Butt Pain

Butt pain is not cool. I’m not talking rectum pain (go see a doctor if you have this), I’m talking pain right in the middle of your booty cheek. Can’t sit, can’t walk, can’t run, can’t get comfortable! What is the cause, and how can I fix it?

No one is immune to butt pain because we all have glutes (unless your glutes were bitten off by a shark). Pain in the butt may have a few causes including pinching by the piriformis, irritation of the sciatic nerve, lumbar disc bulge, low back derangement, SI/sacrum/coccyx dysfunction, and hip arthritis.

With butt pain we can assume that the glutes and hamstrings are tight and weak. There may be some associated quadratus lumborum tightness and weakness as well as quadriceps and IT band tightness (quads are usually pretty strong in healthy adults).  No matter the cause, there are a few simple fixes that can alleviate your symptoms:

Postural Change and Correction–My soap box of all time.  SYMMETRY.  It is SO important that we balance our posture.  Every 15-30 minutes change position, get up, stand, walk, stretch.  Movement helps to shift the pressures in the spine and joints to refresh and replenish the blood supply.  The blood carries vital nutrients and oxygen in and removes waste on the way out.

*If all you do is stand all day, lay down, roll like a ball, throw your legs over your head, hang upside down…change position!

LLD–what people in the biz call leg length discrepancy.  Most people have one leg that has little man syndrome.  Do not let the little or big guy rule your posture.  Either correct or overcome the LLD.  If your SI is always “out” (the biggest PT debate of all time is if the SI really moves at all), or if you have herniated discs, or a “bad side” it’s probably because the little guy isn’t up to par.  Correct LLD by placing an extra insert into the short leg.  If this feels too weird, then you will have to consciously balance your posture by even weight distribution and postural positioning throughout the day.

Cross Training–I marathon, CrossFit and practice yoga.  I began by running, and then my PT brain told me that I needed to strengthen to prevent an over use injury so I started CrossFit.  CrossFit improved my strength, which fueled my cardiovascular health for running but then I began feeling tight and too forward flexed so yoga came to the rescue.  Yoga is the the icing on the cake.  Yoga is the ultimate balancing machine.  No matter the sport, please practice yoga.

Yoga has taught me that prayer, meditation, and a healthy spiritual practice are vital components of the cross training circuit.  Again, it’s all about finding balance.  God made us to be multi-dimensional, multi-modal, multi-talented individuals capable of anything because we house His breath, life essence, talent and creation.

Eat Healthy— A healthy diet produces good neuronal firing and decreases inflammation.  Remember these simple tips:

  1.  You can’t over eat the produce aisle:  If you eat nothing but clean meat and produce, you WILL NOT be fat…it’s impossible.
  2. Clean meat:  Organic, free range, non-GMO.  Remember you are what you eat, so if your food is eating chemicals that can melt plastic, you are too.
  3. Plan your cheat meals:  Look ahead each week and decide when you are going to be bad.  Have a kid’s birthday party with a hot dog and Cheetos buffet in the future?  Know that you aren’t going to win any health awards at that party and plan accordingly.  I would recommend no more than 3 cheat meals in a week.  You can do a cheat day, where the day is dedicated to gluttony, but I’ve found it’s wiser to plan the cheat meals based on social obligations.
  4. Eat healthy most days of the week AND consecutively:  MOST days is four days out of the week. Try to string these together if you can so that your guts get a break.  You’ll notice less pain and swelling in the these four days because your energy will be used to effectively to fire your brain, muscles, and nerves.  Your guts get really tired and cranky kicking into high gear to digest indestructible carbohydrates and GMOs on a daily basis, so they’ll request energy from other sources (like your brain, muscles, and nerves).

The Earth Diet by Liana Werner-Gray is a great reference http://theearthdiet.com/.

Relationships–Look at your relationships and life, is there a pain in your butt? Shift it, fix it, or release it (as Davidji would say).  Remember that some relationships are toxic, get over it–try to shift it, fix it, or let it go if all else fails.  Look for a future blog featuring this approach to healing taken from Davidji’s book Destressifying.

Now to the physical therapy stuff…

Stretching–Feel free to totally “Zen” out in the following stretch poses:

Child’s pose:

Spread the knees wide, let the toes touch and bend forward putting your belly between your knees.  Hold for 3-5 breaths or up to 2 minutes.  Repeat with body shifted to the right and left.

child's

 

Quadratus Lumborum stretches:

This stretch is intense so please modify if needed.  Some are flexible enough to reach the top arm to the shin or grab the toes.  If you get a quarter of the way into the stretch and feel it, good job…that’s it for you today, stay and hold.

QL

Sit on the ground with legs spread wide.  Lean to one side reaching the opposite arm over head toward the toes.  You may use a strap around the ankle to assist.  Hold 3-5 breaths or 1-2 minutes.

twisted tree
Cross one leg over the other.  Allow the top leg to pull the bottom knee down and in.  You may be flexible enough to double cross the legs to take the stretch deeper.  Relax and breathe 3-5 breaths or 1-2 minutes.
Piriformis stretches:

Cross one leg over the other, grab the uncrossed leg behind the thigh and pull forward 3-5 breaths or up to 2 minutes

piriformis2

Glute stretch pigeon pose style. You can also come to elbows, or rest your head on the ground.  3-5 breaths or 2 minutes each side.

pigeon
Spinal twist by pulling one knee across the body, shift that same shoulder out and lower the opposite shoulder to the ground to deepen.  Hold 3-5 breaths or 2-3 minutes each side.

spinal twist

Quad stretches:

I like this pose because modifications can easily be done with depth of lean back (stay propped up on hands, come to elbows, lay on pillow, lay on ground).  I can totally relax and daydream for a while in this pose.  I like to let my head fall back as well.  Hold 2-3 minutes.

quad stretch

Rolling—  Sit on a tennis ball or foam roller and hang out.  Cross one leg over the other, find that nauseating trigger point and chill for 2 minutes.  Exhale through the pain, each exhalation should exit out of the trigger point relaxing it.  Just when it feels like it will never relax is when it does, so give it time–2 minutes of time, then move on to the next trigger point.  Don’t ignore the IT band because it’s often a culprit to be dealt with as well.

Glute roll:

foam roll glute
IT band roll:

ITB foam roll

Strengthening— Just because your butt cramps and spasms tighter than a vice grip does not mean that the muscles are strong.  In fact, the majority of the time, the gluteals are weak in cases of butt pain.  Try some of the following booty tighteners (after you stretch and roll):

Standing forward bend balancing on one leg: rep it out or hold 3-5 breaths.

single leg forward bend
Bridge pose (block optional):  rep it out or hold 3-5 breaths

bridge
Pistol  Squat (a CrossFit favorite):  To perform reps, you may need to modify depth, hold on to a stable object with one hand, or use a band.  Below parallel may or may not be obtained, and that’s OK.  You may also simply hold 3-5 breaths.

pistol

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