Achy Buttock Pain due to Upper Hamstring Tendinopathy

Buttock Pain in the form of Hamstring Tendinopathy is a condition that can affect Long Distance Athletes and also the Adult population from 50 years onwards. It is described as a sore or achy buttock pain that is expereinced when sitting, walking, running uphill and also when bending downwards or when leaning forwards. It is often misdiagnosed as Sciatic Pain due to the close proximity of the hamstring tendon that attaches to the ischial Tuberosity bone in the buttock to the Sciatic Nerve, hence the need for accurate diagnosis by the Physical therapist.

What causes Hamstring Tendinopathy?

Basically there is a muscle strength imbalance between the glute (buttock) muscles and the hamstring muscles which results in the hamstring muscles becoming over dominant when swinging the leg backwards when walking and running. Over a period of time the hamstring tendon becomes tired and damaged due the excessive tensile that is constantly being placed on it. In addition, poor pelvic control caused by weak Hip Abductor muscle strength leads to excessive outward deviation of the pelvis when walking. This leads again to overuse on the hamstrings to help control the Hip during single leg stance when walking.

Hamstring tendinopthy Signs & Symptoms

• Specific Pain in the lower buttock

• General ache around the buttock region

• Aggravated by sitting on hard chairs, walking and running walking uphill

• Aggravated by bending forward in a standing position when gardening, cleaning, even when washing teeth.

• Similar to sciatic pain due to the proximity of the sciatic nerve to hamstring tendon – however sciatic pain can cause pain to travel into the foot.

• Hamstring Tendinopathy is confirmed by pressing on the ischial tuberosity bone for tenderness, placing a strain on the tendon in a hamstring stretched position.

• Diagnosed by pain when testing the contraction of the hamstring upper tendon.

Who can get Hamstring Tendinopathy

• People who have had Knee Replacements with reduced knee bending causing excessive bending at the Hips.

• Patients who have undergone ankle fusion or chronic ankle injuries which has led to poor pelvic control and excessive reliance of the hamstring muscles.

• Athletes involved in Uphill running.

• Patients with Lumbar spine fusions and general restriction in the Lower spine.

Next week’s article will focus on treatment of Hamstring Tendinopathy.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672, Email your queries to: tomaspryan@gmail.com