T Nation

Glute/Hamstring Tie-In Pain


#1

I've had ongoing pain in the left glute/hamstring tie in for about six months now. It's extremely painful any time I have pressure on the foot with the knee bent, such as going up stairs, or doing a forward lunge (which is near impossible). It's also painful at the ischium tuberosty (sit bone) and sitting for any length of time is painful. Doing a leg curl however is painless.

I've tried icing, resting it, stretching, and foam rolling. I even went to an ART practitioner twice a week for four weeks with no improvement. I'd greatly appreciate any advice anyone can give, not squatting or deadlifting is getting very frustrating. Thanks in advance!


#2

#3

Sorry to hear about your injury, I have a simliar issue, which has been ongoing for about 2 years. It got to the point of not caring about squatting or dead lifting anymore, I just did not want to live in pain.

I have gotten a lot better, but I still cannot do heavy leg work. The things that have helped me the most are stretching and foam rolling every night but it has to be the right stretches. One that is extremely helpful is the prone windshield wiper stretch.

Also, I take a lot of natural anti-inflammatories such as flame out and cucumin.

If that is you in your avatar, I also would squat ATG, maybe this is the root cause?


#4

Just saw your response bamit, thanks for the reply. I’ve read a couple forums about Ischial Tuberosity Pain Syndrome, and it seems that it tends to be an ongoing issue once you’ve developed it. Mine started to feel better, made it through a couple weeks of light squats and deadlifts, and ended up right back where I started. Very frustrating. Like you, I’ve found that stretching and rolling (the Rumble Roller has become my best friend.) I’ve tried swimming 3 times a week, 30 minutes per session, as well as built a computer desk that I can stand at while at work. I’ve notice improvements, but slight at best.

Yes, that’s my avatar. ATG squatting from day one.


#5

Does it feel like a pull or something rubbing? If it’s a pull, the stretching is probably doing more harm then good.


#6

[quote]Ironliftr3 wrote:
I’ve had ongoing pain in the left glute/hamstring tie in for about six months now. It’s extremely painful any time I have pressure on the foot with the knee bent, such as going up stairs, or doing a forward lunge (which is near impossible). It’s also painful at the ischium tuberosty (sit bone) and sitting for any length of time is painful. Doing a leg curl however is painless.

I’ve tried icing, resting it, stretching, and foam rolling. I even went to an ART practitioner twice a week for four weeks with no improvement. I’d greatly appreciate any advice anyone can give, not squatting or deadlifting is getting very frustrating. Thanks in advance![/quote]

Can you post any videos of your form?

Form of your lunges / any step ups would help too.

Often times if you’re getting pain at the tie in it’s a sign you are substituting knee extension for hip extension.

I’ll get videos of this up on my site soon but for now try observing yourself (or have someone else). There is probably a good chance when you do a step up or something of the sort you bring your knee back to your body and THEN bring your body forward. This is in contrast to bringing your body towards your knee (forward and up at the same time).

Sorry, this can be hard to visualize.

When squatting, this can manifest as your ass going way up in the air and then your hips coming forward as opposed to both movements happening concurrently.

The overall gist is you are using your hamstrings more than your glutes.


#7

Do you get pain running?


#8

The video touched on a good point in regards to hip instability. The area you described (tuberosity of the ischium) functions as an orgin for the hamstring group, but also the adductors. Of these muscle the adductor magnus is unique as it functions in adduction as well as hip extension. You mentioned stairs and lunges have a particularly greater incidence of pain, As single leg excercises like this require a much greater degree of hip stabilization combined with hip extension.

The adductor magnus will be heavily recruited in a motion such as a lunge which require hip extension combined with eccentric and concentric stabilization of the knee, but not in an isolated knee flexion excercise like the hamstring curl, which requires neither of those things. A strain of that muscle, or chronic tightness from overuse would result in simlar symptoms. Whether it is a muscular issue or an issue of less regenerative tissue such as a ligament or bone, stability of the hip will become a priority at some stage of the corrective process to alleviate the load to that one origin. It could be something to begin focusing on in addition to the SMR and flexibility work.


#9

I’ll have to see if I can get some video’s of my form, although I’m quite sure it’s a bit compromised now. I’ve backed off on the stretching, but not the rolling, because I agree, I think the stretching is doing more harm than good.

I definitely feel it when I run, and I haven’t run at all in months. I actually have never been a runner, but started about a year ago to do a couple Tough Mudder and Spartan races (14 miles and 5K, respectively). I could be wrong, but I think the addition of running brought about the initial ‘injury’, although it may be that it just brought out an underlying problem.

