Ask a Yoga Expert - Over Stretched Hamstring Muscles
Question: Is there an easy way to tell if I have over stretched my hamstring- I believe it is the semi-membranosus since there is pain at the attachment of the hamstring to the ischial tuberosity- near the inner thigh. How to heal? How to avoid re-injury. I have been doing bent knee forward folds to avoid overstretching, other options?
Answer: The hamstring muscles run in 3 bands:
1) Semimembranosus- originating at the ischial tuberosity (sit bone) and inserting at the medial tibial condyle
2) Semitendinosus- originating at the ischial tuberosity and inserting at the medial surface of tibia
3) Biceps Fermoris- originating at the ischial tuberosity and at the linea aspera near the head of the femur and inserting at the lateral side of the head of the fibula
Given that you feel the over-stretched line runs from the ischial tuberosity and down the inner (medial) thigh, I would predict that this could be either the semimembranosus and/or the semitendinosus muscle that has been stressed. Both of these muscles run along the inner (medial) line of the thigh, but the semimembranosus muscle is located more medial than the semimembranosus.
Now, depending on the degree in which you have over-stretched the muscle, the approach in which you require recovery and reconditioning can vary. If you have a mild, over-stretched muscle, you may only require some light rest from deeply expanding and engaging the hamstring. If the over-stretched condition is substantial, you may need to consider applying focussed therapies.
Often these healing therapies involve taking time to reduce inflammation and to decrease the development of chronic conditions like tendonitis at the ischial tuberosity or at the tendon attachment below the knee. This initial recovery stage oftens involves the application of rest cooling packs followed by light warming and mild stretching (note: never place ice/cooling packs directly against the skin). This process will reduce inflammation and hopefully prevent the development of scar tissue (which can lead to chronic, reduced flexibility of muscle tissues). For more serious cases, the process of RICE - Rest, Ice, Compression, and Elevation may need to be applied.
After the inflammation has been brought under control, the therapy often advances into a combination of light strengthening exercises for the hamstrings and slightly more progressive stretching exercises. One needs to be mindful in this stage by not being aggressive or over zealous with the strengthening and stretching as pushing too quickly can redamage the tissues.
Following each therapy session, one should analyze the response of the muscle: How does the muscle feel the next day? Is there more mobility and reduced pain? Should modifications of the therapies be added to enhance the healing?
If the therapy does not achieve positive results within a relatively short period of time (relative to degree of the injury), one should then consider more extensive sports medicine therapy treatments (like physiotherapy). The longer the damage persists, the more the chance that scar tissue will form. This tissue can cause muscular imbalances that can act on the pelvis and spine.
To avoid re-injury, especially with Yoga and stretching, warmup the body substantially with non-stretching poses and flows. Explore modifications like slightly bending the knees in forward bends. By bending the knees, the muscle attachment below the knee holds the muscle much less (and decreases the distance between the main attachment points), therefore reducing the stretch at the top of the hamstring (ishcial tuberosity). Overall, this allows the pelvis to move with far greater mobility/much better forward bend, which keeps integrity in the spine (the primary focus of every yoga pose).
To summarize, I recommend that you consult a sports medicine professional/therapist to properly diagnose the degree of your hamstring injury. With this diagnosis, you should receive a specific program/recommendations for therapy and healing. During this healing stage, enjoy the modifications, embrace patience with your hamstrings, and allow your practice to be focussed on other areas that do not counter your healing. For more detail on the grades of muscle pulls and treatments, click here.
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Hi Jan,
I would personally go see a physiotherapist instead of a chiropractor. A physio with sports medicine experience will be able to apply more therapeutic treatments that can restore the tissues than a chiropractor.
Keep resting and icing - make sure your are icing properly as this can be done wrong. Get into a physio and be patient! It will recover, but only if you give it time and adherence to prescribed therapy.
While in recovery, keep up the Yoga. Simply bend your knees on all forward bends involving the hamstrings. Keep the mobility in your spine and hips and focus on other areas of your practice that could use some attention (ie upper body flexibiilty, balance, core strength, breathing technique etc.). View this injury not as a limitation, but an opportunity.
If you are concerned about weight gain due to decreased running/cardio, consider modifying your caloric intake and timing of your meals (ie shifting well away from late eating). These light modifications will help balance the drop in exercise you have been used to doing.
Hope this helps - let us know how it goes.
Kreg Weiss
My Yoga Online
I am a runner and a yoga instructor. I am experiencing my 2nd bout with hamstring tendonitis. I have not been running for any distance for 6 weeks now. I have been going to a chiropractor for 3 weeks on a regular basis. I have been icing the area and mostly instructing yoga through verbal instruction, less demonstration. But my pain, mainly felt when sitting, which I do alot of at my regular job, is still persistent. Any recommendations for me?
We cant offer any medical advice regarding the injections. Personally, before anyone would be putting any drugs in my body, I would want them to know the exact cause of the pain - what is injured, how is it injured, what could be the cause of the injury? Until they know 100%, I would be hesitant on injections. Too often, people go to the doctor and do not ASK QUESTIONS. They just let someone prescribe drugs without any Q&A. Empower yourself. Ask them to write down everything-the injury, the area affected, the treatment or prescription suggested. Then take this information to multiple other health professionals for additional opinions. So many times, a yoga student comes to class, says they have been to the physio etc because of muscle or joint issue. I ask, “What is the problem? What muscles/joints blah blah”, and I get back “I dont know”. Ask!
Get as much information as possible and source out some more opinions - if they answer, “I’m not sure, but…”, find someone who can answer with confidence.
I just asked a yoga instructor today about the constant pain on my sit bones, mostly the right. She said it’s a common yoga injury, and that I’ve probably overstretched my hamstring. A physiatrist I’ve been going to has been stumped and has given me two steroid injections–to no avail. It makes so much sense that this is an injury from pushing a stretch.
The MD is suggesting prolotherapy (injecting dextrose solution into the injured area) with the hope that the ligament/ tendon will “heal” itself by getting rid of the inflammation or irritation caused by the dextrose–and I think the body does that by making scar tissue. I’m not sure if this therapy is the way to go, since I want to continue yoga. Any thoughts?
Such a usefule blog?wow !!!!
Great post, thank you! This is such a common injury in yoga, I know, it afflicts me! And once you have damaged an area, you really need to be more careful with it forever more… Sigh