Ah, tell me about the ass pain. That’s a bugger, that one. (And oy, the humiliating positions you have to get in at the ART doc’s… just find a female health care provider, is all I can say.) Problem with asses is that so many things are involved there — hamstrings, glutes, smaller hip muscles, nerve bundles, etc. It’s like a big ol’ train station of hurtin’ possibilities.

My guess (and remember, I only play a doctor on the internet) is an inflammation of the sciatic nerves, although it’s unusual to have it on both sides. We often see this as so-called “piriformis syndrome”, which can refer to an inflammation of the actual piriformis or simply the area around it, which, again, is highly innervated. This is actually a common problem for active people. There are injuries that active people tend to get that non-active people don’t, so in fact “I’m not sedentary” is probably what caused this. :) The problem may also originate higher up, in the lumbar spine.

I strongly recommend you DO visit a doctor, preferably one that deals with sports medicine (because a regular GP will not be as familiar with the unique injuries of athletic people). It isn’t going to get better and will likely get worse if you ignore it.

I have been lurking the site and following your advice since 2009 to great effect. Thank you so much for putting all of this information online for free.

Moving on to my question, I’ve been having pain when I sit for about six months. I located the area in an anatomy book, and as far as I can tell its the ischial tuberosity, on both sides (yes I actually managed to develop a pain in my ass). I did some research and learned that its probably an issue with hamstrings, I’ve tried stretching, icing, resting, etc. The pain won’t leave, and I can’t sit through my classes without squirming.

I’m 22 years old, 5’10″, 150lb, in decent shape except for the sitting-pain thing, and I always warm up before weights and stretch after. I lift weights, bike to school, and practice for martial arts. In other words, I’m not old enough to be super stiff, I have good muscle tone, not too much body fat, and I’m not sedentary, so what gives? Have you ever encountered a similar issue? If so, have any ideas on what to do about it? Maybe I should visit a doc, but somehow I don’t think ‘butt hurt’ is covered by my insurance.

Took your advice about bumping up the carbs on workout days. Yep, that was it. I feel much better. Thanks.

Victoria

1 palm of protein (about 4 oz)
1-2 fists of colourful veggies (about 1-2 cups)
1-2 thumbs of fat (about 1 oz)

Around your workouts, throw in 1/2 fist of fruit and/or legumes (beans, lentils) and/or starchy root veg (yams, sweet potatoes).

Eat this way and the macronutrients will take care of themselves.

Get as fit as possible while nourishing yourself as well as possible.

Forget about calories and focus on making every bite of food you put in your mouth the best possible quality — the most nourishing; the most lovingly prepared; the most mindfully eaten; the freshest and realest; the most full of vitamins and minerals and other good stuff. Don’t skimp on your protein, fruits and veggies, and good fats. Eat slowly. (This is key.)

Forget about workout details and focus on this: Jump high. Run fast. Hit hard. Build a heart-lung-muscle engine with lots of power and work capacity. Be real with your movements.

Do this to the very honest best of your ability and don’t bullshit yourself about what you’re eating or whether you put in your most earnest effort.
Everything else is irrelevant.