‘Yoga Butt’ Injury

‘Yoga Butt’ is a term for a range of symptoms frequently experienced in Ashtanga and other forms of Vinyasa or Power yoga after a few months of regular practice. It often starts as

  • Pain or discomfort at either of the Ischial Tuberosities (sit-bones)
  • Discomfort in all forward bending and a feeling that the hamstring won’t stretch
  • Inflexibility or pain in Kurmasana and Supta Konasana.

Yogis with these symptoms might then tear a Hamstring, but even if they don’t force the hamstring stretches, but continue to practice, these symptoms can get worse, until they have some or all of these symptoms:

  • Pain at the outer side of the hip at the Greater Trochanter of the Femur
  • Lower back pain
  • Sciatica
  • Sacroiliac joint problems
  • Pain at the outside of the knee

Yogis try all kinds of modifications to their practice, without much success. Visits to Physiotherapists usually results in a diagnosis of Ischial Tendonitis and being told to rest. Resting and stopping yoga practice may relieve the pain but it often recurs when practice is resumed, and these symptoms usually become chronic if they are not treated. Continuing to practice while you have pain makes hip problems worse: please refer to Practice and Pain.

An emphasis on hamstring stretching in yoga is considered to be the main cause of yoga butt and many health-professionals focus on treating the Hamstrings. However, the reason why a hamstring becomes inhibited and tight is due to hip-muscle weakness and body alignment problems.  Yoga Butt will improve if these are assessed and treated.

When the Gluteus Maximus is weak, the Sacroiliac joint becomes unstable. The hamstrings have an important role in pelvic stability –Hamstring attachments are connected to the Sacrotuberous ligament and a Hamstring becomes neurologically inhibited and tight if its movements affect the stability of the sacroiliac joint. Forcibly stretching an inhibited hamstring will injure it.

As explained in Hinging from the hips, Surya Namaskara and the Ashtanga Standing Sequence involve a lot of hinging forward with a straight back, weakening the Gluteus Maximus. Keeping the feet together in Utkatasana, as well as constant hip flexion and extension weakens the Gluteus Medius.

Treatment by a sports-rehabilitation professional can be very effective. Yoga butt should never be ignored – it doesn’t improve without specific treatment. Finding a professional who can help is not always easy, and treatment will be most effective if it includes

  • A thorough assessment of hip function
  • Hip strengthening
  • Quadriceps strengthening
  • Strengthening the Abdominal Oblique muscles
  • Correcting body alignment, especially shoulder imbalances – shoulders have a direct influence on hip alignment.

The Ashtanga Primary- and Intermediate series consists of forward and backward movements, which can be problematic because the stabiliser muscles are found at the sides of the body – neglecting side-strengthening asanas causes weakness in the hips and oblique abdominals- these muscles help to stabilise the Sacroiliac joint.

All yoga practice is symmetrical, i.e. practised equally on both sides but this doesn’t correct left- right imbalances, which are natural in humans, as explained in Hip pain and injury. Correcting body asymmetry requires about three times as much strengthening work on the weaker side, not just paying attention to alignment.

After a successful treatment, it may be possible to resume Ashtanga or Vinyasa practice if you

  • Are no longer in pain
  • Avoid practices that focus on leg strengthening
  • Avoid anterior pelvic tilt in all standing asanas
  • Avoid lateral pelvic tilt
  • Avoid self-practice and large classes: an attentive teacher corrects bad alignment habits
  • Instead of hinging from the hips with a flat back in forward bending, roll up and down through the spine, using the buttock muscles to move the Sacrum first
  • Back strengthening with Salabhasana unless you are practicing Ashtanga Intermediate series
  • Practice asanas that focus on the sides of the body: a modification of Surya Namaskara B as described in Adductors, the Pelvic Floor and Lower Back Pain, and also regular practice of Vasistasana, Parsva Bakasana and similar asanas
  • Work on lifting and lowering the legs from Sirsasana to Urdhva Dandasana and back. This requires a strong butt and is often skipped in Ashtanga practice because yogis are too tired.
  • Eka Pada- variations of Setu Bandasana, Urdhva Dhanurasana and Viparita Dandasana are great butt-strengthening asanas

Many yogis are reluctant to give up Ashtanga practice, because it is a moving meditation but ignoring pain will not make it go away.

If these problems recur, it’s time to change your yoga practice if you wish to avoid chronic pain and lasting damage. A rigid approach to any yoga practice is not conducive to a healthy body

Reading sources:
Kendall, McCreary, Provance, 1993, Muscles, Testing and Function
De Franca, 1996, Pelvic Locomotor Dysfunction
Cook, 2003, Athletic Body in Balance
Ellenbecker, De Carlo, DeRosa, 2009, Effective Functional Progressions in Sport Rehabilitation
Sharkey, 2008, The Concise Book of Neuromuscular Techniques

Advertisements

19 thoughts on “‘Yoga Butt’ Injury

  1. Pingback: 327 days « yogatrip

  2. I am an Ashtanga yoga teacher and have been a daily practitioner for 15 years…..all that is described in this article has happened to me and is happening to some of my female students……after 3 years of varying treatments and modifications to my practice I have actually found a way to combat this issue without stopping my practice or causing major injury. The Ashtanga Vinyasa method, while amazing for the mind, has not be so balanced for the body! Thankyou for posting this article, it really affirms to me what has been going on and the steps I have taken to help myself and my students :))

    Like

  3. I have been searching for the description of the problem I am facing till I found this post. Everyday when I do forward bend asanas including Paschimottanasana and Kurmasana, I have this heavy pain in the left buttock. I think I will stop doing them for a couple of months.

