As my training ramps back up and as my butt injury seems to be fading far into the background (please no jinx!) I want to look back upon my experience to create a guide for all future pain in the butt* havers. So without further ado here’s Salty’s Guide to the Running Butt, FAQ style.
1. Why Does a Butt Injury Hurt Like a Mofo? The butt is made up of many muscles, but the most problematic for many runners is the piriformis, a lesser butt muscle that lies underneath the gigantic glutes deep inside your butt cheek. The piriformis is a long skinny muscle that attaches at the sacrum, base of the spine and extends all the way across the cheek over the sciatic nerve to the hip. That’s why it hurts. It literally hits a nerve when it’s irritated. When mine is really po’d and kicking up the sciatica it causes me to want to jump out of my chair or driver’s seat and sometimes even causes numbness in my foot. While the muscle is long and skinny, mine always hurts in the same spot:
2. How Does One Go About Injuring a Butt? As I said above, the piriformis is a stabilizing muscle. You can irritate it when you run on mud, ice or other slippery conditions necessitating extra balance. I wish that’s how mine became irritated. I’ve always had a touchy right piriformis and it’s related to my arm-swing. My arm swing is super wonky: my right arm swings perpendicular to my body and the left arm swings way out away from my body. The theory is that the arms are compensating for my weak or over-used right piriformis. On top of that after a couple of pregnancies the muscles in the right side of my pelvis got out of whack which likely caused lower crossed syndrome. LCS in turn caused my right glutes to not work properly which then added even more stress to the piriformis which tried to pick up the slack from the lazy glutes. Basically, my piriformis was doomed!
That being said, the piriformis is used in running all the time. One need not have a funky wonky arm or messed up pelvic muscles to have a cranky butt. Excessive hills and speed work or simple overtraining can be enough to piss off any butt.
3. How Do I Know If I Injured My Butt? When a piriformis is hurt it often feels like pain at the top of the hamstring or right at the point where your rear meets the seat of a chair. It can be anywhere in there. You might first notice the pain, not while running, but when sitting. I remember one of the first times I noticed my cranky butt. I did a long run and then went to brunch at a place with wooden benches. I was sipping coffee and all of a sudden, “OWEEE!” Woo baby. It was like someone stabbed me in the @$$ right in the spot (see diagram above).
The thing with the piriformis is that it’s a touchy muscle with a big nerve next to it. If it hurts it might not be injured in a debilitating sense, but even mildly irritated and you’ll probably know it. It’s like a lot of other “injuries” in that there’s a fine line between a runnable annoying pain and a real injury necessitating modification or cessation of training. Ultimately, it’s something only you can know. When I couldn’t sleep because of the spasms in my butt back in July my pain in the butt crossed over the injury line. On New Year’s Eve when I couldn’t open up my stride it did it again.
4. Say I Have a Pain in My Butt, But I Ignore It. What Will Happen? If you can tolerate the pain, you can probably get away with running with a pain in the butt for a while. Eventually you might end up with night spasms or a real strain like me. If you have sciatica related to your butt pain you could permanently damage the nerve and have constant numbness in your feet or shooting pains up and down the back of your leg. That’s no fun. I do have to admit that I have struggled with butt pain for a long time and most of the time it comes and goes. Sometimes I’ll have a really bad week where it hurts on every run and then out of nowhere after a good tempo or something the pain disappears for a while. Again, it’s really a judgment call on when you need to do something about it that only you can make.
5. How Can I Take Care of My Butt and Avoid Injuring It? To prevent a pain in the butt from developing I recommend a few things. First, if you’re a stretcher, incorporate a butt stretch into your stretching routine. The pigeon pose is a great stretch. For a how-to video go here. Second, keep your core strong. Keep up with your planks and crunches and this will help your butt immensely! Finally, if possible I highly recommend seeing a massage therapist regularly for deep tissue massage. A good masseuse can spot problems in your muscles before they become injuries. Getting a massage once a month to once every 6 weeks is probably sufficient.
If the pain is more intense I would recommend seeing an ART practitioner ASAP. The piriformis is usually highly treatable through this technique. If ART alone does not do the trick and you have reoccurring butt problems then you probably need physical therapy to remedy muscle imbalances and weaknesses.
So there you have it. If you have any more questions about your runner @$$ please leave them in the comments and I will add to the FAQ.
Cheers to happy pain-free rears!
*When I say butt or @$$ or rear I mean the piriformis unless I indicate otherwise.