Question
Hi doctor,

Last week I was at my local gym using the seated press machine with upward press and on completing a set of 15, I felt a sharp pain in the mid to upper buttock.  I have had the pain that I notice depending on how I stand or lie around a week (sometimes it seems fine) and wondered what I should do and what you think it is?

I am guessing I have torn something. Apologies if you have answered this before but I have checked the previous questions and see many dealing with lower back rather than actually what feels like in the deep upper buttock.

My fear is some sort of trapped nerve, which I know can be problematic in resolving!

Many thanks for any advice and I for one appreciate the service you are providing in helping people on this site!

Warm thanks,

Alexandra

Answer
Dear Alexandra,

Chances are that you just have a strain of the buttock musculature.  To test this, the best thing to do is figure out exactly what movements increase the pain and determine what muscles are firing during those motions.  For example, squats, hip extension, and lunges all engage the buttock musculature.  If you perform these activities and the pain increases then a strain is likely.  If the pain is sharp and you see some loss of strength, then you did likely tear the musculature.

Now, the joints in the back of the pelvis are also sources of pain into the buttock.  These are called the sacroiliac joints and commonly result in buttock and hip pain when stressed.  The joints have some of the strongest ligaments in the body which keep them very tight and allow only small movements in the joint.  If you sprain the ligament or if the joint is restricted, the pain can be light to severe.  The best way to address this joint is with an examination performed by a chiropractic physician.

I would take a wait and see approach for the next few days and take it easy in the gym for that time period and see how your symptoms improve.  If you are not noticing less pain and more function, then schedule an examination of the low back to include the pelvis at a local chiropractor's office.  Good Luck.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net