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General question: why would the upper glute area (piriformis, gluteus minimus, gluteus medius) get disproportionately tight and sore from running?

For me, the tightness and soreness in this specific region seems out of proportion to other areas of my body. Nothing else gets this sore or tight.

This area gets sore enough that it is the limiting factor in my recovery from longer runs. Following a long run, typically the rest of my body is ready to go again on schedule, while this area has yet to recover completely.

Info specific to me: I am not currently doing weight training, but I think my strength is fairly balanced across all the muscle groups involved in running. My glutes have genetic capacity to be one of my stronger body parts; this area has never been my weak area.

I am interested in improving my running technique, training methods, mobility or whatever else is required so that I do not over-stress these muscles.

If more info is needed, please leave a comment and I'll update the question.

UPDATE:

  • I have no numbness.
  • My soreness is normal delayed onset muscle soreness. I would not say I have pain other than DOMS.
  • I have no symptoms of nerve compression.
  • I do have tightness immediately after running.

Response to Mike-DHSc

I think you are generally on the right track. I sit a lot, and my sitting posture is not great. I would not be surprised if my hip abductors are lengthened. My hip flexors are shorted, and I have been working on that through Dr. Kelly Starrett's mobility program for a few months (and getting good results). But I have not been addressing lengthened hip abductors. What do you recommend (given that I'm already doing all the stretches you recommended)?

Final Update I implemented some hip abductor strengthening exercises and continued the mobility work and the issue has almost entirely gone away.

  • Fantastic question btw - forgot to add that. – Mike-DHSc Aug 13 '17 at 0:21
  • Great job -- way to stay consistent and glad things worked out well for you! If any other questions come up just let me know. – Mike-DHSc Aug 29 '17 at 3:47
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Pain and numbness always results from either blood vessel or nerve compression /restriction.

You’re describing a classic presentation - movement followed by tight musculature along with pain & numbness.

Based on the region the majority of these cases are related to a tight Piriformis.

Why not the Glutes?

Typically, your hip abductors (Glute Min / Med) are weak or lengthened Jaunda’s Upper and Lower Crossed Syndrome

As the pain is located in the upper gluteal area - the glutes are rarely implicated as you’d likely see pain laterally. This would also commonly present as lateral knee soreness or hip snapping (during movement).

See the image below it shows the vessels that pass exactly where you’re describing. As the sciatic nerve actually pierces the Piriformis muscle in 15% of the population.

enter image description here

Free 3D Anatomy Model


Symptoms are very similar to Piriformis Syndrome or SI Joint Dysfunction. There are a ton of secondary causes that could exacerbate this (spinal pathology, an innominate torsion, stenosis, weak abdominals etc.).

Below I posted some great exercises aimed at alleviating this found at spine-health.com


Supine Piriformis Stretches

(Three Different Stretches)


  1. Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of thebody and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

  1. Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

  1. Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Buttocks Stretch for the Piriformis

  • Begin on all fours. Place the affected foot across and underneath the trunk of the body so that the affected knee is outside the trunk. Extend the non-affected leg straight back behind the trunk and keep the pelvis straight. Keeping the affected leg in place, scoot the hips backwards towards the floor and lean forward on the forearms until deep stretch is felt. Do not force your body to floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Single Knee to Chest Stretch.

  • Pull one knee up to the chest at a time, gently pumping the knee three to four times at the top of the range of motion. Do 10 repetitions for each leg. Press-up. From the prone position, press up on the hands while the pelvis remains in contact with the floor. Keep the lower back and buttocks relaxed for a gentle stretch. Hold the press-up position initially for five seconds, and gradually work up to 30 seconds per repetition. Aim to complete 10 repetitions.

UPDATE

Thanks for the additional info – love trying to make sense of what’s going on.

I work PRN as a PT so I can run it by coworkers if needed but obviously would need a full eval to get a proper Dx.

A couple questions:

  1. Is this pain unilateral or bilateral?
  2. When exactly does the pain first occur (are you just tight after a run or is there pain as well)?
  3. When is the pain most intense? How long before it goes away?
  4. When did you first notice this (sudden onset or gradual)?
  5. Once sore, any specific movement(s) make the pain worse or better?
  6. Have you recently changed your program in anyway (distance, intensity, mode etc.)?
  7. Have you even had any kind of movement screen done? Such as the FMS, SFMS etc.. https://www.functionalmovement.com/system/home

See this: http://www.irunfar.com/2016/04/if-you-cant-do-this-exercise-you-will-get-hurt-hip-stability-and-alignment-for-trail-runners.html


Possibly hip and altered neuromuscular firing patterns. I’ll wait to go any further till I have more info.


| improve this answer | |
  • I have no numbness. And my pain is normal delayed onset muscle soreness. I have no symptoms of nerve compression. But there is tightness immediately after running. – MountainX Aug 13 '17 at 2:12
  • Thanks for your answer. I've been following Dr. Kelly Starrett's MobilityWOD program for a few months. I'm doing a lot of mobility work that targets this area. Another of my favorites is the yoga pigeon pose. I do about 1 hour of mobility work per day now (starting a few months ago). – MountainX Aug 13 '17 at 2:59
  • please see my updated question with answers to your questions. Thanks! – MountainX Aug 13 '17 at 20:40
  • I started by assuming your suggestions were correct. I implemented strengthening exercises for the upper glutes. Result: after just one week there is already a noticeable improvement. So it looks like your analysis was on the mark. Thanks – MountainX Aug 18 '17 at 1:38
  • Very happy to hear things are working out for you! I was hesitant to update this further as probing questions and detailed advice from a licensed medical professional or otherwise seems very unwelcome here. My answers have been deleted, closed etc. Gets somewhat frustrating as I am simply trying to help. fitness.stackexchange.com/questions/33013/… – Mike-DHSc Aug 18 '17 at 18:57

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