Question: I am currently recovering from either a badly strained high hamstring tendon (pain under the sit bone and inner groin area) or a bad case of piriformis syndrome.

I have been seen by a few doctors but, short of throwing thousands of dollars out the window, no one will specify the exact problem. The problem first occurred two months ago, the pain was excruciating for nearly five weeks. During the past two weeks the pain has started to subside. During that time I was doing elliptical work and ran very short runs so that my body didn't forget what running was like.

Prior to the injury I was running 40-50 miles a week at around an 8:30 pace and set new personal records in the 10K and half marathon distances. I am back to running now with my weekly mileage much lower than in the past, 25 miles only the last two weeks at a very slow pace, somewhere around 12 minute miles.

My question to you is even when I feel like I am pushing it, 12 minute miles is all I can seem to produce. I feel as if I lost my edge, my mojo as it was, while healing. How long can I reasonably expect to train before I am back to running fast?

- Matthew, California


Hi Matthew,

Pain that is best localized to the "sit bone" is most likely a proximal (upper) hamstring strain. Typical symptoms include pain when sitting on a hard surface or car seat (most are bucket seats) and pain when wiping the foot on the affected leg or pulling off your shoe. Piriformis syndrome causes pain in the buttock, sometimes with symptoms radiating down the leg.

The decrease or absence of pain is only the beginning of the recovery process. You must work on core and hip strength and flexibility. Some of my favorite exercises include backwards leg lifts (hip extension); this can be performed using an ankle weight or exercise band; planks performed in a face up position (including leg raises as strength improves); side planks with leg lifts and clam shells (lay on your side and bend your knees 50-60 degrees; keep your feet together and open your knees like a clam shell; 30 reps). A physical therapist may assist you with a rehabilitation program. You may also benefit from kinesiotaping.

As strength and flexibility improve, your speed and distance should also improve. Running while injured may be causing you to shorten your running stride, resulting in a slower pace.

Get Over It: Piriformis Pain.

Good luck.
Ice vs Heat for Injuries