Yoga and Yoga Butt

Word of warning: if you google ‘yoga butt’ you’ll likely find pictures of young women in yoga pants and a view of their buttocks, sooo I don’t really recommend that search term. If you just add the word ‘injury’ to the end you’ll get much different results! 

Anatomy of hamstrings

The hamstrings are a group of three muscles located in the back of the thigh that are responsible for bending the knee and extending the hip. When these muscles are overworked or subjected to repetitive stress, it can lead to an injury known as proximal hamstring tendinopathy. This condition is characterized by pain and stiffness in the area where the hamstring tendons attach to the sitting bone, also known as the ischial tuberosity. In this blog, we'll discuss the anatomy of the hamstrings, what causes proximal hamstring tendinopathy, and the various treatment and recovery strategies available.

Your hamstrings are composed of three muscles: the biceps femoris, semitendinosus, and semimembranosus. These muscles originate from the pelvis and extend down the thigh, where they insert into the tibia and fibula bones of the lower leg. The hamstrings play an important role in athletic movements such as running, jumping, and kicking, and are often subject to overuse and strain in sports and other physical activities.

One of the most common injuries in yoga students is a tearing of the tendons of the hamstrings. This happens with excessive stretching and forward folding and absent the inclusion of strengthening that’s not often found in stretchy yoga classes & asanas. 

The anatomical term for the injury is Proximal Hamstring Tendinopathy. 

Let’s break this down so you understand the etymology of the words used in the name of the injury:

• Proximal - in anatomy this term is used to define an area situated near the center of your body (your torso) or the point of attachment of soft tissue. 

• Hamstring - muscle name

• Tendon - the soft tissue that attaches muscles to bone (your muscles don’t attach to your bones, your tendons do).

• Opathy - the term used to refer to a disease or injury.

Here’s what Proximal Hamstring Tendinopathy actually is… 

Little tears in the hamstring muscle near its insertion point at the bottom of your pelvis. The hamstring inserts into what some people call the sit bones (the anatomical term for this area of the pelvis is the ischial tuberosity). It’s a small bony projection on the bottom of your pelvis, just below your buttocks. Pain or discomfort from this injury is felt at the very top of the back of the thigh under your butt.

Hamstring tendinopathy is a condition that affects the tendons located in the upper part of the hamstring muscle. It is a common injury among athletes and active individuals, causing pain, stiffness, and reduced flexibility in the affected area. Proximal hamstring tendinopathy is a specific type of hamstring tendinopathy that affects the tendons where they attach to the ischial tuberosity (sit bone) in the pelvis.

The good news is that proximal hamstring tendinopathy is treatable, and with proper rehabilitation and care, it is possible to make a full recovery and return to your normal activities. In this article, we will discuss some of the best treatment and recovery strategies for proximal hamstring tendinopathy.

What causes proximal hamstring tendinopathy? 

Many things CAN cause it, however again, it’s one of the most common injuries in yoga as there is a LOT of hamstring stretching and very little hamstring strengthening in traditional yoga classes. This continued tugging of the hamstring as it is stretched and stretched and stretched, and lack of strengthening work to give the muscle the ability to tolerate the demands of intense stretching results in these little muscle tears.

Proximal hamstring tendinopathy occurs when the tendon fibers at the attachment site become damaged or degenerated. This can be caused by a variety of factors, including:

• Overuse: Repetitive stress on the hamstrings can cause the tendons to become overworked and eventually lead to tendinopathy. This is common in athletes who participate in sports that require a lot of running, jumping, or kicking, such as soccer, football, or basketball.

• Age: As we get older, our tendons tend to become less flexible and more prone to injury. This can make us more susceptible to proximal hamstring tendinopathy as we age.

• Muscle imbalances: If the muscles in the front of the thigh (the quadriceps) are stronger than the hamstrings, it can cause the hamstrings to work harder and become more susceptible to injury.

• Sudden movements: Sudden movements, such as jumping or sudden changes in direction, can put a lot of stress on the hamstrings and lead to tendinopathy.

How can you prevent it?

Have a BALANCED approach to how you are exercising your muscles. We need flexibility AND strength to move well and injury free. Just because your hamstrings feel tight does NOT mean they are, and likely is an indication that they might be weak - this depends on the entirety of your workouts or ‘movement diet’ as I like to call it. Exercises such as Bridge lifts w/ your feet extended will strengthen the hamstring in its lengthened position.

So if you think you're experiencing Yoga Butt what should you do?

• First, so go see a physiotherapist! They are likely to advise you to stop stretching it entirely and work on building strength - starting with building it in a shortened position (such as hamstring curls) to prevent further tugging on the injury, progressing over time to building strength in the lengthened position. 

• Second, you’ll need to resist the urge to stretch your hamstring muscles, however tempting it might be, this is the worst thing you can do as it will further exacerbate your injury. 

• Third, make sure you’re balancing out your movement diet. If you’re only practicing yoga - for the stretch - change it up and get in some strengthening work. 

• Finally, you’ll have to remember that this is an injury in your tendon (not your hamstring muscle fibers), therefore the recovery time for this injury can take from 8 months to a couple of years. Strengthening your hamstrings is the key to helping repair your tendons. Don’t get frustrated, just continue doing the work you need to heal.

Treatment options: 

When I experienced this injury it took close to 2 years to recover, but it taught me a whole lot about my body!! 

A new category in The Alliance, my virtual yoga studio, we’ve got an entire Category focused on Movement Snacks (short & sweet movements your body will LOVE) & how to incorporate some really healthy movements into your daily life! You can join us in the online studio and keep yourself accountable with good, healthy, nutritious movements with other members who have committed to their health as well. 

Proximal hamstring tendinopathy is a condition that affects the tendons in the upper part of the hamstring muscles in the back of the thigh. The tendons help the hamstring muscles attach to the bones, and when they become damaged or inflamed, it can cause pain and discomfort. This condition is often the result of overuse or repetitive strain and can be especially common in athletes who participate in sports that require a lot of running and jumping. Symptoms may include a dull or sharp pain in the back of the thigh, difficulty with certain activities such as running or jumping, and decreased flexibility or strength in the affected area. Treatment options for proximal hamstring tendinopathy may include physical therapy, rest, pain management, and in severe cases, surgery.

The treatment options for proximal hamstring tendinopathy may vary depending on the severity of the condition and may include the following:

1. Physical therapy: Physical therapy can help to stretch and strengthen the hamstring muscles, reduce pain, and improve mobility. A physical therapist can also provide advice on how to modify activities to minimize stress on the affected tendons.

2. Rest: Taking a break from activities that put stress on the hamstrings can help to reduce inflammation and promote healing.

3. Pain management: Over-the-counter pain medications such as ibuprofen and acetaminophen can be used to manage pain and reduce inflammation. In some cases, stronger prescription medications may be needed.

4. Ice therapy: Applying ice to the affected area can help to reduce pain and swelling.

5. Stretching and strengthening exercises: Specific exercises can help to improve flexibility, strength, and stability in the affected tendons and muscles.

6. Platelet-rich plasma (PRP) injections: PRP injections involve injecting a concentrated mixture of the patient's own blood platelets into the affected area to promote healing.

7. Corticosteroid injections: Corticosteroid injections can help to reduce inflammation and pain in the affected area.

In severe cases, surgery may be recommended to repair or remove the damaged tendon. However, this is typically a last resort and only considered after other treatments have been unsuccessful.

It's important to note that the best approach to treatment will vary depending on your individual case, and it's important to work closely with a doctor or physical therapist to develop a plan that's right for you.

Have you ever experienced yoga butt? What was your experience, how long did it take you to recover, and what was your best treatment option?