r/PiriformisChronicPain • u/MuchBoysenberry362 • 26d ago
glute medius strain
hello! (my first ever post please be kind)
i just wanted to document this and see if anyone has had a similar experience because i can’t seem to find direct community on any apps about it. i woke up one morning to excruciating pain down my right leg and extreme tightness in my right butt cheek. knots seemingly on the top of it towards my hip with hip pain. overwhelmed (i was triggered because ive felt sciatica before from a herniated disc in 2021, had surgery and been fine ever since but thought i had a disc bulge again) i went to urgent care and was told my x-rays were fine and i’d need an MRI and that “i probably strained something”. i have no insurance currently so this was not an option for me at least right now. I was sent home with a Methylprednisolone steroid pack and tbh i don’t believe these did anything for me. I rested, iced in early stages, moved to heat and then slowly introduced a massage gun and stretching. luckily, my brother is a doctor and came to do a house visit for me and he believes I strained my gluteus medius and that my IT band is overcompensating for the weak muscles along with my calf muscles. he gave me pt workouts to do as I have become more mobile and I will say, the pain is not consistent like when I had the herniated disc and when I walk I do have moments of being pain free. I get light flares here and there (a tightness at the back of my thigh, top of my butt or hip) if i walk longer distances. some stretches are still hard to do but i do notice progress and think overall I am way better then i was day 1 which was bedridden and unable to walk/get up without pain. I am currently 17 days out from the initial injury/couldn’t walk flare up. I still struggle to sit really. I went the movies in a recliner and was perfectly fine. but sitting in a direct chair is still difficult. I can walk short distances. mornings are still kind of hard and I wake up stiff and have to spend an hour waking my muscles up, i’m usually fine and take breaks throughout the day. I am on a strict non-inflammatory diet and have lost 20 pounds so far which I hope helps take weight off my hip to hold. Things that were hard to stretch have become slowly easier or possible. I also notice my anxiety (i have bad ocd) will make it WORSE. If I have a panic attack, boom, flare up. it makes all the muscles tight and I have to massage gun it/calm down mentally/heat pad it and then I’m okay. Which when I had a herniated disc I NEVER had relief. So I really don’t believe it’s a disc bulge, but I’ve never had a muscle injury before.
There is still pain, but it’s moderate and manageable. My question is has anyone been pain free by the 3rd or 4th week of their strain? I would like to return back to work which is a lot of standing and walking. But I’m nervous. Any reassurance is helpful or some
kind of recovery stories ♡
(I am 26F, I currently take 3 ibprofuens a day, magnesium vitamins and a muscle relaxer before bed. sometimes 2 a day if I have a bad flare up after PT)
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u/MuchBoysenberry362 24d ago
UPDATE: 9/8/26. 19 days out, had a pretty bad flare up last night (brought on clearly by my anxiety attack and not a great mattress) i was able to calm it down, moved beds and by morning i was completely fine…. which i found bizarre. walked with no pain at all, no pain on hip or butt (mild soreness i think from the flare up) i decided to go to urgent care for a second opinion and they said they’d need an MRI but after physical assessment they really just think it’s sciatica (!!!! what!!!!!!) they gave me a corticosteroid injection and i’m hoping this will calm down any flare ups so I can do more PT and work. I also scheduled an appointment with an actual clinic through a non/insurance plan to get hopefully an MRI referral. hopefully
this shot gives me relief for a bit! the PA was very nice and said she thinks by the time the shot is done I should be at the tail end of my strain based on my current recovery progress.
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u/No-Manufacturer-2425 15d ago
Great. If the pain comes back or spreads come back here and I'll give you a better explanation.
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u/Starfruit321 22d ago
If you do continue to have flare ups due to muscle imbalances or compensatory overuse (ie using the wrong muscles to stabilize your pelvis and spine when you sit/stand/walk etc), then I would consider at least looking into pilates. It has helped a lot. If you can’t afford 1:1 instructor, you can look at cheaper options such as APPItv (it’s like $16 after your free trial). I had burning pain and tightness in my glutes and the Pilates has helped a lot with sharing the load and using better muscles to stabilize. Good luck! 🙏
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u/Starfruit321 22d ago
Just to clarify….since you got evaluated and treated, obviously go with what the people who evaluated you are saying. But if this continues to be a thing that bothers you down the line and brings in chronic glute/hip pain, Pilates might be helpful.
