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HEALTH A pain in the backside



Buttock pain can be caused by the sacroiliac joint or the buttock muscles.
?Buttock pain can be caused by the sacroiliac joint or the buttock muscles.

A pain in the backside

Andrew O'Brien

Everyone knows at least one. My ‘honest’ younger sister has been known to tell me that I can be one when I want to. But what about the literal pain in the backside, rather than the figurative variety? They can be pretty annoying as well.
Buttock pain in sportspeople is generally related to either the sacroiliac joint or the buttock muscles (or most likely a combination of both). Each of these is worth discussing in a little detail before looking at what you can do to alleviate the pain, or reduce your risk of developing pain in the first place.
At the base of your lower back is a triangular bone, called the sacrum, which wedges between the two bones that make up your pelvis (the ilium). The sacroiliac joints (SIJ for short) at either side are covered by a cross hatching of ligaments and muscles which permit only a small amount of movement, and act mostly as a shock absorber, transmitting forces between the trunk and legs. This is particularly significant in running sports, where impact forces are the equivalent of at least double your body weight and create a rotational force through the pelvis and lower back.
No doubt you have heard that the buttocks, or the glutes, are the biggest muscles in your body. But what do you really know about them? There are actually eight different muscles in the buttock, attaching from the pelvis and sacrum at the midline, to the top of your thigh bone laterally. Each muscle is described as having its own separate action, but the reality is that our buttocks work as a whole unit. Their job? To propel you forwards and upwards, and to absorb the shock of landing when you walk and run. Bearing in mind that those forces are at least twice your bodyweight, those muscles need to be big for control.
If we have eight powerful muscles in our buttocks, and a joint that is covered by thick ligaments that doesn’t move much, to control the forces of walking and running, why do we develop pain there? Well, what are you doing right now as you read this? Sitting, I assume. Remember how I said the job of the glutes is to propel you forwards and upwards? They are not there as cushions! In fact, if you look at our closest relatives in the animal kingdom, the great apes, you will see that they don’t really have buttocks. The reason for this is that sometime around 6 million years or so ago, our ancestors started to spend less time in the trees, and more on the ground.
Over time, our anatomy evolved to make upright walking, then running, easier. To do that, we needed bigger buttocks. Sadly, in the last hundred years or so, we have stopped using them properly, so those muscles get weaker, tighter and lazier – according to statistics the average adult spends 50 to 70 percent of their day sitting. Now, when we go for a run, our muscles aren’t able to do their job properly anymore, so we develop painful trigger points within the muscles, or dysfunction at the sacroiliac joint, because the muscles can no longer stabilise it properly.
What can you do? Well, get off your backside for one! As I said, it’s not a cushion. If you work at a desk, every hour, get up and move for a few minutes. Go for a walk, or get a glass of water.
If you already have pain, it’s best to have it assessed by a chartered physiotherapist to see just what the cause is. Depending on the severity and duration of your symptoms, a few treatment sessions, an exercise programme and some tips on how best to adjust your training should see you right, although in severe cases further assessment may be required.
Literally or figuratively though, a pain in the backside is a pain in the backside. If you have one, or there’s one nearby, get up and move to get away from it!

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.