I was in the DC area this month and saw a student that I knew from a previous workshop. At that time Patricia had recently “pulled a hamstring”. Her major symptom was pain at her sit bone (ischial tuberosity) when folding forward, secondary was that it would also hurt when sitting for long periods, especially in the car. I saw her just a couple of weeks ago and she still had the same pain.

Although not my regular advice, the most common way people are told to deal with this problem is to bend their knees in their forward bends. The idea is that by bending your knees you shorten the hamstrings. By shortening the hamstrings you reduce the amount of pull or tension placed on them. It sounds good in theory.
Here’s the problem with this theory. I refer to the hamstrings as two joint muscles. What this means is that changing the position at one of the two joints (hip or knee), changes the end of the muscles that will receive more force from the actual stretching of the muscle.
When you bend your knees and bend forward, more of the pressure created by the “stretch” to the hamstrings goes into the opposite end. In other words, if you bend your knees in a forward bend, you add more force to the end of the hamstrings that connect to the sit-bones.
Assuming that you’ve actually torn your hamstrings (of course a minor tear usually), and that you’ve torn the end of your hamstrings closest to your sit bones, do you think it would be wise to put more pressure on these same tissues? The answer is No, it wouldn’t.
The next question is; Well, what should we do then?
Although I can’t say that this will work in every situation for every individual, this has proven to work for a number of people in this situation. There are always exceptions.
Now, during this most recent interaction with Patricia, I took a moment to give a gentle squeeze to the area of her hamstrings just above the knee joint. (The opposite end from where she was feeling discomfort.) I could see in her face that these tissues were particularly tender and sore. That along with the symptom that she would actually get pain in her sit bone when she would sit in the car clued me in that this technique would probably work for her. The significance of the pain while sitting in the car is that the part of the hamstrings that gets the most pressure in a car seat is the bottom (distal) end of the hamstrings closest to the knee.
The technique I apply is extremely simple, and as I told this student, worth trying for two or three weeks and seeing what happens. Ah yeah, the technique… you’re waiting for it aren’t you? The answer is… Keep your knees straight. That’s it. When you forward bend, either standing or in seated postures, keep the leg extremely straight and don’t go as deeply into the forward bend as you normally do.
By keeping the knee straight, with quadriceps engaged, you keep the stretch in the hamstrings equal between both ends. In the situation mentioned above, the hamstrings had gotten to a place where their distal end near the knee got too tight. The tension in this end seems to lead to consistent tension in the hamstrings as a whole and particularly near the sit bones. That needed to be taken out by keeping the knee straight.
Patricia came to three days of practice with me 3 days in a row. She kept her knees extremely straight and guess what? Pain was reducing after just these few days.
I emailed her just before this past weekend to check-in and here’s what she had to say:
David, Significant improvement indeed! I am not bending the knees on the standing or seated poses (like you instructed me) and now I can bend forward with my torso a lot more without any pain in the moment or afterwards. I am now doing Kurmasana and Supta K (almost fully) without pain and on my own!! It is definitely healing, recovering the flexibility. I am really happy about this!!! Looking back, I think that I may have been stuck on a phase of “pain-avoidance” without doing anything to heal the hamstring for good, addressing the problem. Thank you so much for your help with my trouble-making hamstring. Look forward to keep leaning from you (and of course to my entry to the hall-of-fame through the newsletter).
***please note that this does not account for all sit bone pain, nor does it mean that there are not times when it is appropriate to bend the knees. This advice was specific for this student at this time.
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For more information about David Keil Please visit his Yoga Anatomy website.







Hi David
Enjoying the articles and maybe catch u next yr at Chi & Co
Many Blessings 2u
Alan
Dear David,
I am so grateful for your website ‘yoganatomy’. This is the second article that I have read that explains a problem I’ve been experiencing in my practice (I also heard pop in Kurmasana). You’re explanations are clear and empowering. Thank you so much! I’m so excited to try this straight-leg solution for my hamstring tear/pull! I’ll keep you posted.
