There have been a couple of overlapping issues to the original article on Sit Bone Pain. It just shows that whatever the issue, problem, or pain is… it can be coming from a number of different places. Figuring it out isn’t always so easy. We also naturally try to come to some conclusion about what is going on and sometimes wrongly assume that all, in this case, sit bone pain is created equally. What I’d like to do is offer a couple of other scenarios that are somewhat common. They would also change the way in which you work with sit bone pain. In the original article, I’m specifically talking about dealing with sit bone pain as a result of a hamstring tear or irritation.
First we have the Trigger Point. There is a trigger point in the gluteus minimus or sometimes the gluteus medius which can create pain around the sit bone. One of the most common complaints that goes along with one of these two being the culprit in sit bone pain is this. The pain tends to increase when I’ve been sitting for a long period of time, in a car or in a seat. Yes, this could be the sign of other things as well, including everyone’s favorite… piriformis.
All I can tell you is this. On at least 4 occasions I’ve met students with sit bone pain who have mentioned that the pain comes on during the day while they’re sitting. I check their gluteus minimus on the side of their hip and… when I press it reproduces their sensation. I realize this may be beyond your skill set so have them check themselves with a tennis ball or something similar… or send them to a Neuromuscular Therapist.
Second, we have the Adductor Magnus as the real culprit. Differentiating between the hamstrings and this adductor is relatively simple. If the sit bone hurts when doing a wide leg forward bend but no while doing a forward bend when the legs are together, it’s more likely to be adductor magnus which has an attachment on the sit bone as well. It’s not because of a trigger point but instead it’s because it probably got injured, usually during a wide leg forward bend! I would suggest that the same posture will be the one to stretch that scar tissue and alleviate the problem.
As always, proceed slowly and be willing to change course based on the feedback of the person you’re working with.