    Like

  4. This is a great article. I can say so from practical experience!
    I had all of the above symptoms and realised that giving up on my ashtanga self practise for a more gentler alignment based iyengar practise I have helped bring some sense of balance back to my body. I do very much miss my ashtanga practise but I guess its just not something that works for me. The iyengar practise requires a more mature and awareness based approach rather than just doing something coz you are flexible.

    Like

  5. It’s devastating that four years of Ashtanga yoga have resulted in such a painful, not to mention inconvenient, injury. I’ve been eating supper standing up (it hurts too much to sit down). Healing is taking place, but clearly I may not be able to continue Ashtanga. I know what the foremost yogi in my studio would say, “Don’t blame it on yoga. Blame it on yourself.” Hmmm, if only the human element could be removed might be a fair reply. My body is telling me that I went a little too far too many times. Now I’m paying the price. Ashtanga practitioners: Be aware and be careful.

    Like

    • Hi Ellen

      I’m sorry to hear that, I know exactly how it feels to be unable to sit down, thanks to yoga. It is possible to make a complete recovery with the right rehab treatment, though.
      It is strange to see how many long term practitioners and teachers – and it’s not just Ashtanga yoga – have bad hip or back pain themselves yet have such a vested interest in blaming anything other than the practice. I’m not sure that ‘going a little too far’ is the cause of these problems. The fact that these symptoms are so predictable implies that they are an inevitable side-effect for many people.
      Good luck with your healing process.

      Like

    • Hi Ellen, I have been practicing Ashtanga yoga daily for 15 years and developed a lot of instability however over the last 3 years have included some functional movement into my practice after I received a thorough assessment of what muscles were weak, tight, dysfunctional etc and after treatment and rehab I am still able to practice the Ashtanga method with modifications. I am more than happy to chat to you further if you wish. I feel for you and totally understand what you are going through. It is a shame you don’t have the support of your teacher, I teach and have been able to pass on a lot of what I do to my students which seems to be helping, hope I can help you. Namaste.

      Like

  6. Pingback: “Pain-cation” | TatamiYogi

  7. Pingback: Yoga Butt | get it om

  8. Hi Niki, I think this is called proximal hamstring tendinopathy. Also known as high hamstring tendonitis or simply hamstring tendon inflammation.
    I do not practise yoga but I use some of the pose (usually in a modified way) to stretch tight muscles caused by running and my gym workout.
    Some 8 years ago I first suffered from this problem on both hamstrings due to excessive running. It took about 1.5 to 2 years to fully recovered from it.

    While our physical activities are different, I think the causes are similar so I thought I should share my experience to manage this injury.

    Tight and weak muscles around the hip causes imbalance and this imbalances caused the hamstring to overwork. Overworked hamstring over a long period repeatedly caused this hamstring injury. To correct this imbalance. tight muscles should be stretched to lengthen while weak muscles should be strengthened. Typically, the tight muscles may include the illopsoas, rectus femoris. Sartorius, TFL/ITB. Weak muscles may include the Gluteus maximus/medius/minimus, piriformis.
    Strengthen of the hamstring muscles using eccentric contraction must be emphases.
    In addition, active release with foam rollers helps to break up the scar tissues.

    Like

    • Hi Colin
      It is the same thing, and common in a strenuous yoga practice but unlikely to occur if you are just using a few yoga poses to stretch after a gym workout.
      As you noted, correcting imbalance in the hips is the key to recovery.
      Thanks for your input

      Like

  9. Great post and very helpful comments! I’ve been focusing on stretching my hamstrings for a few months, and now I seem to have all the symptoms of Yoga Butt Injury. It’s unlike other injuries I’ve had that just hurt in certain positions etc. This is more like constant low level pain. I’ve started doing the recommended asanas to strengthen weak muscles, and I’m heeding the other posted advice, but I also have a few questions – I suppose I could use trial and error to answer them, but in the interest of time, I’m hoping to skip all that 🙂

    1) Is ice or heat helpful for this injury?

    2) I recently converted my work desk from a sit down desk to a stand up desk. I’m not sure if this helpful or hurtful? Sitting in a chair is not too painful, and it feels good to rest. Standing doesn’t seem to hurt either, but I wonder if it’s continually doing a low level hamstring stretch and adding to the problem?

    3) I saw foam rolling mentioned, and it does feel good, but I want to make sure that it’s ok to do it since it seems like rolling stretches the muscles?

    Any other advice not already posted is most welcome!

    Thanks!

    Like

    • Hi Steph

      1)I wouldn’t use either, strengthening the correct muscles will relieve your pain
      2)Sitting gives the low-level hamstring stretch, not standing. Standing in good alignment is more beneficial for you than sitting all day
      3)Foam rolling was mentioned, but not by me: it’s quite a popular treatment but it gets prescribed as a cure-all. I don’t think it’s appropriate here. My opinion.
      4)Get an assessment from a qualified rehab specialist and a tailored exercise program – that will save you the most time of all. Most of all, get your pelvic tilt assessed. You can stretch your hamstrings all you want if your hip, Hamstring and Quadricep strength is adequate but it’s a recipe for disaster if not

      Like

  10. Pingback: Sitbone Pain from Yoga Asana | Love Yoga Anatomy

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s