Gluteal muscle strain - symptoms
When a sprain occurs, a sudden sharp pain is usually felt in the buttocks. You may experience pain when going up or down stairs and pain when sitting.
You may experience pain when you move your leg back. The pain will be felt immediately afterwards and may lessen over time.
However, you are likely to experience soreness when using your buttock, such as jogging, using stairs, or jumping. Some pain may be felt even when walking normally.
Some symptoms that may occur:
- Pain and stiffness after physical activity, especially in the morning after starting to move.
- Swelling at the site of the sprain.
- Painful condition of the gluteal muscles.
- Bruises in the area of the pulled muscle.
Diagnostics
To understand whether a person has the syndrome, a neurologist
performs palpation. It should show whether there is pain in the area where the muscle attaches, and also give an idea of its current condition, the degree of tension, and soreness.
The specialist may ask you to do several active tests to determine Freiberg's, Beatty's, Pace's, Grossman's, and Bonnet-Bobrovnikova's symptoms—all of which involve rotating the hip in different positions.
In some cases, to understand how to cure piriformis muscle syndrome, EMG, CT/MRI and radiography are prescribed.
How does stretching occur?
The gluteal muscles are used to straighten and stabilize hip movements. To do this, they need to contract, which leads to rapid muscle contraction.
If too much force or repetitive force is applied during contraction, the muscle can tear. This condition is called sprain.
The likelihood of this happening increases if the muscle is stretched when the contraction occurs. However, muscle strains on the buttock are rare. They most often occur during sports, especially running and jumping, such as athletics or football.
Any injury or degenerative disease of the hip can lead to a tear of the gluteal muscle. Partial or complete rupture may occur due to acute trauma. It can even lead to local bleeding, scar tissue formation and tendon calcification.
Degenerative conditions or chronic inflammation of the gluteal tendons (tendinopathy) from overuse can lead to complete rupture of the tendon.
What is the essence of piriformis syndrome?
Doctors refer to this type of illness as compression-ischemic tunnel neuropathies. With such damage, the sciatic nerve and nearby vessels are compressed. The disease acquired its name due to the fact that the compression itself is localized in the pyriform space located in the buttock area.
Piriformis syndrome can occur either due to pinching or due to irritation of the piriformis muscle and its inflammation. This could potentially affect different categories of patients, but athletes and the elderly are at particular risk.
At the first appearance of pain, you will need to consult a doctor, undergo diagnostics and outline the correct course of treatment.
Degree of stretching
Muscle strains can be classified by severity as follows:
- Level 1: Mild muscle tear with pain but no loss of range of motion or strength.
- Grade 2: There may be a partial tear of the muscle associated with incomplete loss of strength and flexibility.
- Grade 3: Complete tearing or tearing of the muscle fibers in the buttock with complete loss of strength and movement.
Risk Factors Contributing to Injury
There are several factors that may predispose patients to sustain gluteal injuries. These need to be assessed and corrected under the supervision of a physiotherapist.
Some of these factors include:
- There may be insufficient preparation of the gluteal muscles.
- Muscle weakness (especially gluteal and hamstring tendons).
- Inappropriate or excessive exercise or activity.
- Insufficient recovery periods after sports or physical activity.
- Incorrect running technique.
- Poor movement technique or posture.
- There may be fatigue or overwork.
- Insufficient warm-up before training or during competition.
- Joint stiffness (especially in the lower back or hips).
- Inadequate rehabilitation after a previous injury to the buttocks or lower back.
- Muscle imbalance.
How to Diagnose a Muscle Strain
Diagnosis of a gluteus medius muscle tear begins with a physical examination of the patient, including palpation of the affected muscle. When an injury occurs, muscle strength, gait assessment, and the patient's gait are tested.
Standard muscle tests such as hip abduction, flexion, internal and external rotation, and hip extension will be performed.
Special tests, such as the single-leg squat test or a positive Trendelenburg sign, confirm the diagnosis of a gluteus medius tear. An MRI or ultrasound can help see pathological changes in the muscles.
Treatment of damaged muscle
You will need to change or stop the activities that cause the pain until your muscle or tendon heals. If you want to continue training, then replace running with swimming.
Your doctor may recommend stretching and strengthening exercises to help you heal faster.
A mild sprain may take several weeks to heal. More serious injuries may take six weeks or more to heal.
At the same time, physical therapy is vital for the victim. If the muscle damage is very severe, you may need to use crutches for a short period of time. This reduces the strain on the muscles and speeds up the healing process.
Early recovery will involve performing movements that involve the muscle. Further exercises involve movements with resistance.