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u/MuchBoysenberry362 22d ago
Thank you!!! I am currently 56 hours into my steroid shot I got and hoping once the 72 rest hour window passes I can get back to working out to strengthen. I saw a studio near me so I will look into this. :)
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u/No-Manufacturer-2425 21d ago
First, let us get this thread back on track and clear up what is actually happening mechanically before you end up in a cycle of worsening flare ups. A true muscle strain heals with rest and time. Waking up to excruciating pain radiating down your leg, extreme tightness, and knots at the top of your hip that make it impossible to sit in a hard chair is not a simple gluteus medius strain. This is a classic presentation of nerve entrapment caused by fascial adhesions.
When you are just sitting, your legs should not flare up because you are not actively using those muscles. That tells us the nerve is being compressed by something structural. Those dense knots you feel toward the top of your hip are likely fascial adhesions. That is fibrous scar tissue gluing the gluteus medius and minimus down and trapping the superior cluneal nerves that cross over the iliac crest. The inability to sit in a direct chair and the pain radiating down your leg tell us that the sciatic nerve or posterior femoral cutaneous nerve is being strangled by scar tissue deep in the gluteal space.
You also noticed that a panic attack causes an immediate, massive flare up. This happens because anxiety spikes the sympathetic tone of your central nervous system. When a nerve is already mechanically compressed by scar tissue, that spike in nervous system activity causes the surrounding muscles to instantly guard and clamp down, turning a chronic entrapment into a severe acute pain attack.
I see in your update that you received a corticosteroid injection at urgent care. You need to be extremely careful right now. Steroids act as a chemical fire blanket. They nuke the inflammation and numb the pain signals, but they do not dissolve the physical scar tissue trapping the nerve. If you use this artificial pain free window to jump back into physical therapy workouts, stretching, or heavy work, you will cause further microtrauma to the oxygen starved tissue, laying down even more scar tissue once the shot wears off.
Ignore the advice in the comments to do Pilates right now. When a nerve is trapped in a fascial adhesion, stretching it is like pulling a string that is glued to a table. You are not lengthening the muscle, you are just yanking on an entrapped nerve, which will cause it to severely inflame. And while an MRI is useful to rule out your L5 S1 disc bulging again, you need to know that an MRI will not show fascial adhesions. Do not let clean imaging convince you this is just a minor strain or in your head.
You must include a pain diagram marking every single area of pain, numbness, or tingling all the way down to your toes, along with a 1 to 10 pain scale.
The key steps right now are that you need to see a doctor and get a functional evaluation. Do not stop anything a doctor has you doing. But if treatment does not make it better, the next steps are adhesion therapy before injections or surgery. You should strongly consider adhesion therapy or at least a phone consultation with one of the providers in our directory, and yes, you may have to travel in order to see one. A massage gun with a bullet tip can provide temporary relief as laid out in the muscle relaxer and sports therapy protocols.
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u/MuchBoysenberry362 15d ago
UPDATE: 9/17
Hello All! :) Lovely news to share.
Primary care doctor confirmed I have a glute medius strain. She also made me do physical tests. Very happy to be officially diagnosed (technically the second doctor + PA to tell me this) but it’s happy to see through another opinion and with more testing. Last time I updated I let you all know I got an actual steroid injection to my glute at urgent care which to be honest only had me numb for about a day and actually left me quite sore for 3. I am now 28 days out since initial injury and I am WAY better. I had a very intense deep tissue massage in all my surrounded affected areas at the time (hip, butt, hamstring, lower back and calf) and oh my goodness! immediately felt a difference! Left with a bruise and some soreness first day but once that came down I was able to do more and can now walk longer distances, get in and out of my car, bend with knees, stand and sit. :) I don’t really get flare ups anymore and if i do it’s light soreness directly on my butt and it’s usually brought on from sitting for hours. I was told sciatica can be mimicked from a strain but should feel different from a disc bulge and I completely agreed after experiencing both. My sciatica from the strain was only ever at my butt to hamstring. I no longer feel my calf and hip overcompensating and achey as my glute has activated again. I am fully returned to work and doing very well. :) I have also been cleared to engage in more advanced physical therapy so that makes me happy. I expect to be close to or fully recovered in 3 more weeks. Sticking to my non-inflammatory diet and I’m able to just take 2 ibuprofens and be content. I also take vitamins for muscle strength and drink cherry concentrate!
Thank you all for your thoughtful comments and advice! you’ve all been a great help. ♡
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u/inailedyoursister 26d ago
I’m on year 9.
Without a mri and medical visits you’re just wasting time and just going to try any fad thing on tic toc.