We've talked about pains in the butt before, right? The one I'm going to talk about today is the pain situated around the sitting bones. You might talk of this pain as being a hamstring strain and in fact it's right in the insertion of one of the hamstring muscles. A physiotherapist might diagnosis it as hamstring tendonitis or tendinopathy, particularly if it's been there for a while.
There are many types of pains in the butt(ocks) and some of these can be worsened by our yoga classes. The pain I'm going to talk about today is the pain situated around the sitting bones (ischial tuberosities). You might talk of this pain as being a hamstring strain and in fact it's right in the insertion of one of the hamstring muscles. A physiotherapist might diagnosis it as hamstring tendonitis or tendinopathy, particularly if it's been there for a while.
It's quite common – I often have 1-2 students in a class with this issue and without the right approach it can hang around for a while. It's initial onset might have been with an injury, like a hamstring strain; it may be secondary to an episode of back pain. It's common among athletes like runners, but can also affect folk that are involved in long periods of sitting with deskwork and this can certainly be an aggravating factor that needs to be considered. If you are in that middle aged bracket and have just lifted the amount you are walking or running, this might be the onset.
While our first 'go to' self-treatment is perhaps to try and stretch the hamstrings this is not the right approach. Although it may feel like it provides some relief, expert physio opinion suggests this loading of the tendon may inhibit healing. As a lot of folk come to yoga wanting to lengthen their hamstrings, and many attribute the cause of the pain to tightness, it can be particularly frustrating and feel like a real setback to have this limitation.
What the hamstring really needs is to be restrengthened. This takes the load off the injured area and increases blood flow to support healing. It's a bit hard to get your head around if you are hell bent on stretching your hamstrings and worried about the feeling of tightening, but this tightening sensation is OK. You need to trust that you will regain the flexibility again when they injury / aggravation has healed and the pain settled.
So this means in a yoga class you need to avoid forward bending for a bit. You may get away with cross legged forward bends, but straight leg forward bending in standing or sitting is a no, no for a bit. Instead fill your practice and classes with alternatives that are more upright – warrior poses and seated twists. One of my favorite strengthening poses for the hamstrings is done in supine lying – simple bridge pose. You might like to try the straight leg chair variation pictured here. And if sitting aggravates the pain, get up – even just for a minute, before the pain tells you.
Anyway, there are some ideas. My aim always is to provide information and practices to people independently manage wherever possible and to give yoga teachers more skills to support their students'. Certainly seek physiotherapy assessment for further guidance or look out for some of my workshops next year to learn more. Will be sending out an Events list next week, with many exciting opportunities for students and yoga teachers.