Treatments that may be used alongside rehabilitation may include:
- Electrotherapy.
- Massage damaged muscle tissue.
- A special set of stretching exercises (provided by your doctor).
- Training in movement techniques for injuries.
Surgical treatment involves the use of minimally invasive techniques to repair a severe, full-thickness tear of the gluteal bone.
This involves making small incisions through which an endoscope and other miniature surgical instruments are inserted to re-approximate the tendon to the bone.
How to reduce swelling and pain in the buttocks
- Cold compress . Every 3-4 hours, apply an ice pack, gel, or a package of frozen vegetables wrapped in a cloth to the sore spot for about 20 minutes.
- Give yourself an ice massage . To do this, freeze water in a Styrofoam cup. Then remove the top of the cup to expose the ice. Hold the bottom of the cup and rub the ice over the painful area for 5 to 10 minutes. Do this several times a day for as long as you have pain.
- Take over-the-counter pain relievers . Read the label and take the medication as directed. Remember that nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can cause stomach bleeding and other problems. These risks increase with age. Unless your doctor advises, do not take NSAIDs for more than 10 days.
Once you have recovered from your injury, use moist heat. It will help relax your muscles and make movement easier. Before doing warm-up and stretching exercises, apply moist heat to the sore area for 10-15 minutes.
Moist heat includes wet heating pads, which can be purchased at most pharmacies, a damp washcloth or towel heated in a microwave or dryer, or a hot shower. Do not use heat if you have swelling.
Reasons for the development of pathology
Symptoms of piriformis syndrome can develop either independently or against the background of other muscle pathologies or diseases in the body. According to statistics, approximately 80% of all patients suffer from pathology that develops against the background of other types of diseases.
Common causes of discomfort include:
- Long-term preservation of the same posture, which is uncharacteristic of the normal state of the body. If you often sit in an uncomfortable position or for some reason are forced to maintain it for a long time, you should give up this habit. There are also situations in which the patient simply has no other choice - these are cases of improper fixation of a limb due to injury.
- Twisted and oblique pelvis syndrome. Its reasons can be different, for example, different lengths of a person’s legs. The basis for the occurrence of such a disease may also be hidden in pathologies of the pelvic bones.
- Too severe frequent loads. Left piriformis syndrome often occurs because the muscle is overtrained.
- Diseases of an infectious-inflammatory nature. In this case, the spasm occurs as a reflex reaction of your body to external stimuli.
- More rare causes of piriformis syndrome are incorrectly performed injections, as well as severe hypothermia.
It is worth considering separately the four most common reasons for the occurrence of this unpleasant syndrome.
Injury to the pelvic area, sacrum and lumbar area, the appearance of a hematoma
These reasons are relevant if the piriformis muscle has been torn for some reason or there is strong pressure on it. The second case stimulates piriformis syndrome on the right or left under the influence of a hematoma.
Sacroiliitis
This is the name for the inflammatory process localized in the area of the sacroiliac joint. It can develop as an independent disease, as well as against the background of other diseases.
Tumor process in paravertebral structures and spine
As the tumor develops, it begins to have a strong effect on muscle tissue. Often the nerve is also affected. Gradually this leads to the appearance of unpleasant sensations.
Osteochondrosis of the lumbosacral region
This type of disease most often provokes symptoms of piriformis syndrome in women and older men. Pain due to bone degradation and pathological processes in the joints.
Butt stretching exercises
Hip flexion . Start this exercise lying on your back. Slowly bring your knee toward your chest as far as you can without pain. As long as you feel no more than a slight to moderate stretch. Then calmly lower it down.
Repeat 10-20 times if symptoms do not worsen. Once this becomes easy, you can use your hands to gently bring your knee a little further towards your chest. Provided that the exercise is performed painlessly.
Hip abduction to the side . Begin this exercise by lying on your side with your feet together. Keeping your back and knee straight and your foot pointed forward, slowly lift your leg up.
Feel the tension in the thigh muscles on the sides (glutes). Hold for 2 seconds and then return to the starting position. Perform 10-20 repetitions on each leg, provided that the exercise is painless for you.
One leg kicks . Start this exercise by lying on your stomach with your hands under your forehead as shown in the picture below. Slowly bend your knee until your shin is pointing upward. Raise your bent knee just a short distance from the floor without moving your lower back.
Slowly straighten your knee, then lower your leg back to the floor, returning to the starting position. During the exercise, keep your spine and pelvis motionless and breathe calmly. Perform 10 repetitions with the leg on which the muscle is damaged, provided that the exercise does not cause pain.