Glutes hurting like hell, can't find the cause

[AndreiDecker]

Hi coach Rip,

I'm having pain in my glutes, around the tailbone area. I have used the search function but found nothing about why this happen, could you please help me.

I'm doing the LP, my squat is 100kg and Deadlift 115kg. The pain appears to intensifie right after training the squat, even on non deadlift days. My form is decente, I can't see any flexion on my videos or basic mistakes, maybe I have a slight overextension at the top on some sets, but I could be wrong. Here's a video of me squatting and deadlifting:

Squat form check - YouTube


Deadlift 115kg form check - YouTube

The pain is sharp and I feel it on the glutes around where the tailbone is located. It hurts a bit when squatting, when I'm getting out of the role, but just on some reps. It started a few weeks in the LP, gets WAY worse when sitting and is lessened when I stand up or lie down. While sitting, it gets better if I extend my knees for some reason.

What's strange about it is that when I contract the muscles the way you do to hold your piss, I feel a sharp pain right between my buttocks and down to the tailbone.

Any idea what can cause this? It's starting to heavily affect my day because I can't sit for too long before it hurts so bad I have to stand, it feels like a burning sensation. I didn't have this the first time I did the LP, so I don't know what's going on.

[Mark Rippetoe]

I'm having the same pain right now myself. It's an SI joint issue that I have managed in the past with heavy squats. This knee injury has really fucked me up, and I can't squat heavy to fix it. I think the gait asymmetry caused by the injury has destabilized my pelvic situation, in conjunction with several old injuries. Mine hurts when standing and goes away when sitting, but the pain sounds similar. I've had three therapists look at it, and nothing has helped so far. Had to stop taking NSAIDs for my stomach, so there is no effective way to control the pain.

If you figure it out, let me know.

[AndreiDecker]

Do you also feel it when holding your piss coach? It's crazy because I can induce the pain by contracting the pelvic floor muscles hard, I've never heard about something like this before.

[David A. Rowe]

I had an undiagnosed SI injury with similar pain expression, and it's caused a few muscle spasms in the past in my lower back. It occasionally causes my back to go out. I've found the same as Rip... squatting consistently helps, and I also use a stretch between warm-ups and work sets when I feel the pinch/pressure. I don't go nuts with it -- I just hold it for around 20-25 seconds on each side. If my sacrum-lumbar is out, it will self-adjust gently. I can usually continue pain-free, afterward.

Rip, have you seen if you can tolerate Toradol? I recently started using it for acute issues because I figured if I continued to pound 800 mg of ibuprofen I was going to wind up in a similar spot. I found out about it when the hospital used it on me for a kidney stone.

[Mark Rippetoe]

Do you also feel it when holding your piss coach? It's crazy because I can induce the pain by contracting the pelvic floor muscles hard, I've never heard about something like this before.

Not that in particular, but I get flashes of acute pain in certain positions while standing.

Rip, have you seen if you can tolerate Toradol? I recently started using it for acute issues because I figured if I continued to pound 800 mg of ibuprofen I was going to wind up in a similar spot. I found out about it when the hospital used it on me for a kidney stone.

I have some IM Toradol for emergencies, but the shit is very hard on the kidneys and I try not to use it casually.

[AndreiDecker]

Found something that might help coach. I did 5x5 Deadlifts with good form and 1 minute rests, felt relief from the pain right after the workout. Have you tried this before?

[JFord]

I'm having the same pain right now myself. It's an SI joint issue that I have managed in the past with heavy squats. This knee injury has really fucked me up, and I can't squat heavy to fix it. I think the gait asymmetry caused by the injury has destabilized my pelvic situation, in conjunction with several old injuries. Mine hurts when standing and goes away when sitting, but the pain sounds similar. I've had three therapists look at it, and nothing has helped so far. Had to stop taking NSAIDs for my stomach, so there is no effective way to control the pain.

If you figure it out, let me know.

Have you tried taking famotidine (Pepcid) 20 mg once a day (or Prevacid) with the NSAIDs? That helps me when I HAVE to take NSAIDs and protect my gut at the same time.

[Mark Rippetoe]

My pharmacologist tells me that the presence of famotidine, an acid reducer, does not mitigate the prostaglandin-related damage caused by the NSAID. I'm just laying off of the naproxen for a while.

[JFord]

My pharmacologist tells me that the presence of famotidine, an acid reducer, does not mitigate the prostaglandin-related damage caused by the NSAID. I'm just laying off of the naproxen for a while.

I wasn't aware of that. Not saying it's not true but this is a pretty common way of mitigating the consequences of Frequent NSAID use. It's been very effective with many of my patients who need NSAIDS chronically (most of whom are quite elderly and frail). Here's a review article I've referred to in the past:

The use of H2 antagonists in treating and preventing NSAID-induced mucosal damage

Certainly it doesn't eliminate the problem but if you're only going to require NSAIDS sporadically, it may be worth a go. It definitely has helped me. I can't tolerate NSAIDS more then one or two days before I have problems. famotidine helps a lot! I try to refrain from NSAIDS for the most part. On the other hand I use them when nothing else works. I'd prescribe Dilaudid to myself but strangely, the DEA frowns upon that and the little snoops keep records.

Now if you have kidney issues, that's another issue altogether when it comes to NSAIDS...

[Mark Rippetoe]

My kidneys are fine, but Dilaudid doesn't do a damn thing for me. Tylenol is all I've got.