For 2 or 3 years I’ve noticed an increasing pain in my left glute, this year it’s got much worse and spread to my left hamstring muscles.
When it becomes most noticeable on a ride, towards the end (55-60 miles), at a traffic light I “massage” the glute by jabbing the nose of the saddle into it, doesn’t make much improvement and cars honk at me).
It hurts most when sitting in a chair or in a car seat (after 30 minutes I start squirming, which doesn’t look good on Zoom.
For perspective, usually I ride 3 times a week, road only. I do a lot of climbing (last year 15000’ a week but less this year 10000’. Last year I wasn’t feeling any pain while sitting in a chair/car.
I feel it has something to do with muscle imbalance, hamstring/glute/attachment point (it’s very localized).
I’m getting physiotherapy, stretching, deep massage, ultrasound but they’re less confident than they were at first, so I’m reaching out, in forlorn hope, to the combined wisdom of Slowtwitch and will reward the winner with a ringside seat at my Colonoscopy in July.
For 2 or 3 years I’ve noticed an increasing pain in my left glute, this year it’s got much worse and spread to my left hamstring muscles.
When it becomes most noticeable on a ride, towards the end (55-60 miles), at a traffic light I “massage” the glute by jabbing the nose of the saddle into it, doesn’t make much improvement and cars honk at me).
It hurts most when sitting in a chair or in a car seat (after 30 minutes I start squirming, which doesn’t look good on Zoom.
For perspective, usually I ride 3 times a week, road only. I do a lot of climbing (last year 15000’ a week but less this year 10000’. Last year I wasn’t feeling any pain while sitting in a chair/car.
I feel it has something to do with muscle imbalance, hamstring/glute/attachment point (it’s very localized).
I’m getting physiotherapy, stretching, deep massage, ultrasound but they’re less confident than they were at first, so I’m reaching out, in forlorn hope, to the combined wisdom of Slowtwitch and will reward the winner with a ringside seat at my Colonoscopy in July.
I have had similar issue in past with my left glute. Strength work and glute activation exercises helped to address the issue for me. I have an imbalance as my right knee is w/out ACL and my left leg is stronger and more stable (long story). I mainly felt it after running hills and had the same issue you did re: squirming when driving car. As I said, strength work and specific glute activation exercises solved my issues. For what its worth. And I will gladly pass on any rewards – especially if it involves watching some Dr. stick his fingers or a camera in your a**!
I had a similar thing to what you describe - glute and hamstring pain. Learning a few piriformis stretches seemed to sort it out in my case. I expect it’s one of the first things your physiotherapist suggested but I’ll just throw it in there anyway - good video here: https://www.youtube.com/watch?v=eKp2f5-jRbI&ab_channel=PainTherapy
I had similar symptoms last year with glute pain, especially from sitting down. I did PT and that gave me some specific strength and range of motion exercises (like split squats for example, body weight only) that helped ease the issue. I’ve also been doing yoga regularly to increase range of motion and that definitely helps. 15-20 minutes a day, with lots of warrior pose variations strengthens your hips and glutes and relieves some of the tightness. You have to be consistent and diligent with the yoga for it to work, but in my opinion it’s the best thing for hip tightness and glute soreness.
Classic piriformis syndrome. I am the poster child. In my experience it is not a muscle imbalance. Just piano-cord tight piriformis (and other deep six muscles) and ischial tuberosity. Of course do all the stretches (i find immediately after whatever activity aggravates the area is most beneficial, but all stretching is good stretching), but what turned it around for me was a lacrosse ball. Also most beneficial after the activity, but not wasted at other times. Get it in there as hard as you can manage, i mean all your body weight (but you probably won’t be able to tolerate that much pressure when you first start doing this). You will curse this idea because it will get worse before it gets better. There is no instant fix, including this. Stick with it. If you have never done this before, your body will be quite sore after, probably for days, so the first time you do it (and probably more than a few times after), don’t plan on doing much during the sore period - you won’t do any damage, it’s just as uncomfortable as hell. Maybe make the first day after a rest day and the next a swim day.
If you can only tolerate light pressure it’s a sign that it’s bad - the muscle is very tight and probably inflamed. This “pressure point” or “trigger point” massage (or whatever else you want to call it) is less about movement than pressure. Sure, work your way around, but slowly. It takes me ~15 minutes to cover a whole butt cheek and hip (yes, get it into there too). This is not a process for the impatient.
Of course this same technique works everywhere and i consider ongoing maintenance. Over the course of a week i will hit my whole body twice (abs can’t be reached with the ball, just use finger tips). Never needed this when younger (read did, but without symptoms didn’t know or care). Best of luck to you.
Had something similar develop on a plane flight about 8 years ago and it has plagued me ever since. Running is the biggest trigger but biking does it too. The squirming and the need to dig something into it are 100% how mine presents too.
Agree with the advice for a lacrosse ball and the hip/glute strengthening. I am using some of the Jay Dicharry routine with banded clamshells/monster/prisoner etc as well.
How do you tell the difference between that and high hamstring tendinopathy? I got an ultrasound, but I mean, can you distinguish based on symptoms alone? And of course, for HHT I was told to avoid most stretches…
I would see a back/pain management specialist to rule out a disc issue. I have a bulging L5/S1 disc and when it flares up the symptoms are exactly as you described.
I’d get some imaging done just to isolate the problem and to make sure it’s nothing more sinister than a deep-seated (no pun intended) knot.
A dear friend of mine had the exact same pain in the rear as you did, left it unchecked for over a year (hey all cyclists have rear pain right?), and we lost her three years ago to Ewing’s Sarcoma.
Disclaimer: MD here. Also one who has had nearly every injury under the sun.
You really need to get some imaging done.
Traditionally much of medicine and physiotherapy etc was clinically based, history, examination etc, but these days with the revolutions we have seen in imaging you really are at the point where you should get proper imaging done to figure out what is going on and then target treatment at that.
As an example, I have severe right buttock pain. Like someone shot me in the ass. I also happen to work with an excellent interventional pain specialist. Specialist imaging (MRI followed by bone scan), I have a degenerative L5/S1 disc which is causing that pain. Do a targeted disc block and bam. Pain gone.
Not saying yours is a radiculopathy, but with what you describe you certainly have features to suggest it could be, hence imaging would be wise.
Well, thanks all for the suggestions and advice. Here is the progress (or lack thereof) report.
I mentioned the Piriformis advice to my Medicare assigned physiotherapist. He’d already included some appropriate stretches so that was a good sign.
I’ve had 3 appointments a week for the last month doing an assortment of stretches, including several “warriors”, which have greatly increased various ranges of movement. I feel almost as limber as when I did 2 yoga classes a week for a year or two
Also included have been painful elbow deep massages(which I’ve been able re-create at home 3 times a day), some heat and some “theragun” application.
There has been no reduction in the pain, it may even be worse.
They reluctantly suggested that I reduce my cycling from 3 times a week to once every 4 days, which has also been no help.
So I guess it’s time for imaging. I’ll have to persuade my doctor (who has suggested I stop riding for 4 weeks).
I am sorry you have to go through all of this just to get to the bottom (sorry bad pun) of things.
If you do feel happy to, please update us on how things are going.
Sorry to say but this is not the first time, and it won’t be the last time, that these sorts of things happen.
Hope you can get it sorted soon.
