June 27, 2022

To Your Good Health: Walking difficult after visit to bowling alley

My partner and I are in our 60s, exercise regularly — three to five times per week — eat a well-balanced diet and are of average weight. Recently, we went bowling for two games and found ourselves sore in the area right below our buttocks. We were very sore for several days, making walking difficult, especially up and down stairs. What would have caused this area to get so sore? We named it “bowling butt” for lack of a medical term.

Starting a new activity will often cause people to overuse some muscles that aren’t used to the strain. Bowling involves forceful extension of the thigh, which is the gluteus maximus muscle, as well as other muscles in the hip to maintain stability.

Two games were enough to exhaust that muscle, and the untrained muscle will often suffer small tears, which take days to heal properly.

The fact that you were sore with activities involving thigh extension helps confirm the diagnosis. Some people think it’s lactic acid in the muscle, but that is gone after a few hours.

Naming a disease is serious business, and I did a look for similar names in the literature. I did find “Wii butt,” a pain sensation after playing games, including bowling, on the Wii video game system, but none for actual bowling. I’m not sure “bowling butt” will catch on, however.

I have no health issues, but I’m a cheapskate. I see products labeled as “grain-free” or as “gluten-free,” but they always cost more than the regular product. Are there any health benefits to using these, or are they marketing gimmicks?

They are not marketing gimmicks at all. People with celiac disease have a sensitivity to a protein in gluten, called gliadin.

Even small amounts of gluten can cause long-lasting damage to the intestines, and many people with celiac disease will be unable to properly absorb nutrients if they are regularly exposed to gluten.

This can manifest with severe symptoms, such as weight loss, diarrhea and severe metabolic disturbance. Or, it can trigger much milder ones, such as mild abdominal discomfort after eating, skin changes, anemia or joint pains.

Because the symptoms of celiac disease are so varied, a physician must be fairly convinced it’s celiac before making the diagnosis.

Biopsy is the gold standard for certainty, but blood testing — if done while consuming a diet containing gluten — is suggestive. I strongly recommend getting a diagnosis before going on a strict gluten-free diet if you suspect celiac disease.

For people with diagnosed celiac disease, strict adherence to a gluten-free diet is essential, and the increasing availability of gluten-free foods has made the lives of people with celiac disease better. Many grains are gluten-free naturally.

There are people with symptoms from gluten-containing foods, but who do not have celiac disease. The term is “non-celiac gluten sensitivity.”

Some people with this condition are sensitive to components of the food other than the gluten, although there are some people who are sensitive to gluten, but do not have celiac disease.

For people without NCGS and without celiac disease, avoiding gluten is not necessary. A diet with many different whole grains has been proven to reduce heart disease risk compared with a more meat-based diet.

Keith Roach

Dr. Keith Roach

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. © 2022 North America Synd., Inc.