Got Sit Bone Pain? What to do with that Hamstring. ~ David Keil

Via on Mar 15, 2012

A previous student of mine informed me that she had pulled a hamstring.

Photo contribution: David Keil

Her major symptom was pain at her sit bone (ischial tuberosity) when folding forward, secondary was that it would also hurt when sitting for long periods, especially in the car. I couple of weeks after she informed me of her incidence, I saw her again and she still had the same pain.

Although not my regular advice, the most common way people are told to deal with this problem is to bend their knees in their forward bends. The idea is that by bending your knees you shorten the hamstrings. By shortening the hamstrings you reduce the amount of pull or tension placed on them. It sounds good in theory.

Here’s the problem with this theory.

I refer to the hamstrings as two joint muscles. What this means is that changing the position at one of the two joints (hip or knee), changes the end of the muscles that will receive more force from the actual stretching of the muscle.

When you bend your knees and bend forward, more of the pressure created by the “stretch” to the hamstrings goes into the opposite end. In other words, if you bend your knees in a forward bend, you add more force to the end of the hamstrings that connect to the sit-bones.

Assuming that you’ve actually torn your hamstrings (of course a minor tear usually), and that you’ve torn the end of your hamstrings closest to your sit bones, do you think it would be wise to put more pressure on these same tissues? The answer is No, it wouldn’t.

The next question is: well, what should we do then?

Although I can’t say that this will work in every situation for every individual, this has proven to work for a number of people in this situation. There are always exceptions.

Now, during this most recent interaction with this particular student, I took a moment to give a gentle squeeze to the area of her hamstrings just above the knee joint. (The opposite end from where she was feeling discomfort.) I could see in her face that these tissues were particularly tender and sore. That along with the symptom that she would actually get pain in her sit bone when she would sit in the car clued me in that this technique would probably work for her. The significance of the pain while sitting in the car is that the part of the hamstrings that gets the most pressure in a car seat is the bottom (distal) end of the hamstrings closest to the knee.

The technique I apply is extremely simple, and as I told this student, worth trying for two or three weeks and seeing what happens. Ah yeah, the technique you’re waiting for it aren’t you?

The answer is: keep your knees straight.

That’s it. When you forward bend, either standing or in seated postures, keep the leg extremely straight and don’t go as deeply into the forward bend as you normally do.

By keeping the knee straight, with quadriceps engaged, you keep the stretch in the hamstrings equal between both ends. In the situation mentioned above, the hamstrings had gotten to a place where their distal end near the knee got too tight. The tension in this end seems to lead to consistent tension in the hamstrings as a whole and particularly near the sit bones. That needed to be taken out by keeping the knee straight.

The student came to three days of practice with me three days in a row. She kept her knees extremely straight and guess what? Pain was reducing after just these few days.

I emailed her not too long after that and here’s what she had to say:

David, Significant improvement indeed! I am not bending the knees on the standing or seated poses (like you instructed me) and now I can bend forward with my torso a lot more without any pain in the moment or afterwards. I am now doing Kurmasana and Supta K (almost fully) without pain and on my own!! It is definitely healing, recovering the flexibility. I am really happy about this!!! Looking back, I think that I may have been stuck on a phase of “pain-avoidance” without doing anything to heal the hamstring for good, addressing the problem. Thank you so much for your help with my trouble-making hamstring. Look forward to keep leaning from you (and of course to my entry to the hall-of-fame through the newsletter).

Please note that this does not account for all sit bone pain, nor does it mean that there are not times when it is appropriate to bend the knees. This advice was specific for this student at this time.

Read more: Mulha Bandha Anatomically Speaking.

David Keil is an Ashtanga practitioner and Authorized to teach by KPJAYI in Mysore. David has traveled around the world teaching yoga workshops as well as anatomy to yoga teachers and practitioners since 2001. David is known for his simplicity in such a complex subject. He has a straight forward and no frills delivery that makes the anatomy come alive in a way you’ve never experienced. He leaves space for you to make your own connections to your practice. For more, visit his website here.  

 

~

Editor: Tanya L. Markul

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9 Responses to “Got Sit Bone Pain? What to do with that Hamstring. ~ David Keil”

  1. Lorin says:

    Ok, I'm willing to give it a try. I'll report back!

  2. Tanya Lee Markul says:

    Posted to Elephant Yoga on Facebook and Twitter.

    Tanya Lee Markul, Yoga Editor
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  3. Tanya Lee Markul says:

    Just posted to "Featured Today" on the Elephant Yoga homepage.

    Posting to Elephant Yoga on Facebook and Twitter.

    Tanya Lee Markul, Yoga Editor
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  4. Branáin says:

    You should have put your note about your answer being "specific for this student at this time" at the top of the post, in giant letters. Many students will read the post and immediately straighten their legs all the time, without knowing whether it is truly helping them. In this situation, you were dealing with a student who had already injured her hamstrings. Other students will react differently.

    In addition, keeping the legs extremely straight causes the lower back to bend, rather than extend. If you do Ashtanga every day, you probably don't notice this because your body is pretty open. If you are an infrequent student of yoga, you may feel more compression/pinching/bending in the back.

    The best advice is for students to work with a competent teacher who can assess what he or she needs.

  5. patrick says:

    I don't have hamstring injury but I think that keeping the leg straight is better for me than bending the knee in forward bend. Just keep in check that voice that tell you to bend the knee so your forehead could touch the floor.

  6. Katja says:

    Hi David, I also pulled my hamstring ages ago. I was in so much pain that I could not do any yoga so i had a break of about 6 weeks. After that I started slowly but i also did not bend the knees. i just did not go as deeply as usually. additionally i went to a doctor for accupuncture which really helped. This really supported the healing process.

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