“Yoga Butt” Injury: A Real Pain in the Butt

“Yoga butt.” What a terrible name. Moreover, what a terrible condition. A high hamstring injury is a frustrating interruption to your yoga practice. Let’s look at yoga butt symptoms, yoga butt recovery time, and how to adapt your yoga practice to work with this serious pain in the butt.

How Do High Hamstring Injuries Happen?

You’re in your favorite yoga class, practicing seated forward bends. Ahh. Stretching is your favorite part of yoga.

Then, suddenly: PING! You feel a pop at your sitting bone. For months and months afterward, stretching causes you pain. Yoga butt symptoms include a deep ache or feeling of tightness just under your tush, right below the bone. The sensation likely gets worse when you stretch your hamstrings. And it feels like it just … won’t … go … away.

What causes high hamstring injuries? Long-held forward folds or repeated hamstring stretches. Um, it sounds a lot like a yoga class, no? Long periods of sitting can also be a culprit. So, if you’re at your desk all day and then pop into a yoga class afterward, you can imagine how your hamstring tendons might get cranky.

But we can’t just blame overstretching. You know what we don’t do nearly enough of in yoga? Hamstring strengthening. Do you have to give up your favorite yoga class to do Nordic hamstring curls at the gym? Nope. But you do need to build hamstring strength. Fortunately, with a little adaptation, we can use familiar yoga poses to that end.

But first, let’s look at the anatomy of this common condition. It’ll give us insight into the healing process and time frame, and understanding is the antidote to frustration.

Hamstring Muscle Anatomy

Your hamstrings attach to your sitting bones via a tendon. And it’s that tendon that’s affected when you have yoga butt. Just what exactly is a tendon? To understand that, we need to look at the makeup of a muscle.

Have you ever eaten Pull ‘n’ Peel Twizzlers? The ones that you can tear apart into long strands? Okay, imagine that you have one Pull ‘n’ Peel strand. That’s a single muscle fiber. Now, wrap that strand in plastic wrap. Each individual muscle fiber is wrapped in the fascia, called the endomysium. One important detail: the plastic wrap needs to be longer than the candy, and don’t tuck in the ends! You should see material extending beyond the Twizzler. You’ll see why.

Now, take a bunch of individually wrapped “muscle fibers” and encase them in another band of plastic wrap. Your bundle represents a muscle fascicle engirdled in fascia called the perimysium. (Leave the ends of the wrap untucked!)

Once more, grab a slew of these “fascicles” and band ’em together in yet another piece of plastic wrap (sorry, planet Earth!). That’s a muscle.

If you heeded the instructions about leaving the ends of the plastic wrap loose, you should have a bit of “fascia” sticking out on either side of the candy. That’s a tendon. The tendon is fascia that interweaves muscle and attaches it to bone.

A Major Pain in the Butt

Have you heard the term “proximal hamstring tendinopathy?” Or maybe you’ve heard of “high hamstring tendonitis”? These are fancy ways to say “yoga butt.”

“Proximal” refers to the hamstring’s attachment to your sitting bone. (“Distal” refers to its attachment to your lower leg.) “Opathy” means “painful.”

“Tendinopathy” means “painful tendon,” or a big ole pain in the butt. This can be a result of tendon swelling (“tendinitis”) or a degradation of a tendon’s collagen.

It’s useful to note here that there’s not necessarily a correlation between tissue damage and pain levels. You may be in a lot of pain, but imaging may not show terribly severe damage. That’s encouraging because it can mitigate fear around the injury and in still confidence in your body’s robust healing capacity.

Why You Should Stop Stretching Your Hamstrings if You Have Yoga Butt

Does it feel like the tightness at your sitting bone would just go away if only you could stretch it out enough? It turns out that more hamstring stretching is about the worst thing you can do. Why?

The hamstring tendon wraps around the sitting bone. When you stretch your hamstrings, it gets pulled taut around the bone. That compression exacerbates the condition. 

This doesn’t mean you have to stop going to yoga! It does, however, mean that you need to back way off forward bends for a while. For example, put your hand on a block in Triangle Pose (Trikonasana). Tuck your pelvis in the Standing Forward Bend Pose (Uttanasana). (Yes, it’s okay to round your spine!) This moves your sitting bones closer to the backs of your knees and decreases tension on the proximal hamstring tendon. Turn your feet out in a Wide-Legged Standing Forward Bend Pose (Prasarita Padottanasana). Doing so moves your sitting bones closer to each other and the floor, easing the stretch.

