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Doctors Lounge - Orthopedics Answers
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| jensau
- Fri Aug 14, 2009 7:49 am |
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Hello
I am a healthy 30 year old female who does alot of road running. On 15h April 09, I did a hill run, instead of coming down slowly I got carried away and flew down the hill (uneven ground for a good few miles). The next day I had pain in both my hips, weight bearing on either leg sent a sharp pain through my hip, the left was worse than the right. I rested for over 3 weeks. Started running again (no hills) and the pain returned. GP sent me to physio which is still on going. They initially treated me with accupuncture saying i had ITB injury, I have never had knee pain, everything I read about ITB talks about knees. My pain has not gone away, it has eased slightly in that I no longer get the sharp pain through my hip when weight bearing, but it has changed slightly. It has been made worse recently following a six hour drive.
My pain now is like sciatica which is mainly in my glutes its bilateral and there all the time, sleeping is becoming a problem(, I get very occaisonal pins and needles in my big toe. I also have new low back pain and still the pain in the hip area. THe pain is made worse by prolonged sitting or running. My glutes feel numb after I have been sitting for some time and some tingling is also felt. I have had sports massage and in one particular area in both glutes when he presses quite firmly It makes the sciatica pain worse - it shoots right through my glutes just to the top of my hamstings.
I have had weekly massages since may on my ITB, glutes, hamstrings and Piriformis. I also do alot of stretching.
Could this be bilateral Piriformis? or is there something else going on. GP has refered me to an orthopaedic Consultant have been waiting since 8th July appt not till 23rd Sept.
Only other pain is in my pubic symphisis this just become uncomfortable after a hard/long training session.
Please help I want to this pain in my Glutes to go so that I can start to enjoy running again.
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| Tom Plamondon PA-C
- Wed Sep 02, 2009 9:04 pm |
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 Hello,
Certainly piriformis syndrome can cause the sciatic nerve pain. The sciatic nerve in most people runs under the piriformis - when the piriformis tightens or spasms, the sciatic nerve can become compressed or irritated.
The other possibility is some structure in the lumbar spine. Running downhill (especially at high speed for a long distance) places a large amount of stress on the lumbar (and sacral iliac) joints. You might even say that it overly extends the spine - again placing lots of stress on the small facet joints in the lumbar spine.
An MRI of the lumbar spine may help rule out any lumbar pathology.
Otherwise, continuing with conservative treatment including abdominal strengthening and hamstring stretching should add to the rehab as this places the hips and trunk muscles in better balance especially in runners.
Take care.
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