January 16, 2020

Yoga Butt – a.k.a. Hamstring Tendinopathy in Yoga – According to a Physical Therapist

Monica smiling in paschimottonasana

High hamstring tendinopathy (tendinopathy = an updated version of “tendinitis”) shows up as an ache, burning sensation or other pain near your sitting bones. The sitting bones, or ischial tuberosities, are the upper attachment point to the three hamstring muscles on each side.

In the yoga world, this uncomfortable sensation has a name: “Yoga Butt”.

“Yoga butt” — though it sounds like it would be a a good thing — is not a good thing. The emphasis on forward folds and on hamstring lengthening in modern postural yoga practice has contributed to hamstring pain, weakness and tears.

That excess focus on hamstring stretching and forward folds looks like these cues and actions:

  • “Fold forward from the hips”
  • “Soften your glutes”
  • “Lengthen your spine” or “Find the backbend” or “Lift your chest” (in a forward fold)
  • “Belly to thighs”
  • “Straighten your leg”
  • Walking forward from down dog, down dog itself, lunges with hands to the ground, paschimottanasana, uttanasana, etc.
  • Repetitive forward folds in sun salutation-based vinyasa
  • An absence of (or relative lack of) hamstring and hip strengthening

Women’s Health magazine recently interviewed Yoga Anatomy Academy founder, Dr. Ariele Foster, about the phenomenon of hamstring injuries from yoga.

[Yoga butt] is a common issue in yoga due to the repetitive nature of certain yoga practices like Ashtanga, Vinyasa, and Bikram, which use a specific sequence of poses (or very similar sequences) every class. “What everybody needs is a variety of movement, and even though the yoga lexicon has a huge library of movement within it, we’re not really taking advantage of that,” says Dr. Foster.

How to Heal a Yoga Butt Injury, According to a Physical Therapist
Womens Health, December 9, 2019

We have written about the importance of posterior chain (hamstrings, glutes and more) strengthening being incorporated into yoga (here and here) and taught workshops on yoga and “Posterior Chain Awakening“.

What happens if you already have that “burning, discomfort, cramping, or pinching high up in the hamstrings”? What can you do? Here are Dr. Ariele Foster’s best tips:

Bend your knees.

Stop the incessant stretching of your hamstrings. They are probably long enough for healthy function.

Strengthening can still help.

If you are in pain, start with isometrics (long static holds), and build up slowly to resisted strengthening activities. Work with a physical therapist if you can.

Know that spinal flexion is not a bad thing.

Allowing your spine to round in yoga practice will not cause a disc to herniate, and is part of needed healthy everyday mobility.

Sit less.

Sitting puts a passive long term “stretch” across our backsides, including upper hamstring attachments. It also adds pressure to irritated hamstring tendons if pain is already present. Stand as you are able.

Consider taking a break from your beloved yoga.

Walking is so underrated! Try walking meditations. Listen to a Tara Brach podcast as you briskly walk through a park or nature reserve. Get out of the car, use the car less, stand at your desk.

Your hamstrings will thank you.

Read what else we have to say about Yoga Butt in Womens’ Health.

3 Comments on “Yoga Butt – a.k.a. Hamstring Tendinopathy in Yoga – According to a Physical Therapist

Cathy Lortie
January 16, 2020 at 5:55 pm

This is so appropriate for the population I teach. So many students think they need to straighten their legs if forward folds. Too much pain and too many injuries!

Sarita S
April 3, 2022 at 1:29 pm

Thank you for sharing. I am an avid yogi and yoga teacher. I have been experiencing ‘yoga butt’, pain high on the sit bone, from proximal hamstring tendinopathy. Pain so bad that it has completely stripped me of my practice. It is so important to properly educate on how to find balance for each body type. Most literature attributes PHT to long distance runners. Yogis take note!

Dr. Ariele Foster
April 4, 2022 at 11:36 pm

Sorry to hear how bad this has been for you. I promise you can get your practice back. It may look different. It probably should involve targeted strengthening (like in our Hips Happy Hour weekly classes).
The reason there is more literature on hamstring tendinopathy in runners is because there are more of them, and their movements are more homogenous than yogis.


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