Torn Hamstring

[Questioner]

I have a new student who has done a lot of strong Hatha yoga (Ashtanga et al.) and also was a dancer. Consequently she has several injuries that she has come to me with – saying that she is ready to work differently (i.e., remedially). She has torn her right hamstring (which one I don’t know). And has also done some damage/strain to her right groin and perhaps also psoas/hip flexor. External rotation of the right hip seems to irritate these injuries. She finds baddha konasana (going forward) very uncomfortable, feels a pull through the front of the right hip when she is doing Parsvakonasana to the left, and also feels discomfort in this hip when in is flexion with knees to chest in Apanasana and prayer pose. She also feels a lot of pain in the R hamstring (so I had her modify by bending the leg slightly) when she drops that leg across the body in a one-legged version of Jathara Parivartanasana (from Gary Kraftsow Yoga for Wellness).

My assumptions are that she needs to work on stretching the psoas/hip flexors with lunges, quad stretches, deep groin stretches, as well as piriformis stretches like Gomukhasana, Pigeon pose (Eka Pada Rajakapotasana) etc. I am also thinking she needs to strengthen psoas with leg-lifts, as well as work on building stability in the sacral area with Salabhasana variations (including one-legged raises where she strengthens the hamstrings). Also core-strength building abdominal exercise. Firstly, am I on the right track? And secondly, can you tell me what may be happening with the interrelationship between hamstring and hip/psoas/SI joint on that same side which I also suffer from?

Thank you for your numerous wise and interesting insights on yoga and Ayurveda and I look forward to your reply. Many thanks

[Mukunda]

My strategy with injuries is to strengthen the injured muscle and avoid stretches to the injured tissue until there is no strain pain in it (time varies). I suspect injury is to medial portion of the hamstring as there are two muscles here and this portion, along with the psoas, also does external hip rotation. It sounds like the injury extends above that region into the adductors of the groin too. Hamstring does hip extension and knee flexion. The only true antagonist is the rectus femoris as it does hip flexion and knee extension. So I would focus on strengthening this muscle for sometime. Later on check the poses that brought pain in the hamstrings. When the pain is gone or substantially reduced (70%), then she should begin with strength building in the antagonists. The antagonist to the hamstrings are the other hip flexors (psoas, sartorius, and 5 adductors) and knee extensors (quadriceps). So recommendations would be locust and sunbird (Krishnamacharya’s – Chakravakasana) with variations – single leg, knee flexed, hip internally and externally rotated.

The sacroiliac is often at the root of the problem in this area (lumbar to mid thigh). The sacroiliac should move into elevation as the hip goes into flexion. When this is not there then muscles will not be toned even though they are being correctly worked and pelvic imbalances will continue to persist. I have a specific exercise that corrects this and she should do this too. It is attached. