Marta Montenegro: Women Friendly Pain

There are definitive, gender-specific differences when it comes to men and women, and this even includes common aches, pains, and injuries.

Let’s start with the fairer sex.

While injuries themselves are not gender-specific, many women-only factors can influence them; for example, age, anatomic variations, weight, strength, and flexibility. Plus, a woman’s body and subsequent lifestyle may differ quite a bit from a man’s, from the places where she stores fat to the size of muscle in relation to bone mass to greater hip width to even how she sits and walks.

With that in mind, here is a look at two specific pains that women often confront more than men, why they occur, and how to fix it.

1. Piriformis Syndrome

What is it? An irritation of the piriformis muscle, located deep in the buttocks. 

“The sciatic nerve runs right by the piriformis and in some people actually goes through the middle of it, which can lead to nerve symptoms down the leg, says Chris Finn, PT, CSCS, CGFI, sports physical therapist.

What are the symptoms? Pain and tightness in the buttocks during prolonged sitting sessions. It can also feel like a sharp pain down the leg.

What are the causes? This deep hip muscle can work overtime, Finn adds, due to weakness of the gluteus muscles and lack of hip stability, which can lead to erratic movement and body compensation patterns.

How does it affect gender? 

Jill Murphy, DPT, LAT, CSCS, physical therapist and owner of MotionWorks Physical Therapy,, explains some of the reasons why women may deal more with this posterior injury than men:

  • Women tend to have weaker hip stabilizing muscles, gluteus medius, and gluteus maximus, which place extra stress on the piriformis as it attempts to compensate to stabilize the pelvis, making the piriformis tighter and leading to pain.
  • Females also tend to suffer more frequently from central nervous system sensitization issues, such as fibromyalgia, chronic low back pain, migraines, sciatica, etc., all of which tend to lead to increased resting tension in the piriformis.
  • Women, unlike men, cross their legs at their hips, and typically do so asymmetrically, having one dominant leg crossing 90 percent of the time or more.  This creates asymmetry in the muscle length between legs, making the tighter leg at risk for piriformis syndrome.
  • Women with small children also habitually carry the child on one hip, and do other tasks with their dominant hand, which also creates a functional asymmetry, which can lead to tightness and pain in one side of the hip.

How can you prevent it?

According to the article “Piriformis Syndrome, Diagnosis and Treatment,” published in the Muscle Nerve Journal, some of the preventive measurements are:

  • Strengthen the hip extensor muscles—hamstrings and gluteal deltoid muscles (see exercises, left).
  • Work on the core, particularly the deep abdominals, such as the transversus. Exercises like planks, side planks and “stir the pot” may help.
  • Foam rolling the back of the legs and the glutes to get some myofascial release.

2. Plantar Fasciitis 

What is it? When the connective tissue on the bottom of the foot becomes inflamed.

What are the symptoms? Pain in the heel and/or arch, particularly in the morning when getting out of bed.

What are the causes? Being overweight, prolonged standing periods, high arch or flat feet, and tightness of the calf muscles.

How does it affect gender? In Murphy’s experience, these factors may tax more women than men, exacerbating the problem:

  • Women frequently navigate between high heels and non-supportive shoes, which can increase the stress on both the heel and the ball of the foot.
  • A recent study shoes that women who favor high heels tend to have tighter calf muscles and joint ankle. Both conditions increase the risk of plantar fasciitis.
  • Women often have weaker hips muscles, thus providing less body stabilization all the way through the foot in functional activities, such as squatting, rising from a chair, or getting in and out of a car.

How can you prevent it?

  • Plantar fascia and calf stretching.
  • Avoid walking barefoot and wearing flip-flops, ballerina shoes, and other unsupportive shoes for long periods of time.
  • Heel support may be needed if the pain is located in this area (consult with a professional.)
  • Strengthen the hip muscles.
  • Wearing a plantar fasciitis splint at night may be recommended.

Marta Montenegro is an exercise physiologist, certified strength and conditioning coach and master trainer, who teaches as an adjunct professor at Florida International University. Marta has developed her own system of exercises used by professional athletes. Her personal website,, combines fitness, nutrition and health tips, exercise routines, recipes and the latest news to help you change your life but not your lifestyle. She was the founder of nationally awarded SOBeFiT magazine and the fitness DVD series Montenegro Method.

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