I actually was thinking that my hamstrings are being used less than my glutes, and have become my weak link. I’ve always felt that I’m pretty glute dominant, I’ve never had an issue getting out of the hole in a deep squat, it feels like that’s where I generate the most power. I also bottom out the leg press when I do it, and feel myself pressing with my glutes. Same with deadlifts, I’ve had a habit of what I now realize was ‘squatting’ the weight up, getting my ass super low at the start of each rep. I’m attempting to address each of these issue, squatting low enough to ‘tap’ a box, not going as deep in my leg press, getting over the bar and more upright in a deadlift.


#10

There are lots of conditions that cause buttock pain, some more common than others. It is hard to say over the internet and I hesitate to diagnose as with all posts, however you not getting pain when performing a leg curl tends to steer me towards a condition called “hamstring syndrome”. Google that and reply if it sounds like you.

As with most conditions you need to get a correct diagnosis to fix the problem. No good generalising about this and that.


#11

DP- Did a Google search on ‘hamstring syndrome’, and the first hit seems to describe it dead on, even to the driving part. From the sounds of it, I’m addressing this correctly, lots of rolling and stretching, especially the hip flexors, and particular attention to addressing the glut issue, I started doing weighted glut bridges about six weeks ago. The worst part of this is not knowing what the actual ‘cause’ is. Thanks for the info.


#12

If it is indeed hamstring syndrome, it will probably have happened as a result of inflammation/ degeneration of the hamstring tendon insertion into the ischial tuberosity. You probably don’t want to stretch it significantly because then you are putting extra pressure on the sciatic nerve. You probably want to do/ get someone to do some manual therapy for the hamstrings/tendons and obviously get to the root of the problem.

Like I said you have to know what is happening to fix the problem especially long term.


#13

Sounds like a tendon issue.

  1. Google mob wod floss band and use it on the glute/ham tie-in every second day.

  2. Perform negative only leg curls with the bad leg. Raise with both legs (A partner is better to perform zero concentric) and lower for a 7 sec count. You want as much pain as possible on the eccentric. 3 sets every second day. Ice afterwards for ten minutes.

  3. Compressive ice/heat therapy will also work well.

The floss band will encourage blood to the tendon for healing. The eccentrics do the same thing but inflict micro trauma of the tendon encouraging collagen production. You may also like to consider the herb Gotu Kola. You need to perform these for at least 4-6 weeks before you will notice improvement.


#14

[quote]thrasher_09 wrote:
Sounds like a tendon issue.

  1. Google mob wod floss band and use it on the glute/ham tie-in every second day.

  2. Perform negative only leg curls with the bad leg. Raise with both legs (A partner is better to perform zero concentric) and lower for a 7 sec count. You want as much pain as possible on the eccentric. 3 sets every second day. Ice afterwards for ten minutes.

  3. Compressive ice/heat therapy will also work well.

The floss band will encourage blood to the tendon for healing. The eccentrics do the same thing but inflict micro trauma of the tendon encouraging collagen production. You may also like to consider the herb Gotu Kola. You need to perform these for at least 4-6 weeks before you will notice improvement.[/quote]

Yeah if you think you have hamstring syndrome, don’t do that. Go see a PT in person and get a proper diagnosis.


#15

[quote]Ironliftr3 wrote:
I’ve had ongoing pain in the left glute/hamstring tie in for about six months now. It’s extremely painful any time I have pressure on the foot with the knee bent, such as going up stairs, or doing a forward lunge (which is near impossible). It’s also painful at the ischium tuberosty (sit bone) and sitting for any length of time is painful. Doing a leg curl however is painless.

I’ve tried icing, resting it, stretching, and foam rolling. I even went to an ART practitioner twice a week for four weeks with no improvement. I’d greatly appreciate any advice anyone can give, not squatting or deadlifting is getting very frustrating. Thanks in advance![/quote]

I know this is an older post, but I wanted to see if you have any relief as of yet.

I’ve got a similar condition it seems, but I do get pain from hamstring specific exercises such as lying hamstring curls. I’ve gone to multiple doctors, multiple chiropractors, multiple physical therapists, dedicated a lot of time and money for very little measurable results.

I’ve posted on many forums, read far more, and this is honestly the closest thing that matches what I ‘have’ as far as symptoms are concerned. I’m looking for a ‘start to finish success story’ but as of yet I haven’t found it, so that’s why I’m asking here. Thank you in advance.