Tight hip extensors: In this day and age when everyone sits all day, this is unusual.  It is more common in runners than most groups of ‘normal’ people since we do 10,000,000 hip extensions every week.  This problem can cause pain anywhere from the low back to the feet because our entire running cycle is changed.  Tightness of the hamstrings is similar, but very different than tightness of the buttocks muscles since the hamstrings also effect the knee.

History: Usually slow onset, no trauma.  About the only activity which hurts is running.  It us usually when your knee is at its peak if hip swing, when those tight buttock muscles pull on everything.

We feel like we are getting slower in spite of our hard training.  It feels like your strides are getting shorter.  We seem to stretch our hamstrings and they just get shorter.  The question I always ask is, “When is the last time you stretched your gluteals?”  The answer is usually something like, ‘Well 1990 something’.

Self-Exam: 

1)      Lie on your back and try to pull your knee to your chest.  If it pulls tight in the butt, this is one indication you have tight gluteal muscles. VID 

2)      To differentiate between tight hamstrings and tight butt muscles, try the following test.   If you pull your knee straight up in the air but feel tightness in your hamstrings, it is probably your hamstrings, not your butt.  90/90 full motion  VID 

3)      Try to pull your knee across your chest to the opposite armpit VID

4)      Try to pull your ankle up to the opposite armpit.  VID

Treatment:

1)      Manage the pain:

a.      NSAIDS will help. 

b.      Kinesiology taping to stabilize your knee until you get your strength back.  Traditional kinesiology taping usually has you applying the tape directly to the effected muscle.  I could not find any videos of somebody (credible) taping a butt.  In this case, apply the tape to the sore knee where you are experiencing your pain. (If you find a credible, legitimate video of kinesiology tape to the butt, please let me know.)  LIN

c.       Continue running but avoid aggressive speed work and especially hill repeats.

2)      Restore full motion:

a.      A lot of patients with tight gluteus medius/maximus muscles may have limited hip extension motion.

b.      You should include Both of these sequential short-term stretches in your exercise program.  VID1    VID2

                                                              i.      Stretching does not have to be part of your warm-up or cool-down.  But it HAS to be part of your training program. LIN

3)      Most runners with tight gluteus maximus/medius muscles do not have weakness.  It is just the opposite; your butt muscles are tougher than they are long.

4)      Begin body weight exercises.

a.      You can go straight to our section on weight training for runners.

b.      As soon as you can pass the flexibility tests listed in the self-examination, consider yourself good to go.

c.       Continue to tape your butt….. see number one on pain management.

5)      Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.