Tools for working with sit bone pain
I want to share with you an exercise that I regularly do with students who are dealing with achy hamstrings and/or mild sit bone pain. This could be as a result of an earlier hamstring “tear” or general aggravation due to muscular imbalances.
I do not offer this as “the” solution, but it’s one that I have used successfully a number of times. It takes advantage of what are commonly known as PNF techniques. PNF stands for proprioceptive neuromuscular facilitation. This essentially means that we will take advantage of some neuromuscular principles.
The specific neuromuscular principle at work here is called post isometric relaxation (PIR). This neuromuscular principle says that when a muscle has sufficiently contracted against a resistance followed by a relaxation, the muscle goes into a somewhat “ultra” relaxed phase. At this point we apply a moderate stretch to the tissue, feeling for the next level of resistance and repeat. Reference
This type of work does start to play with the edges of therapy and starts to deviate from what we would be doing in a typical yoga class. However, the number of hamstring related pain problems is significant enough that this technique is worth knowing about. The popularity of two different sit bone pain related articles on this site is a testament to the number of people that are either dealing with this issue or who want to learn more about it.
This technique is fairly simple to understand and implement for both the teacher working with a student and for a student working on their own. Let’s take it step by step and then you can look at the two video examples at the bottom.
First, have the student stand close to the wall with their back against it. This removes the need for balance. The student should be leaning on the wall slightly. Have them lift their leg as high as they can and then hold their leg near the ankle or on their heel with your hand(s).
At this point you want to put a little more pressure on the hamstrings than what they can do under the strength of their own hip flexors. Pay close attention and slowly start to lift their leg until you feel a change in the amount of tension in the hamstrings. The student should be able to confirm that you shouldn’t go much further but instead are on an edge of discomfort. This is what I refer to as resistance level 2 (R2) in my Hands-On Adjustment DVD. From the student’s point of view, the amount of pressure should remain tolerable but perhaps just slightly uncomfortable.
Once you have reached this point, you want the student to press down into your hand towards the floor with their heel and activate their hamstrings. This should be done with about 10 – 15 % of their strength; the pressure they create should remain steady for about 10 – 15 seconds. I usually count slowly up to eight. Try to have them avoid tightening their entire leg, for instance, the quadriceps shouldn’t need to contract.
When you reach eight have them stop pressing their leg into your hand. At this point, have them RELAX the leg and then slowly take the leg up until you hit the next level of tolerable resistance. When I originally learned this, we were advised to repeat the process until there was no noticeable change in the tissue’s flexibility after relaxing the contraction. I usually find that three times is sufficient.
This process in some ways helps re-establish balance in the tissues. In this case, we are working to restore balance in the hamstrings. This imbalance can be the result of an initial injury or tear, or can be due to postural distortions, such as the pelvis being tilted or rotated.
Watch the second video below to see me use the same technique myself using a step ladder, and my own body weight. Of course, you could use a window ledge, kitchen counter top or whatever else fits the bill.
Please keep me posted below in the comments section with the results, good or bad. Remember, this isn’t a miracle cure, so it won’t work in every case.
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Hello, thank you for this opportunity to write our experiences of this kind of pain and feed of each other. My little story started in february the 13th 2015. I am studying professional dancing and during a splits exercise, where the teacher slowly lifted my right leg upward into oversplits, something clicked pretty loudly and the teacher put my leg slowly down. I was warm at the time so I didn’t much pain so i continued with the exercise followed by high kicks and leaps. At the end of the day i could hardly walk. I got so scared, I went straight to a physio next day and he told me that the attachment ligament most likely is inflamed or torn. I had weekly physio sessions and the pain was slowly easing off. now I am on summer holidays so my college physiotherapist wont be available until the first week of September, so I decided to start stretching again as I feared of not being as flexible as I was before. I think I shouldnt have done that as now the pain is back; it is so frustrating and I dont know what to do. I was told not to foam roll the area as rolling the inflamed tendon you aggravate it. so I am stuck with the pain… I am just doing some gluteus strengthening exercises but even those hurt sometimes. I am scared as I start college in september and I do not want to be injured as it will restrict my studies.
Thank you again
Thank you so much for the post David (and the articles). I’ve been suffering from the injury for quite some time. Do you recommend the exercise from the video pre practice, post practice, later in the day, or some combination? Thanks again!
Hola, how refreshing I find your approach and website. I wonder whether you could contact me regarding setting up some arrangement where I send my teacher trainees to your website to purchase your DVD’s. Many thanks.