Blog

11 Jun 2018

PAIN IN THE BUTT??

By Sue Van Evra, BSc, MSc BHScPT, Dipl. Canine Rehab

There are LOTS of reasons that you may have a ‘pain in the butt’!

1. Muscles:

Many of you will be familiar with the term ’glutes’, short for ’gluteal’ ( butt!) muscles. We have a ’gluteus minimus, medius and maximus’ that are collectively called the ‘glutes’ or ‘gluteals’.

These muscles rotate your hip and also ‘extend’ your hip - or push your leg behind you as when you are walking quickly or running. There are also smaller and deeper muscles that work to ‘fine tune’ the movements of your hip. These are the piriformis, superior and inferior gemelli, quadratus femoris, and obturator internus and externus.

Each of these muscles has one or two jobs to stabilize and to move the hip joint. When they are all working together and doing their own job, life is great! … When one of the muscles is working too much/not enough/is too tight, etc then an ‘imbalance’ is created around the hip which can lead to pain.  

2. Joints:

The hip joint is very ‘deep’ and surrounded by many layers of muscle. The hip joint is held together by ligaments. If the ligaments are ‘sprained’ or over stretched (ie catching a tip while skiing and the binding does not release) this can result in deep pain either in the groin – or sometimes in the ‘butt’. Arthritis of the hip joint can cause pain in both areas as well.

The sacroiliac joint (SIJ) is part of the pelvis. We have one on each side. If this joint is inflamed, it can refer pain to the buttock and also the area on the outside of the hip and thigh.

3. Nerves/Spine:

The sciatic nerve is a large nerve that runs underneath the piriformis muscle behind the hip. If the piriformis muscle is injured or in spasm – this can put pressure on the sciatic nerve. This can result in pain in the buttock – but also the whole leg!

In the spine, there are nerves that branch from the spinal cord, run between the vertebrae and run down to the limbs. If anything is ‘pinching’ or irritating a nerve in the spine, sometimes it is felt in the butt! The joints between the vertebrae can also be sprained and refer pain to the butt! 

4. Bursa:

A bursa is a small fluid-filled sac that provides cushioning between bones and tendons and/or muscles around a joint. There are bursas around the hip – and one common culprit is the ‘trochanteric bursa’ which is just behind the ‘greater trochanter’ – or the bone that you can feel on the outermost point of your hip/thigh. Bursas themselves are not painful, but can become inflamed and develop a ‘bursitis’ which is painful.

Now, how are you going to know what is causing YOUR pain?? And more importantly what to do about it!!? Well, you consult a physiotherapist at Two Hands Physiotherapy! A physiotherapist can assess all of your muscles, ligaments, joints, spine, nerves, and tell you exactly why you have a pain in the butt! The physiotherapist can then create a treatment program (including homework!) that will make a huge difference!

Call for more information!