in_the_butt_gluteus_mediu.html

It could be from stepping wrong, doing the same continuos motion over and over (running, or running on a track), or maybe just sleeping on your side on a weird way.

I've had a similar problem..but i've been injured for 4 months. Doctors have told me it's greater trochanteric bursitis or a tight piriformis. I have been advised to (guess what) heat, stretch, ice, roll. I take ibuprofen and try to loosen up the muscle after heating. I have done some cross training but also tried taking time completely off. Nothing is working. Bottom line I hope you do not have what i've got OR have competent doctors and trainers who give you useful information/things to do.

The original thread was from 2010 so hopefully the OP got it worked out. I'd be concerned about the possibility of sacral stress fracture.

http://www.chiro.org/radiology/ABSTRACTS/Sacral_Stress_Fractures.html

Yes! I like that video a lot!

What is funny is the person who blogged about the video is in rehab from hip arthroscopy for a labral tear (which I've had done on both hips). So that is one of the things I have been trying to improve on the most.

But yes -- that's a good example of Trendelenburg. To simplify it, what's happening is your hip abductors (particularly the glute medius) are not functioning at the level they should be for whatever reason (trigger points, intra-articular instability within the hip itself, lumbar/sacral alignment issues, etc).

When you stand on one leg, a healthy hip should be able to keep that level plane in your pelvis so your center of gravity remains in alignment with your spine. However, with a hip that has weak abductors, it cannot maintain that stability so the opposite hip (in the leg being picked up) dips downward which creates instability.

Even though this instability might not be extreme during running, even a slight weakness in itself can pose for major problems in your lower extremities because you are obviously taking thousands of steps for each run you go on. If the forces transmitted through your leg are not efficient, it's going to cause injuries down the road.

I haven't heard of the gait guys I am definitely going to check out that second website you posted, thank you!!

Impossible Is Nothin wrote:

I've had a similar problem..but i've been injured for 4 months. Doctors have told me it's greater trochanteric bursitis or a tight piriformis. I have been advised to (guess what) heat, stretch, ice, roll. I take ibuprofen and try to loosen up the muscle after heating. I have done some cross training but also tried taking time completely off. Nothing is working. Bottom line I hope you do not have what i've got OR have competent doctors and trainers who give you useful information/things to do.

I might have some ideas for you and also suggestions on how to go about getting a more appropriate diagnosis/prognosis. If it has been 4 months and you are not seeing an obvious improvement (granted you are being smart and doing all of the above) you deserve to be reevaluated. Trochanteric bursitis is usually painful, but it's a secondary problem that tends to result from a much separate joint related issue. I would be incredibly surprised if that is the ONLY source of your hip pain/dysfunction. Tight piriformis is another secondary issue that 90% of the time is not the sole problem. It's a red flag that your body is relying too much on smaller muscles to do the job of the larger ones because something is not allowing your hip to function properly. The goal should be to find out what that biomechanical issue is and not treat the secondary symptoms.

I had hip/lower back/glute pain for a few years. I did strengthening of hip flexors and psoas muscles, which helped some. I also did ART on the piriformis and psoas, which didn't seem to help. It turned out that I had a labral tear in my hip. That might be worth checking in to as well.

Neliah, it is my blog and I know about our labral tear from all the advice and information you have given me and others here. I just got back from the 3 month post-op visit this morning. Everything is fine, but I have to still work through the imbalance and muscle issues (they don't offer much help for that-they are just concerned with the joint) and one of the pains I get post running a after a few days in a row or after 8 milers is a piriformis/glute medius pain.

Funny thing, my 6th grade daughter just finished cross-country and pictures show her hip doing the same thing with the hip dipping down and the knee going in. At least I am learning what to do to strengthen her.

...and yes the Gait Guys are great. There share a lot of information and are very helpful. They even analyzed a video of my running on their site for me two summers ago before the labral tear stopped my running fully. I appreciate when the experts are so willing to educate and share their knowlege and thinking. It shows they love what they do!

Very glad to hear you are back to running (hopefully 100% in the future).

I am 8 months post-op but having a very similar issue to what you are describing. It has taken me all summer to diagnose the cause of the imbalance (it was very vague and hard to pinpoint) and also what was causing me random pain pre/post running. Sometimes I can run pain free and then other days I will feel very tight or have random sharp pains post-run. Also, there were days it would feel like my pelvis was not aligned. I was not able to generate as much force with one hip which made my running tiring and inefficient. If you think you are experiencing something similar let me know because I might have an two different ideas for you to talk about with whoever is working with you in physical therapy.

If you are only 3 months post-op you sound like you are doing great. What you described does not sound abnormal to me -- it sounds like a combination of lack of ROM and possible scar tissue. I'd be curious to hear more about what type of pain it is though.

it's hip/buttocks pain

I have not read this thread but had a similar experience. I rotated one side of my pelvis (shoveling wet snow, probably) and it eventually pushed enough things out of whack that I really had a 'freeze up' of my lower body/low back. One symptom was a similar feeling (not exactly the same, but is was 5 years ago). A good evaluation by a sports-type therapist should be able to pick this up if it is the case.

The solution, if it has not gone on too long can be relatively simple. One approach is to push out with the knees (legs bent at 90+ deg) against pressure (5-10 seconds), first a few inches, then a couple more times widening. This is followed immediately by pressing IN against resistance. If it is the source, you will get a bit of a click.

This is not the only way accomplish the realignment and it is not a highly likely 'diagnosis' but it is a possibility. Good luck.

Neliah,

I would be interested to hear your ideas. If you think it would be benificial to others here, then post it here, if not you can find my e-mail on the blog.

I know my hips are imbalanced, had it my whole life even before I started running back in junior high school. The muscles or ligaments around both hips get tight now. I don\'t get any pain, but if I run too much I get pinching on the inner thigh of the operated on leg. This is decreasing, but I would feel it in my knee, arch, and big toe so I think it is a nerve. I also get a tightness-pain in the piriformis or glute medius. That makes lifting my leg difficult the next day. I may have an lower-leg problem too, the Gait Guys looked at my video last year and said I had tibial torsion on my operated on side. PT is working on my strength around the hips.

I got referred today while I was at the hospital to go to their spine center to check for musculo-skeletal issues. I\'ll see if they have anything else to offer. I can\'t comlain, as post-surgery I thought I would not start running until after the 3 month check-up (today). I have done about 100 miles already off and on testing things out. I would consider myself good as new if I didn\'t enjoy running so much and still wanting to get our there and compete.