How to tell if I have injured my nerve or ligament while exercising?

Doctor's Answers (2)

Hi,

Pain in the gluteal and hamstring region may be difficult to identify due to the complex interaction of deep muscles (also known as the hip rotators), the bigger superficial muscles (such as the  hamstrings and glutes) and the main nerve that runs in the back of the leg (the sciatic nerve).

The character of pain indicates the likelihood of the offending source. Ligamentous or muscular pain is similar to muscle aches, toothaches or normal limb injury. It is identified by sharp, tearing pain and usually gets better with rest. Off-the-shelf painkillers are usually effective in reducing the discomfort.

Nerve pain, or neuropathic pain, is either burning or ice-cold, associated with electric shocks and numbness; this is similar to hitting your funny bone. Numbenss or weakness may accompany the pain. In extreme cases, the nerve becomes so sensitive that there is pain in the affected area while bathing or exposed to wind. This is not relieved by common painkillers.

Your symptoms seem to suggest a deep gluteal syndrome, more commonly diagnosed as 'piriformis syndrome'. This is usually muscular in origin; but the close interaction of the muscles with the sciatic nerve means that any muscle injury and inflammation will irritate the nerve. This will explain your sensation of weakness.

A focussed bedside examination will usually confirm this diagnosis. Commonly, physicians may send you for a nerve conduction test, which may turn out normal as this only tests for specific types of nerves.

Thanks for your question - you have already been given an excellent answer by Dr Daniel so I will try to add to this.  

Your symptoms do sound suspiciously like piriformis syndrome, where the sciatic nerve is irritated by its close proximity to the piriformis muscle. 

In some situations, it can be due to muscle enlargement or entrapment.  However, there are other potential diagnoses that must be considered, including 

1. This pain might be originating from your spine - such as a disc bulge - in which case an MRI spine might be required.

2. It be a bursitis of the sitting bone (the ischium) and hence when you are sitting/standing you get pain.

3. It could be due to hamstring tightness.

My suggestion would be to be assessed by an MSK/Sports Physician or a physiotherapist who is experienced with these conditions.  You can be examined, investigated and treated appropriately.

I hope this helps.

BW
Dr Dinesh

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