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Common running injuries - buttock pain

Buttock pain can be caused by inflammation of the hamstring tendons where they join the bone you sit on - the injury is called 'hamstring origin problem'.
Neil Black
Neil Black, MCSP, SRP qualified as a physiotherapist in 1981 and is an ex international middle-distance runner. Neil has worked with the British track and field team (including Paula Radcliffe) since 1990, has been the Chief Physiotherapist for UK Athletics and is now UK Athletics performance director.

Buttock pain can be caused by inflammation of the tendons that are attached to the bone you sit on (the ischium). These tendons are together called the hamstring. The injury that causes the pain is called hamstring origin problem. 


  • Aching or sharp pain in the upper hamstring or the buttock
  • painful to run, particularly at faster speeds, when sitting on hard surfaces and when driving
  • can also be painful when the hamstring is being stretched or being used to resist a force
  • sometimes there can be aching, or less frequently sharp shooting pains into the hamstring itself.

Hamstring origin problem is commonly caused by accidental over-training, on the introduction of racing or intense training, or running on slippery surfaces. Spinal problems, tight muscles (particularly in the buttock and hamstring) and nerve related problems can all be contributory factors.

Other than hamstring origin problem, buttock pain can be caused by the following:
  • pain coming from joints, nerves or discs of the lower back
  • irritation of the major nerve that leaves lower back and passes down through buttock to lower thigh (Sciatic nerve) as it passes through the buttock (piriformis syndrome)
  • inflammation of a fluid filled membrane which overlies the ischium (ischial bursa). This is called ischial bursitis
  • degeneration of the hamstring tendon near where it attaches to the bone (tendonosis)
  • partial tear of the tendon where it attaches to the bone
  • tendon pulling off part of the bone (called avulsion of the ischial tuberosity). This is more common in adolescents.
Self help
  • Avoid faster running and slippery surfaces
  • massage the area before runs and ice or cool immediately after training
  • stretch the lower back, buttock, hamstring and quadriceps regularly
  • do regular self massage into the local area and the total hamstring
  • ask your doctor about oral anti-inflammatories or homeopathic remedies
  • seek professional help if the problem is not showing signs of settling within a week.

This involves investigating other potential causes to make sure that inflammation of the tendon is the problem.

Treatment begins at the lower back with releasing techniques, progressing into the soft tissues of the back, buttock and thigh. Manual therapy techniques and electrotherapy to the affected area would be applied to reduce the inflammation and improve the quality of the tissue. Strengthening and re-educating (i.e. learning a better running technique) may be necessary along with a biomechanical analysis.

Find a local sports injury specialist.

Average recovery time

Mild inflammation could settle within a week. If other factors are involved or the problem is allowed to become chronic, it can persist for many months.

  • Avoid over-training
  • warm up and stretch appropriately with particular emphasis on the lower back, hamstring and buttock
  • be careful to avoid slippery surfaces where possible and progress intense training and racing very steadily
  • make use of regular self and professional massage

The ischium The ischium

Sciatic nerve Sciatic nerve

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