left buttock pain radiating to mid back

[sharileedahl]

Hi Jacinta. Sounds like you are on the right track with sorting this fellow out. Without "poking and prodding" it sounds reasonable that he could be getting over a very acute strain of gluts and underlying SIJ ligs / fascia (based on the pain with kicking position that you described).
Have you looked at his thoracic spine lately?? Now that the acuity of his symptoms have settled, you may be able to get a clearer picture. Considering pre-injury he c/o trigger points in his Tsp he may have some long-standing mobility issues there. If he is not rotating throughout his thorax with kicking (and any other functional activities for that matter), he is going to get more stress through the hip / pelvis. If you can address mobility issues in the thorax it may decrease the possibility of reinjury to the gluts with return-to-sport.

[Dr Damien]

To jacinta

I have some guesses why the neurodynamic tests did not test +ve
1) because the protrusion was not large enough and the dural sheath rather than the nerve root was irritated. A crossed leg SLR may have helped to confirm a compression
2) because a significant amount of inflammation had reduced before any of the tests were undertaken

When there is a low back pain with multisegmental distribution of pain (as described by you, downward and upward referrals), the dural sheath irritation should be suspected.

it sounds like your treatment so far has focused on resolving the abnormal biomechanics that may have caused some stress in the low back hence the minimization of pain. It is not uncommon to have low back problems that never start with the low back but emanate somewhere else. Cyriax techniques mention this phenomenon.