Dear Dr. Batchelor:
My boyfriend told me to contact you because you are an athlete and because you would understand my problem. He has run with you at Kennesaw Mountain in the past.
I am a 36-year-old female triathlete who trains 35-plus miles per week running, 150 miles per week biking, and 3 miles per week swimming. My goal is to do a half Ironman Triathlon race.
My right hamstring pain initially began when I jumped over a ditch during a hilly cross-country run. I continued to try to run through the pain for the next few weeks, but the pain continued to get worse and worse. I took off four weeks, but the same pain began when I tried to run again.
The hamstring pain begins at the top of my right hamstring muscle, and when I bend forward to touch my toes, I feel a sort of crunching, "gristle-like" sensation where my hamstring attaches at my buttocks. When I sit on it, it feels sort of hot or swollen. I can press into the area and can actually press in deep and get to the root of the pain.
In addition to the above-mentioned pain, I have another pain that began last year when my boyfriend was teaching me to ride wheelies on my mountain bike. I crashed backward and fell on my tailbone. Ever since then, I have had localized pain at my tailbone. When I feel the area, it feels as if the tip of the tailbone is not as prominent as it used to be. Occasionally, the pain gets severe and I can't walk or run very fast without pain.
Can you help me?
~ Margaret
Dear Margaret:
I had a patient recently with a condition similar to yours. This patient had pain in the hamstring area where it attaches to the ischial tuberosity. An X-ray of the area revealed calcium exostosis where the hamstring attached to the ischium. When the hamstring contracted and relaxed repeatedly during a run, it would rub over this roughened area and the patient would experience similar symptoms to yours. Over time, the hamstring tendon gets irritated and swollen. It's like if you tried to stretch a bungee cord around a corner, but the corner was made up of ground-up glass.
Treatment consists of no stretching, running with a shortened stride, and the use of ultrasound to dissolve the roughened calcium area. The end result of the treatment is a smooth ischial tuberosity and no hamstring pain. Of course, your condition may be different, but this is an example of what worked for one patient. You could have a minor tendon strain at the best, or in the worst scenario, an avulsion fracture at the ischial tuberosity. The only way to know for sure is to examine you.
Your tailbone injury is also not that uncommon. When a patient comes in with a tailbone injury, it is usually the result of falling back on a hard surface, and the tailbone is usually tipped and misaligned forward (anterior) toward the front of the body.
One exception was when I treated a woman who suffered a sacrococcygeal injury as a result of delivering a large baby. As the baby began to exit the womb, pressure was exerted against the woman's tailbone and the tailbone tipped backward, or in a posterior direction.
Treatment of the tailbone misalignment involved manipulating the coccyx by hand into a more normal position. A clunking sound was heard and felt during the manipulation, and the patient experienced immediate pressure/pain relief in the area.
Daniel Batchelor, DC
Roswell, Georgia
Editor's note: Dr. Batchelor is certainly well-qualified to give advice regarding running-related injuries - he has won more than 350 road races and run over 60,000 miles. In addition to his impressive running record, he has been a consultant for such magazines as Runners World; Running in Georgia; Running Journal; Georgia Runner; and Run and See Georgia. Several years ago, he was interviewed by CNN Headline News as an expert on athletic injury and back pain.
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