Pain in the buttock after yoga? It could be hamstring tendinopathy!

Hamstring tendinopathy is usually experienced as pain or tenderness directly on the sitting bone, most noticeable with sitting on hard surfaces, after walking or yoga practice. Hamstring tendinopathy is often not painful during yoga practice, but more commonly after practice!

So what is hamstring tendinopathy and how can we treat it?

Tendinopathy is a term that is used to describe changes in the tendon likened to weakness, or wear and tear. We used to describe this as ‘tendonitis’, however, research has more recently revealed that chronic tendon pain is NOT an inflammatory process but instead a process of tendon overload which initially causes reactive changes to the tendon cells, that in turn can become signs of tendon weakness.

Tendons in the body are like thick strong ropes that attach muscles onto the bone. So the springy hamstring muscle turns into a thick strong tendon (rope) that connects onto the sitting bone. Much like the springy calf muscle turns into a thick strong Achilles tendon (rope) before attaching onto the heel bone.

Muscles are designed to be springy, to stretch and recoil. Tendons are designed to be thick and strong, firm places of attachment. In the presence of tendinopathy, the tendon can show signs of weakness, much like a frayed rope. If you imagine a frayed rope- you don’t want to overstretch or overload it, but take the pressure off and perhaps stitch some new fibers into it so it becomes strong again.

When the hamstring tendon is showing signs of tendinopathy, it will often be tender right at its attachment point which is on the sitting bone (ischial tuberosity) of the pelvis. A physiotherapist can test if you have tendinopathy, as there can be many other reasons for buttock pain!

So how do we manage hamstring tendinopathy?

Like a frayed rope, the first step is to avoid overloading or stretching it over the sitting bone. Unfortunately, this means many of the forward bend postures will be limited! Like to watch a FREE video on how to modify your practice? Click here!

The next step is to start a progressive strengthening program, including isometric exercises. These are very specific exercises that should be guided by your physiotherapist. Building up the nearby gluteals can also help! Try this exercise to strengthen as a starting point

The repair and recovery process for tendons can, unfortunately, be notoriously slow. All tissues in the body repair and rebuild at different rates. Skin heals very quickly- if I cut my skin it will usually be healed within a few days. Bones are slower- if I break a bone it will take generally 6 weeks of doing all of the right things (such as wearing a plaster cast) before it is healed. Tendons can be slower than bones. So if you do have signs of hamstring tendinopathy you will have to have patience with your recovery and do all of the right things to assist the process.

The Yoga Physio is powered by Nichole Hamilton and her physiotherapy practice Synergy Physio. To learn more about her physiotherapy practice and her team at Synergy Physio click here

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