A few months ago I tuned into a yoga class over lunch and felt pretty significant pain afterward. I brushed it off at first but, before long, I could barely walk. I later learned that I had hamstring tendinopathy, also known as “yoga butt”. Hamstring tendinopathy is the most common yoga injury, yet I knew nothing about it until I was limping around the house. It wasn’t covered in yoga teacher training or talked about by any teacher in the ten years I have practiced. This article is meant to help you understand this common injury, what to do if you have it and how to prevent it before it bites you in the butt.
Surgeon general’s warning: I am not a physical therapist or doctor. If you are injured, please seek professional advice and diagnosis. This article is meant to be informational and complementary to that advice.
Hamstring tendinopathy is inflammation, irritation and sometimes tearing of the tendons that attach the hamstrings to the buttocks. Pain is often felt right at the bottom of your derriere but can manifest as pain in your hamstring and calves as well. Since it’s a tendon injury it can take months to fully heal, yikes!
Why is this the most common yoga injury?
Most of us sit all day, with our hips flexed, our glutes turned off and our shoulders slumped. Therefore, most of us suffer from gluteal and posterior chain weakness. What’s the posterior chain you ask? The quick answer is that it’s the back of our bodies (all three gluteal muscles, hamstrings, upper and lower back). Weakness in one muscle leads to over compensation in other muscles, tendons and ligaments, which is a recipe for injury.
The oversimplified answer to why yoga butt is so common is because yoga classes often focus too much on stretching over strengthening, specifically stretching hamstrings, glutes and outer hips. Stretching these areas when you have a weak link in the chain can cause injury, while strengthening that weak link brings stability and injury prevention.
Prevention Tips for Practitioners
These tips are meant to empower and encourage you to do what feels right and safe to you during a yoga class, even if a yoga teacher is cueing something different.
Bend your knees in:
- Forward folds (seated and standing)
- I’m gonna say this loud so you can hear it in the back, THERE IS NO AWARD FOR THE PERSON WITH THE STRAIGHTEST LEGS! Yoga class isn’t a flexibility contest.
- Downward Facing Dog
- When I began doing yoga I thought the “best” way of doing downward facing dog was to get my heels to the ground. For many people this is an unnecessary stretch on the backs of your legs that can lead to injury. Additionally, I’ve found that playing around with bent knees and raised heels has given me access to new sensations and fun in downward facing dog.
Some people can straighten their legs in forward folds and downward facing dogs without issue. Some people can’t. If you feel a stretch in your hamstrings in these postures, that’s generally good. If you start to feel a lot of sensation up into your butt and sits bones, back off and bend your knees.
Engage your glutes in postures like:
- Bridge, wheel, camel, locust
- Chair, eagle
- Warrior 3, Airplane, Standing Split
- Any posture where you feel your glutes naturally activate! Keep squeezing!
Since glute weakness is part of the reason yoga butt is so common, it’s important to activate and strengthen those muscles any chance you get.
Let’s talk about pigeon pose
- Stop trying to get your shin parallel to the front of your mat in pigeon
- It’s totally acceptable to have your shin at whatever angle feels good to you in pigeon. I often have my heel close to my belly in pigeon and I still feel a juicy stretch in my outer hip.
- Try reclined pigeon
- I’ve found this variation to give me a lot more control over how deep I’m stretching into my hip and glute. Pigeon is a pose we can easily do “wrong”. When I say wrong I mean that it’s easy to align your body in such a way that you over-stretch your ligaments and muscles. Pigeon is also one of those postures that most teachers cue in a yoga class so you’re likely doing it a lot. I recommend switching it up and choosing reclined pigeon once in a while (or always) to lessen the risk of doing damage.
Do glute and back body work outside of yoga classes
The following is a non-extensive list of exercises you can do to strengthen your glutes
Bridges with leg lifts
Get creative and have fun with these exercises!
Make it a challenge
Nicole and Jeremy, the founders of Dope Yogi, did a squat challenge where they did 100 squats a day.
Do it with friends
Accountability buddies make things more fun and more likely that you’ll do it!
Make it a habit
I started doing a 10-15 minute glute sequence every morning. Shout out to Cindy Lunsford of YogaSoul Nashville for the sequence. After doing the exercises I would allow myself to make tea and breakfast.
Prevention Tips for Yoga Teachers
Encourage practitioners to do all of the things listed above
And avoid cueing things that go against these prevention tips
Include glute and posterior chain work
Modified Sun Salutations/Vinyasas
Rather than always going from chaturanga to upward facing dog in a sun salutation/vinyasa, have practitioners come to their bellies and take cobra, sphinx, or locust. This will engage the posterior chain of the body.
Think about where you can add some extra glute activation and strengthening
Maybe it’s by cueing practitioners to lift a leg in bridge pose, maybe it’s by having practitioners bend their back knee and squeeze their booty while in warrior 3, maybe it’s through the use of a prop or a cue to engage the glutes. You don’t need to invent a whole new way of teaching or throw away your favorite poses. You can simply modify your favorite postures to be more posterior chain and strength focused.
Ask yourself why you give the cues you give and call the poses you call
It’s easy, especially as a new yoga teacher, to copy cues and sequences from other yoga teachers you admire. However, this can perpetuate harmful habits in our practitioners, like encouraging everyone to get heels down to the floor in down dog or shins parallel to the front of the mat in pigeon. I encourage you to be curious about why you’re telling practitioners to do certain things with their bodies. If you’re not sure, ask other yoga teachers, learn more about anatomy, read books and articles. As you learn more things, you will likely change your cueing and sequencing. We won’t ever be perfect teachers but we can always get better!
Tips for those of you who have yoga butt
As my friend Meg said to me after finding out I had yoga butt, “This is a long-term relationship”. A long term relationship to which you probably didn’t want to commit. Take a deep breath, remind yourself that this will not last forever, and don’t rush into activity as this will only prolong the recovery process.
I sat on a frozen block of tofu for about 2 weeks before doing anything more strenuous than walking around my house. Ice will help relieve inflammation and reduce pain.
Go to a doctor or physical therapist
A professional will be able to tell you what’s going on in your body much more than I can. They can assist in coming up with a plan to heal your specific body and injury.
Avoid any movement that brings about pain
After a few weeks of rest and ice you may want to start moving on your mat again. Avoid any movement that brings pain. In my opinion, you should avoid forward folds altogether until you are feeling much better.
Start to strengthen
Once you’re feeling a little better, start to do some glute exercises. I would recommend things you can do while lying on your back or in a table top position. Save squats and lunges until you’re feeling much better. If you feel pain, back off.
Utilize the prevention tips listed above
After going through the extensive process of healing you will NOT want to experience yoga butt again. Prevention is key.