Question

pain area   QUESTION: Hi Everyone,

I'm 30yr old Ugandan (E. Africa) male i used to work out {mainly jog, do sit ups and stretch} daily, played tennis twice a week. The pain started immediately after an uphill (very steep hill) contest-silly i know, I think I either twisted or tore something not sure. It has now been 2 years, no major changes for better or worse.
The nature of my work is such that i sit on a computer all day...)

The pain is localized around my lower left butt, towards the hip area-near the joints. Pain is felt mainly when I bend to touch my toe, when doing a humstring stretch, bend or do the piriformis stretch, or the piriformis nerve floss-PAIN IS MOST EVIDENT WITH THIS.
My lower back seems ok, though oddly I have no problem sitting just discomfort after sitting for long hours-not pain. No pain when sleeping, driving, walking and almost all other activities. Pretty much normal till I stretch -strange, strange, strange. When the Chiro asked me where I felt the pain, I literally forgot because it only shows up when I stretch, I had to stretch to locate the pain.
I also feel like my lower back is really very weak.

It has not stopped me from daily activities, since the pain only shows up when I’m stretching. Otherwise I’m almost normal, i miss playing tennis and jogging all of which i've given up since the pains begun-coming to one year now.
I have since discontinued all my workouts and any such activities.

I would greatly appreciate any advice, experience, literature and any help you can share with me.

The doctors, chiro & physios I have seen have said that what I’m suffering from is probably a tear of a gluteus muscle, such as the gluteus maximus. We have tried various things some have told me to stretch others advised against it. Nothing seems to make it better or worse. I can still carry on with daily activites and feel no pain, except when I stretch. YES! I only feel this pain when I stretch. When doing  the Piriformis nerve floss is when I feel the pain.

When doing that is when I really feel the pain.
I've attached a photo showing the areas where i feel the pain and discomfort, marked in red and black outline.

Thank you,

Mikey

ANSWER: Have your lower back treated (origin for the sciatic nerve), check for a short leg on on side, get a set of orthotics for you shoes. Have electrical stimulation and deep tissue massage performed. The tear has healed by now, but alot of scar tissue and spasm is there. The stretching is still necessary.

---------- FOLLOW-UP ----------

QUESTION: Thank you Doctor,

What type of stretches and exercises would you recommend?? Is that piriformis nerve-flossing thing ok? I feel like it抯 the only action that actually stretches all the way, from neck to heel. I抦 confused since some docs said stretch and others said don抰.

Also, what exactly do you think the problem is??
My Chiro is currently doing some work on my lower back and nerve. But no one has ACTUALLY told me what the real condition, cause or issue is.

Thank you for taking the time, I really appreciate.

Answer
Continue your stretching, it is OK. I would suggest deep tissue massage/myofascial release. The problem is a myofascial pain syndrome from scar tissue and muscle shortening due to the past injury. An ART practitioner is recommended if possible. The advice in my previous answer is still recommended.