More about my butt than you probably need to know.
What stopped me from running was sciatic pain. Because I'd had it before and because it happened when I tried to run, I was pretty sure it was a common running injury called piriformis syndrome. The piriformis is a small muscle in the buttocks that can press against the sciatic nerve and cause pain; piriformis syndrome is easily identified by two trigger points (places that hurt if you press on them) at the muscle attachments at the femur and sacrum. I had pain there and in the center of the muscle, where the nerve passes - pressing there caused my leg to go numb. I also had trigger points along the iliac crest, which is a problem with the gluteus medius and/or gluteus minimus muscles. There was also a lower trigger point, which was proximal hamstring tendinopathy.
Standard treatment for piriformis pain is stretching and using a foam roller, both of which I'd been doing. Something more sinister was going on. Visits to numerous specialists led to the knowledge that, not only did I have these problems, but also iliotibial band syndrome - yet another common runner's malady - which presented with pain at yet another trigger point near my hip.
The full monty
I also had hip adductor problems. And achilles tendon problems. And peroneal tendon problems. And foot tendon problems (I forget which ones). And psoas problems. And mild problems in the muscles in the mid-back and abdominals.
Tendinosus, not tendinitis
I'd been trying to slap a coat of paint over the problems, rather than treat them. The first step in dealing with severe tendinosus (a chronic problem) is breaking up the calcified scar tissue in the aponeuroses by myofascial release. The method is similar to using foam rollers for tendinitis, but it's like comparing pulling out a tooth to pulling out a hair - it's a big deal. I'll probably discuss it in detail in another post.
I'm told that I can expect significant improvement in 6 weeks and a more-or-less "cure" in 6 months. If 6 weeks doesn't do anything for the heel attachment of my right achilles tendon (the worst problem), I'll have to schedule surgery. I'm already seeing improvement in the lesser problems.
The first goal is to be able to flex muscles without cramping and spasms; that's when I'm done with this first step. Then comes mobility and stretching. Then mild strengthening through isometrics and resistance bands. Then priopoception, balance and stability. Then strengthening and agility. Then sport-specific drills. Then I can return to running. "I'm not dead yet."
JFK 50 mile 2014 race report
8 hours ago