Yoga Butt Recovery Time

The healing process is long, folks. Sorry. Six months to a year (if you stop stretching it!). Your body will lay collagen down willy-nilly to patch the affected tissue. Picture pick-up sticks. That unorganized collagen becomes scar tissue unless …

You organize it. And here’s where you can take action. Strengthening your hamstrings during the healing process tugs the new collagen fibers into line with the fibers of the hamstring tendon. Moreover, it turns out that tendons respond really well to high load. Yes, you’ll need to rest in the acute phase after sustaining an injury. After that, strengthening your hamstrings can be useful to assist the healing process and to stiffen the tendon so that it’ll be less prone to re-injury. 

Hamstring Injury Exercise Ideas

The following movement ideas are not intended to treat a proximal hamstring tendinopathy. You’ll need to see a clinician for that. But they’re great ways to strengthen your hamstrings in keeping with the guidelines suggested by tendinopathy research. Best of all, they’re all variations of yoga poses. As we’ve said, no, you do not have to give up your yoga practice!

Locust Pose (Salabhasana)

You’ve heard of isometric muscle contractions? “Isometric” means your muscle fibers are contracting, but they’re not changing length. Essentially, an isometric exercise is a static hold. Isometrics have been shown to help alleviate pain. Here are some ways to apply this principle in Locust Pose.

1. Lie down on your belly. Rest your forehead on your hands.
2. Lift your legs. Hold them up. That’s it! Want to make it a little harder?
3. Place a yoga blanket on your ankles and lie down on your abdomen again.
4. Lift your legs and keep them lifted. The blanket on your ankles adds weight that your hamstrings have to support.
5. Now, try lifting the blanket’s weight with only the affected leg. Move the blanket closer to your knee for less load and closer to your foot for more.
6. You can also vary the line of pull across your hamstring muscles and tendons by turning your leg(s) in or out. (Yes, you can turn your legs out in a backbend!) 

Bridge Pose (Setu Bandha Sarvangasana) 

Again, you can use a static hold or an isometric contraction in this pose for pain relief. Here are some ideas. They get progressively more intense, so they might not all be appropriate for you right away.

1. Turn your feet in or out. 
2. Hold a weight on your pelvis to progress the exercise. Yoga sandbags work really well for this.
3. Step your feet forward. This decreases the bend in your knees and requires your hamstrings to work more. You could even straighten your legs so that just your heels are on the floor. Yowser!
4. Place your feet on blocks. You’ll slightly diminish the bend in your knee and demand more effort from your hamstrings. You can scoot your hips away from the blocks, again further straightening your legs.
5. Do you want to make that really hard? Put your feet on a chair.
6. Do any of the above only on one side.

What Else Can We Do in Bridge Pose? 

Research has shown that tendinopathies respond remarkably well to eccentric muscle contractions—that’s where muscle fibers lengthen while they contract. Imagine you’re holding a coffee cup above the table. Your arm’s not moving. Your bicep is contracting isometrically. Now, slowly lower the cup to the table. Your bicep is contracting to control the cup’s descent. If you squeeze it with your free hand, it’ll be hard, but its fibers are lengthening as you straighten your elbow. That’s an eccentric contraction. 

You can make Bridge Pose an eccentric exercise by lowering oh … so … slowly. Try it in any of the variations listed above. My personal favorite? Bridge slides.

1. Lie on your back with your feet on washcloths. (If you’re on a carpet, use paper plates.)
2. Lift your hips into a Bridge Pose.
3. Slide your feet forward, away from your body.
4. Lower your hips to the floor in order to pull the slider back toward you.
5. Repeat.

Warrior III Pose (Virabhadrasana III)

As you tip into Warrior III Pose, the hamstrings of your standing leg contract to control your torso’s descent, but they’re also lengthening at the same time. More eccentric work!

They’re also getting stretched over your sitting bone, so this might not be one to explore right away. But you can minimize the stretch by not tipping all the way forward. Here are some variations to play with:

1. Tip forward s-l-o-w-l-y. Remember, the aim is to target the hamstrings eccentrically.
2. Turn your standing leg in or out. (Hold a wall or chair as needed for balance!)
3. Add load by holding a hand weight. You can dangle the weight or hold it at your chest.
4. Add load by anchoring a resistance band with your standing foot and holding the other end in your hands.
5. Put an ankle weight or yoga blanket on the leg that’s in the air. Sneaky isometric contraction!

Yoga butt is a common, frustrating, and discouraging condition. Add some hamstring strengthening to your practice to prevent it or to lessen the likelihood of re-injury.