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Episode 25: Got Yoga Butt? Now What?
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Welcome to Episode 25 of the Movement Logic podcast! In this solo episode, Laurel shares her history with yoga butt, or, proximal hamstring tendinopathy (high hamstring pain.) This episode is packed with tendon and muscle physiology. It also busts the big myth that yoga butt (and any yoga-related injury) is because we’re all woefully “overstretched”. At the end, Laurel shares a 3-step approach to nipping yoga butt in the yoga bud using strength training knowledge and tools.
Additionally Laurel examines:
- What yoga butt is (hint: a pain in the butt right at the sit bone more technically referred to as proximal hamstring tendinopathy).
- What a tendinopathy is.
- Short and sweet hamstring anatomy.
- Why yoga students might be more likely to experience PHT.
- That a typical vinyasa or Iyengar-inspired asana class involves a whole bunch of passive forward bends/hamstring stretching and why that makes managing and overcoming yoga butt tough for students in those classes.
- How Laurel nipped her yoga butt in the bud.
- The contradictory advice yoga teachers (including Laurel!) gave about what to do about yoga butt.
- How proximal hamstring tendon compression (rather than tension) plays a role in causing or exacerbating PHT.
- How strength training can help students overcome and avoid yoga butt.
- Why the narrative that we’re overstretched is illogical and a distraction away from the solution.
- What motor units are, what muscle recruitment is, and how understanding this aspect of muscle physiology can explain why yoga asana won’t make your tendons stronger but strength training will.
- A 3-step process to overcoming yoga butt as well as encouragement to see a clinician if what you try doesn’t seem to help.
Reference links:
Get the Hip & SI Joint tutorial before the cart closes this Sunday 11/27/22: https://movementlogictutorials.com/movement-logic/hips-tutorial/
If you want to stretch your hamstrings please continue to do so
Ebonie Rio - Isometric exercise in tendinopathy
Putting “Heavy” into Heavy Slow Resistance
Do we need to think about connective tissues when strength training?
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Watch the video of this conversation at: www.movementlogictutorials.com/podcast
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Thanks for listening!
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Transcript
Introduction to Movement Logic Podcast
00:00:02
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaversdorf and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up to date and cutting edge tools, evidence, and ideas to help you as a mover and a teacher.
Laurel's Journey with Hip and SI Joint Pain
00:00:39
Speaker
Hey, it's Laurel. You know, back in 2017, when I started Movement Logic with Sarah Court, it was in part because I had just recently overcome my persistent hip and SI joint pain.
00:00:52
Speaker
through a combination of interventions, including self massage, strength training, and just moving in different ways. It was that positive outcome that spurred me to want to create tutorials in conjunction with a physical therapist to help teachers like myself who might be experiencing pain themselves.
00:01:11
Speaker
but who are also in service to their students to help them feel better. And so out of that idea came all of the tutorials that you hear us talking about. But you know what just happened actually is we just launched a brand new tutorial. Jason Parikh, Sarah Cort and I have put together a incredible resource for you all about the hip and SI joint. Now let's be honest, the hip and SI joint get a ton of attention.
00:01:36
Speaker
especially in the yoga world. And why? Well, maybe not for the reasons we would like.
Understanding Common Yoga Injuries
00:01:42
Speaker
A lot of people have hip and SI joint pain, a lot of long time yoga teachers and yoga practitioners.
00:01:48
Speaker
suffer from persistent pain in this area. It might be because of something called yoga butt, high hamstring pain, or maybe sciatica, which is kind of a radiating nerve pain. Maybe it's just a generalized pain around the SI joint. Then, of course, there is the hypermobile practitioner who may have initially been drawn to the practice because their bodies bent easily to the whims and the will of the asanas, but for whom those large ranges of motion, those repetitive movements over time have
00:02:20
Speaker
persistent pain and maybe we can all relate to just a general feeling of tightness in and around the hips and maybe even a tightness that just no matter what we do, it just doesn't seem to go away. In any case, a lot of the time that pain is a symptom having to do with really just not moving within a variety or not challenging the areas of our hips, the tissues of our hips enough. In some cases, it's really just not understanding how pain works in the body
00:02:38
Speaker
cause them to also suffer.
00:02:49
Speaker
or perhaps how movement impacts our body and influences our pain. Well, this is why I'm so excited to tell you about the hip and SI joint tutorial because that's what this four hour course is all about. It's about the hip joint and how it moves. It's about the structural variation that every single individual has
00:03:12
Speaker
in terms of the way their hips are shaped and how that influences how they can move. It's about the way that injuries happen as well as how we experience pain in these areas and then of course a whole lot about how movement can be a solution to these obstacles. Specific obstacles like SI joint pain or sciatica or yoga butt.
Critique of Traditional Yoga Instruction Methods
00:03:35
Speaker
Additionally, we take a critical look at how a lot of yoga instruction unfortunately tends to take a one size
00:03:42
Speaker
fits all approach and to even leave out and alienate whole groups of people such as people in bigger bodies or trans folks. So if you're interested in learning a whole bunch about the hip and SI joint and getting a treasure trove of ideas of ways to help yourself or your students feel better in this area, then make sure you check out the hip and SI joint tutorial before the cart closes
00:04:08
Speaker
We don't actually know when we're opening the card again. So head on over to our website, www.movementlogictutorials.com or just click the link in the show notes and check it out. Yo, what's up everybody? Laurel here. I'm doing this one alone. Dr. Sarah is probably either riding her motorbike really fast and safely or listening to Prince. One of those two things for sure.
00:04:36
Speaker
At least I hope, because those are two things she enjoys doing. Before I get into all things yoga butt, proximal, hamstring, tendinopathy, for those of you who appreciate the more technical terminology, the cart is closing very soon on the movement logic hip and SI joint tutorial, like it's closing this Sunday.
00:04:59
Speaker
And we will sell it again for sure. We took a long time to create it and it's an amazing piece of content. So we're definitely going to sell it again. We just don't know when we're going to sell it again. And so if you don't want to wait for yet undetermined long amount of time, click the link in our show notes to purchase it or go to www.movementlogictutorials.com. It's right there at the top of our homepage.
Deep Dive into 'Yoga Butt' and Hamstring Pain
00:05:25
Speaker
Okay, let's talk yoga butt.
00:05:28
Speaker
Sounds like something you want, right? Yeah, let me get my butt to yoga so I can get a yoga butt. But no, those of you who've had it, you know, it is definitely not something you want.
00:05:41
Speaker
It is a quite annoying slash painful condition to endure, and it can actually last a really long time. If you have, again, never heard the term yoga butt, you're not sure what the heck that means. That is a proxy term that we use as a stand-in for the more likely situation, which is proximal hamstring tendinopathy. Tendinopathies are basically tendons that have problems.
00:06:10
Speaker
Usually we know about them because we start to have some pain. I really like the term high hamstring pain because it speaks more to the actual issue, which is pain. And it's not so medical sounding, so I feel like I get to stay in scope when discussing high hamstring pain slash yoga butt with students. Instead of calling it proximal hamstring tendinopathy,
00:06:38
Speaker
I don't have the instruments to determine whether or not it's actually a tendinopathy. There could be other things, honestly. There could be bursa involved. There could be some other reason why you have pain that we call yoga butt. I like high hamstring pain, but all three of these terms, yoga butt, proximal hamstring tendinopathy, high hamstring pain, you'll be hearing me use all of these terms. Anecdotally, I don't think this has been researched, but anecdotally, yoga students tend to often develop problems with
00:07:07
Speaker
their proximal hamstring tendon. So proximal means closest to the trunk and it's where your hamstring muscles insert into the ischial tuberosities on your pelvis. So your ischial tuberosities, one time I was teaching a teacher training and a new teacher got up to practice teach and she said, sit on your butt bones.
00:07:30
Speaker
Yeah, your butt bones. I probably encouraged her to say sit bones because, you know, I don't know, some people get upset when you say yoga, but so butt bones might also be offensive to some in a public class or.
00:07:43
Speaker
You know, a bunch of random people come in and they don't want to hear butt bones. They want to hear sit bones probably. But yeah, they're your butt bones. So when you sit on a chair and it's a hard chair and you kind of tilt your pelvis forward and back a couple of times, you feel, I always think the ischial tuberosity are actually really quite large and they're sort of convex.
00:08:02
Speaker
but also sort of curved on the bottom and it's almost like the rockers of a rocking chair, like the two rockers of a rocking chair. You can literally rock forward and back on them and that's where your hamstrings attach. And so with yoga butt forward bending becomes kind of a pain in the butt.
00:08:18
Speaker
Forward bends are ubiquitous in the yoga practice. We do a lot of forward bending. Forward bending is any time that your hips are flexed, but typically also the knees are fully extended or heading in that direction.
00:08:36
Speaker
What's happened then is that the hamstrings have been brought into a stretch. And so the hamstrings insert onto the lower leg, the bones, the lower leg, even onto the back of the thigh, one of them, and then they cross the knee and the hip and insert into the ischial tuberosities of the pelvis. Yoga butt is not something that only yoga students or teachers experience, high hamstring pain or proximal hamstring tendinopathy.
00:09:00
Speaker
is something that people who sprint have a tendency to experience. PHT, we'll call it for short so that I don't totally twist my tongue up into a knot in my mouth in this episode. PHT, proximal hamstring tendinopathy is something you could get from
00:09:15
Speaker
doing a lot of squats and even just sitting a lot. It is something that yoga students develop likely from doing poses like Uttanasana, okay? Prasarita-paratanasana, parasvottanasana, trikonasana. Just think of how many forward bends there are in the yoga asana practice.
00:09:41
Speaker
I mean, if you take Surya Namaskara A, for example, there are nine vinyasas in Surya Namaskara A, and of those nine vinyasa, so the vinyasa is a transition, say, from arms overhead to forward fold, from forward fold to half forward fold, from half forward fold to chaturanga, from chaturanga to up dog, from up dog to down dog, from down dog to half forward fold, half forward fold to forward fold, all the way up to arms overhead, there are nine of those.
00:10:07
Speaker
five of them are forward bends so that's over half now in a modern postural yoga class let's say it's the vinyasa style uh i would go as far as to say i wouldn't be surprised let's just put it that way if every third pose was a forward bend it tends to be that
00:10:26
Speaker
It's the long held static hamstring stretches that might be responsible for at least aggravating the problem. It's where students tend to feel the pain when they do have Ph.D. And so we're going to talk a little bit about why that would be. I'm also going to, of course, take you on a walk down memory lane and share with you kind of where I was many years ago and
00:10:53
Speaker
what i thought was happening and why i thought it was happening with regards to high hamstring pain and kind of where i've landed now of course high hamstring pain is something that i experienced when i was a pretty serious student and newer teacher to us i've been practicing
00:11:13
Speaker
really pretty consistently. Yoga was the only thing I did for exercise. It was this practice that I did probably four or five days a week. I wasn't doing vinyasa flow necessarily, but I was doing practices that were heavily inspired by vinyasa flow as well as the Iyengar tradition. And I had a brief case of this nasty little pain in the butt, but I ended up nipping it in the bud by temporarily stopping all forward bends, basically stop practicing.
00:11:43
Speaker
Because my practice was, you know, the styles that I named and there were a lot of forward bends involved in the Iyengar practice. There was quite a bit of long held forward bends.
00:11:52
Speaker
I didn't just stop the practice, I also started to do some hamstring strengthening. So I had, along the way at this point, gotten wind of the fact that maybe what I needed to do was load my hamstrings from the standpoint of effort rather than flexibility. So I started to do bridge slides, I started to do long lever bridge lifts.
00:12:17
Speaker
So bridge slides is when you lie on your back, you put your heels on a blanket, bridge your hips up, dig your heels into the blanket and then slide the blanket forward.
00:12:25
Speaker
without letting your hips drop and then pull the blanket back. And you can kind of break that down into various levels of challenge and progress through variations of bridge slides.
The Balance of Stretching and Strengthening
00:12:35
Speaker
There's also a straight legged bridge where you take straight legs, heels up on blocks, press down into your heels and bridge your hips up with straight legs. You could do double or single leg, straight legged bridge lifts.
00:12:48
Speaker
The reason those tend to be effective, which I didn't know at the time, but I know now is that when we work to extend the hips with straight knees, we tend to bias more effort from the hamstrings versus when we extend our hips like bridge pose, like typical bridge pose with our knees bent, this tends to be more glute dominant. So if you really want to target your hamstrings for strength, straight legged bridging variations are probably a pretty good way to do that.
00:13:12
Speaker
There's a lot of other ways we can strengthen our hamstrings, so I'll talk about some of those exercises as well. But I wanted to start first by sharing a little bit about my past and kind of what I did back then, what I knew to do back then to get rid of the high hamstring pain. Around this time, there were, of course, warring camps. I say that with a little twinkle in my eye, of course, nobody was warring. But there were groups of people offering contradictory advice to yoga students, to yoga teachers about what to do when they presented with
00:13:40
Speaker
the symptoms of high hamstring pain. By the way, the pain is felt, and I don't think I've made this clear, but the pain is felt right at the sit bone typically on one or both sides. It could just be felt on one side. Typically, it's not felt while you're just standing or walking, but more so when you're doing the activity that probably originally started to provoke the symptoms like a forward bend or sprinting or squatting or sitting maybe.
00:14:04
Speaker
It can be felt at a mild level where it's almost like it's stiff like the area needs to be stretched more and actually erroneously a lot of people think initially like oh my my hamstrings are tight I have this tight feeling right at the sit bone and then they go to stretch it more and they make it worse but it can also be like very painful it can almost feel like and I remember having this feeling a couple times very disconcerting that like
00:14:26
Speaker
Hamstrings ripping away from the bone that's not what happens but you know that's kind of what it feels like the sensation is kind of freaky but the advice that these two camps of people were promoting were very contradictory one camp advocated for always bending the knees and a forward bend to protect the hamstrings.
00:14:46
Speaker
This idea of bending the knees as a way to protect the hamstrings is maybe a conversation for another day. I talked a lot about how this fearful protective language around the body can in and of itself be problematic. But I think what we thought, and I bought into both of these pieces of advice, by the way, I probably gave both of these pieces of advice. When we both flex the hip and extend the knee, we
00:15:11
Speaker
bring the hamstrings into a long muscle length so then if we were to forward fold but bend the knees we might not bring the hamstrings into such a long muscle length so they wouldn't be stretched as long as they would if we straighten the knees and in slackening the hamstrings
00:15:28
Speaker
what I think we thought was that we were maybe not tugging on the tendon as hard, and there's some truth in that, right? That advice we'll soon learn was kind of missing the point of why someone maybe even develops proximal hamstring tendonopathy. Okay, the other camp was saying, keep your knees straight. So we got one camp saying, bend your knees, always bend your knees. And the other camp's like, no, keep your knees straight in a forward bend.
00:15:51
Speaker
And I believe when I think about what the rationale for keeping the knees straight was, I think that what makes sense to me is that when people fully extend their knees and then forward fold, they simply won't incline their pelvis as far forward. They won't achieve as deep of a range of motion and hip flexion as they would if they were to bend their knees a little bit.
00:16:12
Speaker
So if we can maybe borrow from the knees some of that range of motion and back off a little bit at the range of motion of the hip, then there again is this sense that like maybe it's the depth of hip flexion that's causing the problem. So we reduce range of motion at the hip and we think, okay, now we're going to be okay. Now yoga butt is going to be solved.
00:16:35
Speaker
Now that I know a little bit more about this area of the body, I understand that it's not so much tension that's causing the issue, maybe it's disruption in the tendon, but rather compression. So tension and compression as terms can get a little bit of a bad rap like
00:16:54
Speaker
They kind of have negative connotations in that, oh, no, we don't want any tension. Release all of your tension in yoga. Oh, no, we don't want to compress anything. We don't want compression at, say, various joints in the yoga practice. But actually, tension and compression are neutral terms in terms of just a way of describing mechanical forces or load. They really are neither positive nor negative. They're neutral. Tension is a pulling force and compression is a pushing force.
00:17:22
Speaker
When we think of hamstrings, when we think of tendons, we often think of tension. And that makes sense because when muscles contract, they generate tension, which is a force. And tendons attach muscles to bones. And so when muscles generate force, that force is transmitted to and through the tendon to the bone so that the muscle then is able to pull on the bone and move it or keep it from moving or lower it slowly with control, whatever it might be that you're doing or how you're moving.
00:17:51
Speaker
Compression, on the other hand, is a pushing force, and so it's kind of counterintuitive to say like, oh, this proximal hamstring tendinopathy is from compression until we look at the anatomy of the way that the hamstrings, the hamstring tendon relates spatially to the sit bones, and then how when we move the pelvis forward over the thighs, when we anteriorly tilt the pelvis at the hip joint, how the sit bones actually go from a downward pointing direction, they lift,
00:18:20
Speaker
and they start to point, if you can visualize yourself folding forward into Uttanasana, your sit bones face the floor, and then they go to pointing toward the wall behind you that you were originally standing up with your back
Tendon Compression and Pain Management
00:18:32
Speaker
to. The hamstrings attach to the sit bone, and so as the sit bone is lifting up, can you imagine the hamstring tendon actually folding over the sit bone? The sit bone is pushing into the tendon. There's that pushing force, there's that compression.
00:18:47
Speaker
A couple of other places in the body where tendinopathies are common because of tendon compression are the patellar tendon. This tendon gets folded over the patella, which is the kneecap when you bend your knees, for example. Another place where tendon compression is common is at the Achilles tendon. So your heel bone is this really convex bone that sticks out of the back of your foot. You get blisters on it maybe sometimes and your
00:19:15
Speaker
Achilles tendon is really the tendon of your calf muscles. So that tendon at its most distal end, which is furthest from the trunk, attaches to the calcaneus or the heel bone. And then when you flex your ankle or dorsiflex your ankle,
00:19:30
Speaker
right so that that's what happens when we squat for example in your your shins push forward over the tops of your feet the front of your ankle joint decreases in its angle becomes more acute and on the back side of your ankle where your calf muscles attached to your calcaneus bone the tendon is folded over the calcaneus bone so tendinopathies
00:19:51
Speaker
because of tendon compression are actually really common. And the hamstring tendons actually haven't been studied as much as the patellar tendons and the Achilles tendons. So there's actually a lot more research on what to do about tendon compression and tendinopathies in those areas actually. But we could potentially take some of that understanding and extrapolate out to what we should maybe do about the hamstring tendons as well.
00:20:16
Speaker
That's my crude visual of why compression is potentially more the culprit just in terms of like how the structure is being stressed in a bad way. So what do we do if we have ouchy tendons or proximal hamstring tendons hurt? We suspect we have
00:20:33
Speaker
yoga butt or proximal hamstring tendinopathy, I think you really can't go wrong making yourself stronger, getting stronger muscles which at a certain dosage, strength training, the stress of strength training, the good stress or the you stress, not the distress of the tendinopathy, but the you stress, the good stress of strength training when progressively overloaded in
00:21:01
Speaker
a logical and responsible way, can translate to stiffer tendons as well. And the stiffer tendons, so there's another word that we tend to be like, oh, I don't want to be stiff, and I don't want tension, and I don't want compression, and I don't want stiffness, but stiffness is another one of those terms that has really a neutral meaning in terms of physics, right? So materials, when they have stiffness, they have an ability to resist deformation.
00:21:30
Speaker
Really, the ability to resist being pulled apart, and when materials lack stiffness, they lack that ability to resist being pulled apart. They're more easily deformed. When we make our tendons stiffer, they're potentially less likely
00:21:46
Speaker
to be injured. The collagen is less likely to become disrupted, let's say. So, we get stronger. And like I said, I'm going to give you a couple of ideas of how to do that actually in the real world in terms of exercises.
00:22:02
Speaker
But before I do that, I want to again take you down memory lane to talk about what I think used to be my thought process around why I had a yoga butt and to encourage you not to buy into that narrative because I don't think it's helpful. In fact, I think that this narrative and it's it's really the narrative of overstretching like we're overstretched and that's why we have yoga butt. We're doing too much hamstring stretching. It's all
00:22:31
Speaker
the stretching that we're doing constantly in these end range positions and we're hanging out in our joints and we're destroying our joints with the over stretch. Just stop the record player. I don't think that's it. And the reason I don't think you should buy into that narrative is because it's just a massive distraction that obscures the solution. It's also illogical.
00:22:54
Speaker
Now, I say that with love because, listen, I've had very illogical firmly held entrenched beliefs. And now I know, like I look back on it, I'm like, why did I believe that? That was so illogical. But you can't necessarily put the pieces of something together until you have all the information. And I don't say that I have all the information, I certainly do not, by any means, have all the information, but I have a lot more information than I had. Okay, so here's why I don't think it's because we're overstretched. And also, I don't think
00:23:24
Speaker
being overstretched is a thing. Okay, so around this time, folks believe they had yoga butt because their hamstrings were overstretched. I think they thought they had all their problems from yoga because they were overstretched. Eventually, we just started blaming being overstretched for everything. The problem with this is that stretching doesn't make your tissues weak. Stretching is when you bring tissues into longer lengths, but those tissues go back.
00:23:47
Speaker
they go back to their original length because they're elastic, they have elasticity. Stretching doesn't make your tissues weak, just like not stretching or stopping stretching doesn't make your tissues stronger, okay? So we would be asiological to say, if I don't stretch my hamstrings, they'll be stronger. As it is to say, my hamstrings cannot tolerate the loads I'm placing on them, even though those loads are extremely low, passive forward bends are extremely low load stretches,
00:24:16
Speaker
because I'm overstretching. So stretching doesn't make your tissues incapable of managing and mitigating and transmitting forces. That's not what stretching does. Stretching simply brings your tissues into longer lengths temporarily and then they go back. Okay, here's what makes your tissues weak. Insufficiently loading your tissues makes your tissues weak.
00:24:42
Speaker
just like sufficiently loading progressively overloading over time your tissues.
00:24:48
Speaker
makes them strong. Here's an example. I like this example a lot. Yoga practitioners who do both yoga asana and strength training are constantly stretching their hamstrings, but they're doing it in two very different contexts. In the context of yoga, the stretch is a low load stretch, and we might call this a passive stretch. In the context of strength training, say they're doing a deadlift,
00:25:18
Speaker
The stretch is a high load stretch. Say they're doing a heavy deadlift, right? It's a high load stretch. Picture it. Uttanasana, you're standing upright in Tadasana and then you incline your pelvis forward and pretty soon your torso's folded forward over your legs. Your hamstrings, which attach from your lower leg right below your knee joint all the way up to your sit bones above your hip joint, they lengthen to permit the inclination of your pelvis forward.
00:25:45
Speaker
Now, whether or not your knees are bent or straight depends on your approach to the pose and your flexibility probably as well. When you deadlift, say you start from a standing position in your deadlift, you're holding onto a kettlebell or a barbell, you're going to start to hinge at your hips, your knees will bend a little bit, and you'll set that weight down.
00:26:04
Speaker
And then you probably pick it up again and set it down a couple more times and do a couple reps. Well, same thing. Now, as you start to incline your pelvis forward at your thighs, your hamstrings start to lengthen, but this time you're holding on to something heavy. So the loads your hamstrings are experiencing as they elongate, as they generate tension,
00:26:23
Speaker
As they generate tension to slow down the inclination of your pelvis forward so that you lower the weight with control, your hamstrings are stretching, but they're experiencing a very different type of input, right? And so let's talk about what the big difference is here.
00:26:42
Speaker
In Uttanasana the load is low, your hamstrings are elongating, they're generating tension, they're controlling the inclination of your pelvis forward. You're not just flopping forward like a rag doll and your torso is not just free falling toward the ground. You're folding forward slowly, maybe on the
00:26:59
Speaker
length of an exhalation, which could be like four to six to 10 seconds long. I don't know how slow you're flowing. But your hamstrings are generating force, but they're generating a very little amount of force. They don't need to generate a whole bunch of forces they lengthen. It's called an eccentric contraction, right? Because the weight of your torso and upper extremities is relatively light. So what happens then is that your brain, which is the governor really of all muscle contraction, your brain sends
00:27:27
Speaker
a signal that sends small signals to your hamstring muscles and your brain in sending these signals is really recruiting like a recruiter, right? A job recruiter. They're recruiting what are called motor units and motor units are muscle cells which are called muscle fibers that connect to a single motor neuron. And so you've got this motor neuron that extends really from your brain and spinal cord all the way to the muscle
00:27:52
Speaker
It's like the electrical cord almost, connecting your brain to your muscle. And it's sending this signal to just certain fibers, which are a part of that motor unit. All the muscle fibers of a muscle group, each muscle fiber only belongs to one motor unit. Okay, so this particular motor neuron controls only a certain number of muscle fibers.
00:28:14
Speaker
You have very, very small motor units and very, very big motor units in every muscle. And the hamstrings tend to have quite a few very large motor units, which just means that high threshold motor units are motor neurons that connect to many, many fibers of the muscle, whereas low threshold motor units, low threshold meaning the threshold to recruit those motor units is very low. The load only needs to be small.
00:28:36
Speaker
for the brain to recruit those small motor units whereas for high threshold the bar is much higher the load needs to be very high for the brain even to send a signal to those motor units because it's like not necessary right it's only gonna recruit those large motor units when it's necessary to do so so if your hamstrings are made up of all these different motor units from small to large but mostly large it's very genetic by the way to like some people have many many more
00:28:59
Speaker
high threshold motor units than other people that's why we see people like the olympic gold medalist in the marathon has a very different looking body and probably genetically in that level of the muscle fiber type very different proportion of small motor units to large motor units is a small motor units tend to be
00:29:19
Speaker
low fatiguing motor units, and so people with a higher proportion of those Type 1 fibers, they tend to be better at endurance. So then we've got Usain Bolt, who's the fastest man alive, and he's probably got a high proportion of
00:29:34
Speaker
fast twitch or type 2 or high threshold motor units. So it's very genetic. But anyway, we know that in Uttanasana, the weight of the torso is very, very low. It's just a small percentage of our body weight. And so what's the brain going to do? The brain's going to recruit small motor units.
00:29:51
Speaker
low threshold motor units. What does this actually mean? It means that the vast majority of the fibers of your hamstring muscles aren't even going to work at all. They're going to go largely unworked. They're going to receive no signal. It's only those fibers that connect to those motor neurons that the brain is sending the signal through that the brain recruited that are going to fire. OK, so that's tension, but it's not a whole lot of tension.
00:30:18
Speaker
The tendon is experiencing a little bit of that tension, but it's not nearly enough tension. It's not nearly enough input. Think of it like nutrient, right? It's not enough mechanical input for that tendon to have to change. I mean, that low load of tension from lots of Uttanasanas is not going to be a stimulus. In other words, it's not going to be high enough input for the body to go
00:30:45
Speaker
You know, we got to actually make these tendons stiffer, tougher, to be able to manage this. Now, Uttanasana is not going to do that. The deadlift, on the other hand. So we got this person who does yoga and strength trains. So they go to stretch their hamstrings, they're doing lots of forward bends, and then they go to their strength training practice and they're doing deadlifts, which are
00:31:06
Speaker
For events but now they're doing heavy deadlifts, right? So they're picking up heavy kettlebells are picking up heavy barbells and what's happening now is Okay. Now as they're slowly lowering that weight to the floor their brain goes. Uh-oh
00:31:23
Speaker
We need the big guns because now this is such a heavy weight that if we don't have full recruitment or close to full recruitment, if I don't send big signals and get all the motor units firing, if I don't do from low to high all fibers on deck, this person's going to drop the weight. So then there's a massive amount of tension that all the fibers of the hamstrings
00:31:46
Speaker
Remember, uttanasana was just a few of the fibers, right? A very low percentage, really exponentially fewer. Your hamstrings are made up probably of thousands of muscle fibers, the group itself, right? Thousands of muscle fibers. When we have uttanasana, we're probably recruiting maybe hundreds.
00:32:03
Speaker
And now we're doing deadlifts, heavy deadlifts, and we're recruiting thousands. Don't quote me on those numbers, but it's a big numerical difference. Then when we are measuring the difference in force, it's a big numerical difference. The muscle is lengthening, it's generating tension. That tension is going into the tendon and into the bone, right? To control the movement of the bones, to control the pelvis, this inclination over the thighs. And the tendon is experiencing enormous amount of tension.
00:32:29
Speaker
And that tension is high enough to create a change. It is enough for there to be this cascade of signaling that we call adaptation over time, right? Over the course of weeks, days, weeks, months for your tendon. And it takes a long time actually for tendons to adapt. So it might be months, right? For the tendon to make itself stiffer, right? So there's
00:32:52
Speaker
more collagen being laid down, it's getting more closely packed together, and the material itself becomes better capable of sustaining tension, but also that compression, that compression of the sit bone. So here's the takeaway, with low load activity, which yoga asana, modern partial yoga is for the most part, predominantly low load, low intensity, your brain is only recruiting a few motor units of any of the working muscles involved,
00:33:21
Speaker
Most of your muscle fibers are going completely untrained. Now there's some high load stuff in yoga and I don't want to get into that right now, but when it comes to the lower body, specifically with hinging, it's pretty tough to get higher levels of recruitment when we're just working with body weight. But I'm actually going to give you some examples of ways you could do it, but just know that it's pretty tough.
00:33:40
Speaker
knowing all of this, okay, that it's probably a lot of the repetitive low load tendon compression that might be causing some of the issues in yoga practitioners.
00:33:53
Speaker
We don't have to go, oh, the stretching is to blame. So now what we're going to do is just stop stretching. Because like I said, this idea that we're overstretched obscures the solution. No, that's not the solution. For sure. For sure. Stop doing the thing that's hurting it. Absolutely. And you might actually have to back off on the forward bends for a while. Your practice might have to look really, really different for a while. But that's not actually going to address the root cause.
00:34:18
Speaker
Because the root cause actually has more to do with the capacity of your tendon. We know we have to do things to get better at doing things. The same goes for all the tissues of your body. We press pause on all the long held static stretches. Absolutely. We know compression is...
00:34:34
Speaker
probably the problem. What are we doing in yoga that's causing that compression? It's all the forward bending. By the way, deadlifting, I would not recommend deadlifting as the first exercise you go to try to do to make your hamstrings stiffer because it involves that compression. So we stop all long held static hamstrings stretching and we find a non-compressive way to feed our hamstrings those high doses of tension, the dosages that are gonna actually surpass that threshold where the body goes,
00:35:04
Speaker
Yep, now we need to change this tissue. We need to make this tissue tougher now. We need to build it up. We find non-compressive ways to feed our hamstring tendons that high dosage of tension. And this is where the straight-legged bridging comes into play. This is where bridge slides come into play.
00:35:21
Speaker
It's potentially also where the hamstring curl machine at the gym comes into play. So when you lie prone, specifically the one where you lie on your belly and your legs are behind you and you hook your heels underneath the pads and it's probably like a stack weight machine or there's plates loaded onto it somehow and it's a lever system, right?
00:35:42
Speaker
Pull your heels up towards your butt to move the weight that's connected to your heels to your butt. Your hips don't change position at all, so you're really just working at the knee joint. That's a great exercise as well. You find these non-compressive ways to load and strengthen your hamstrings. When you're strengthening your hamstrings, you're also strengthening the tendon.
00:36:05
Speaker
Now I've heard conflicting advice about the dosage for this. I've heard that it's moderate loads and time under tension that matters most. In other words, you don't have to do high loads, something that you could lift like seven to 12 times as a moderate load.
00:36:22
Speaker
What's extra beneficial to do when we have pain, but also when we're trying to make a tendon stiffer is isometrics. And the reason isometrics are so beneficial is because isometric muscle contractions are contractions that involve the most amount of tension and that's going to feed the tendon more tension. Isometrics are great for that reason. They're also analgesics.
00:36:46
Speaker
They can be analgesics in that they can actually reduce symptoms of pain temporarily, so holding something from 30 to 45 seconds is probably a moderate load. If you can't hold it for 30 seconds, it's probably getting a little closer to a heavy, what we would call a heavier load. A non-compressive way to feed your hamstring tendons high doses of tension might mean isometric straight-legged bridge variations.
00:37:08
Speaker
So picture you're lying on your ground, you put your heels up on a support, you keep your knees as straight as possible, press your heels down and bridge your hips up. Once that becomes easy, what does that mean? Well, say you can hold it for more than 45 seconds, then start working on the single leg variation of that. I don't love the physio ball as a thing to support your heels on, and I'll tell you why.
00:37:30
Speaker
It's very squishy. It's not a stable structure. And so what you end up then working on is stability more than strength. And what we really want to work on is strength. So I recommend that you put your heels up on a couple of yoga blocks or a box or something like a coffee table, something that's not going to move around.
00:37:45
Speaker
When you have something squishy moving around underneath you, it feels harder, but it doesn't necessarily mean that it is harder for the target muscle. There's a lot of co-contraction going on when we're on squishy surfaces, and it might be good for balance. Sure, it's definitely good for finding stability, right? But it's not necessarily always the best platform to put your body on for strength. So just put your feet up on something solid. Okay, so we got step one, stop the forward bends for a while, temporarily.
00:38:11
Speaker
Not forever. Don't demonize passive stretching. It's literally not the enemy. It might have provoked the symptoms, but you'll be able to get back to it. Feed your tendons a lot of tension through static, straight-legged bridge poses. Here's where I want to say the conflicting advice is that I've also read that moderate loads are insufficient for tendon adaptations toward increased stiffness. Now, that doesn't mean moderate loads are insufficient to reduce the symptoms of
00:38:40
Speaker
proximal hamstring tendinopathy and to just help you feel better. But if you really do want stiffer tendons, I do think that heavy loads are pretty well supported in the research with regards to the benefits of heavy strength training. One of those benefits is increased tendon stiffness.
00:38:55
Speaker
What is heavy strength training? It's strength training where you're lifting a weight that is so heavy you couldn't lift it more than six times, maybe more than five times without having to rest for a couple of minutes before picking it up and lifting it again.
Tendon Healing and Strength Training Solutions
00:39:06
Speaker
This is something that is so difficult that you maybe could only hold a static isometric for like 10, 15, 20, 25 seconds. And it's like, whoa, that's it. That's all I got.
00:39:17
Speaker
The thing is, is that the medical and scientific community still don't actually know a whole lot about tendons. I don't know why, maybe they just haven't been researched as much for some reason, but they're being researched more now. I think that you can play with both and just see which one seems to be most useful to you and know that like just because you feel better after a couple of workouts where you're doing these long lever
00:39:44
Speaker
bridge variations just because you feel better after a couple workouts doesn't mean that the issue is resolved it could be an analgesic right a lot of times we feel better after just moving our body it could also be it's helping but you need more time to adapt and unfortunately tendons actually take quite a bit of time to heal so
00:40:00
Speaker
It could be as long as six months to a year I've read for tendons to heal and I think it's really important to have realistic expectations on that as well so that we don't get discouraged and we don't feel like total failures when we're doing all the right things and then we go back to do our practice and we've got the yoga butt symptoms cropping up again and we're like, man, what's wrong with me? You know, it's nothing wrong with you. It's just that the timeline for tendons is very different than say muscle.
00:40:26
Speaker
Okay, tendons take a lot longer to heal, even bone, right? Tendons take longer to heal than bone. So know that. Alright, so then step three, after your symptoms have disappeared, hopefully, they're gone, they haven't been back, you may want to consider starting to build your hamstring strength within compressive contexts as well.
00:40:47
Speaker
So that's where you might want to learn how to deadlift. You might want to start picking up heavy things in that hinge pattern so that you can begin to train your hamstrings through that more specific range of motion that you explore a lot in yoga, but under considerable load so that they get stronger and the tendon gets stiffer. And you're just going to be less likely, hopefully, to have to go through, you know, this really annoying slash painful experience of yoga, but again, keep doing the practice you love.
00:41:16
Speaker
Keep doing all that passive stretching that you love. I think that's about it. I'm a student right alongside most of you listening. Maybe there are tendon experts listening to you right now. God. But hi. Sorry if I said a lot of wrong things. I don't think I did. But what I want to say is that I'm not giving you any of this advice as an expert or a clinician, as a member of the medical community in any way, shape or form. And that ultimately, if
00:41:45
Speaker
Some of these things that you try don't help you gonna need to go see somebody who is a clinician who can assess you and Figure out what is going on because as I said, you know tendinopathies can be really tricky. They can take a long time to heal They can be kind of frustrating for that reason and it might feel really good to have a support of an expert and
00:42:07
Speaker
of a clinician helping walk you through the process of rehabbing that injury. Another thing I'll say is that while I've given you some exercises to consider adding into your practice, these exercises are by no means a prescription from me. They're just simply something that I know has worked for a lot of folks. They're also exercises that make sense when you take into account
00:42:37
Speaker
what the scientific and medical community are able to share about why we might develop something like high hamstring pain or proximal hamstring tendinopathy. And so this is just based off of really my current understanding of best practices for trying to nip your yoga butt in the butt, in the bud. I know that's the correct idiomatic expression. My dad would always say, nip it in the butt.
00:43:04
Speaker
And my mom would always go, oh, Tom, it's nip it in the bud. So now I like saying nip it in the butt because it's funny. Nip it in the yoga butt. These are just ideas that you can play with to see if you can nip your own yoga butt in the butt or help your students with some ideas for at least something to do other than all the forward bends, right? And maybe some simple tools to start to increase hamstring strength, maybe reduce those symptoms and maybe
00:43:33
Speaker
completely overcome the issue entirely. All right, I think that now officially, officially wraps it up. So if you found this episode helpful, if it sparked your interest in learning more about not just solutions to the problem of yoga butt, but also solutions to issues like sciatica,
00:43:59
Speaker
Sacroiliac joint pain just stiffness in your body specifically around your hips and or the connection between hip stiffness and low back pain as well as like why a one size fits all approach to
00:44:16
Speaker
Teaching an alignment based instruction might not be of service to your students what to do about hyper mobility if you are a particularly bendy person all of these topics related to. Ways to make your hips and i don't feel better than you definitely gonna wanna.
00:44:34
Speaker
take this opportunity to get the hip and SI joint tutorial before the car closes this Sunday. We will make the course available for sale again. We just don't know when. It'll probably be many, many months from now. I think that just about now officially, officially, officially, officially wraps up this episode. I'm going to say just a couple of things that I always say. And I know I say them a lot, but I really mean it.
00:45:03
Speaker
I'm not begging. I might be begging. I am a little bit begging. It's tough to get you to do this because I never do it. I listen to lots of podcasts. And when the hosts are like, leave a rating and a review, I never do it. So I get it. I get it. You might never do it either. But if you find some time
00:45:29
Speaker
And you're like, yeah, I'm going to do it. We would love that. We would love it if you would just rate us. You could just click the stars, but reviewing is even better. And if you want to request a topic, that would be amazing. We really feed off of your ideas and our ideas are so much better when they involve your ideas as well. So leave us a rating and a review and in your review, you can request a topic for a future episode.
00:45:57
Speaker
All right, thank you all for joining me today, and I hope you have a wonderful rest of your week. It's a holiday in the United States, so I hope you all are enjoying your time on holiday. And for those of you not in the United States, I hope you are having a wonderful November week as well, and we will be in your ear again next week.