Ivan’s Story: Overcoming Hip and Glute Issues

Why did Ivan come to us?

Ivan came to us with dull and achy pain in his left hip that radiated down the back of his leg and stopped at the knee. Most of the pain was made worse by sitting for long periods of time, going from sitting to standing, and walking. Additionally, he was only able to bend over and reach his mid-shins before his pain got worse.

So what caused Ivan’s pain?

Exam findings revealed he had tenderness near his ischial tuberosity or his “sit bone” on the left side. He said this was primarily where he felt his pain. Additional exam findings revealed weakness and loss of muscle mass in the hamstrings and glute muscles, tension in his sciatic nerve, and decreased hamstring length. It was determined that Ivan’s primary cause of pain was proximal hamstring tendinopathy, and a secondary cause was sciatic nerve tension.

Proximal hamstring tendinopathy is a weakening of the hamstring tendon where it attaches to your pelvis at the ischial tuberosity. This weakening is commonly due to deconditioning, weakness, or dysfunction of the hamstrings themselves, placing additional strain on the ends. The muscles are not strong enough to do their job, so they tighten to adapt. This condition is best fixed by progressive mobilization and loading of the hamstrings through active and dynamic stretching, as well as progressive strengthening exercises. This issue can also cause sciatic nerve “entrapment” where it passes the ischial tuberosity, which can then cause additional pain, numbness, and tingling down the leg.

How did Ivan get better?

Ivan was prescribed active hamstring stretching, sciatic nerve glides, gluteal strengthening, and hamstring strengthening exercises that he was very faithful about doing at home. Each time he would come in, he made sure to say which exercises made him feel better and which ones weren’t doing much for him, so we could then tweak the program a bit. His pain resolved fairly quickly and we moved into higher-level full-body strengthening exercises while he continued the basic ones at home.