Hi,
As a yoga teacher, I have a persistant pain in my hamstring. And as a teacher, it doesn’t get much rest!
Recently, I went to an Iyengar class and the instructor had me put a strap around the top of my thigh and pull just to tension. It supported my hamstring and the results were almost immediate. My hamstring felt better very quickly.
Why and how did this work? I have since used it with one of my advanced students who also noticed a difference.
Thanks for all the info, it’s great to have!
Melissa
I can’t say I know exactly why… but I have a guess. It’s possible that the tension from the strap redistributed the tension in the hamstring. Perhaps the location of pressure acted like a new attachment place of sorts (not exactly). Did it fix the hamstring pain, or did it just alleviate it while in the posture? Either way… I’m for whatever works. I’ll have to play with it with some students and make some more observations.
Hi,
I have been using the strap on and off and it has not cured the pain. I have very open hamstrings and I am flexible but my guess is that once they are warmed up, the pain subsides. Driving long distances in a car becomes very painful.
I guess the only way to really heal this is rest? Not sure if that’s possible!
Melissa
Melissa,
Interesting… might I suggest that you may have a trigger point that gets activated. Is it possible for you to have someone check your gluteus minimus for TP’s?
http://www.triggerpoints.net/triggerpoints/glut-min.htm
I have had a few students who complained of sit bone pain… assuming it was hamstring attachment who had this. I checked personally and when pressing into the gluteus minimus on the side of the hip their pain was elicited. All of them found that it activated when sitting for long periods. For some of them the whole thing did begin with a hamstring “event”
You can also check yourself with a tennis ball, but better to be assessed by a neuromuscular therapist or good massage therapist.
Let us know what you find
Thank you so much. I will definitely keep you posted. Just sitting here in my chair and pushing on my hip alleviates most of the tension. I will definitely see if I can find a good therapist in my area.
Thanks again,
Melissa
Hi there
This is a very interesting way to address pain at the sitbone. I have the same pain too, though it is not tender above the back of my knee. An interesting thing is when I go into Trikonasana and try to grab my toe (Ashtanga style) I have to bend my knee and my hips are not stacked — this causes bad hamstring pain at my sitbone. However when I let go of my toe and move into proper Trikonasana alignment with my hips stacked, and I get that noticeable “crack” in my hip joint that most students get going into Trikonasana, this seems to immediately release a lot (though not all) of the pain at my sitbone.
Should I also be straightening my legs? Or just focussing like crazy on engaging my quadricep? By the middle-end of my Mysore-style practice, my hamstrings are not hurting much anymore in the forward bends (maybe because they are warmed up, or some tension was released)?
Thanks for your advice!
I have to admit… this technique will not work in every situation. Yours might be one of them. It is of course difficult for me to assess you from where I am… meaning, not in front of you.
Your mentioning of changing trikonasana is interesting to me. It makes me think that it is possible that you have actually aggravated your Adductor Magnus. Do you feel any sensation there when in a wide leg forward bend?
If the answer is yes, more likely it’s your adductor magnus in which case, straightening your knee will not change it.
Yes… in general when you warm your tissues it’s likely that tension is less in your muscles so you don’t feel the same discomfort. This is almost always an indication that the problem is muscular.
Let us know
Hmm, yes I definitely feel pain in wide-legged (standing) forward bends, that and going into Trikonasana with a bent knee are the most painful poses. Seated forward bends are much easier and less painful, though I may still feel the pain on occasion.
Adductor magnus — I will look at my Bandha Yoga books to figure out where that muscle is and see if it may be causing my problem.
If the problem is muscular, that may be a good thing? Better than connective tissue/tendons. I may try the seated massage with a sensei ball or something.
Thank you! Great and very detailed blog (I have a biology background so I enjoy it coupled with the yoga)
In fact I isometrically contracted those muscles (standing, squeezed inner thighs together) and felt pain upon contraction at the top insertion point by the sitbone but in towards the groin a bit.
Will try massage.
Thank you for the help!
You’re welcome… make sure they treat the whole of adductor magnus… not the insertion point!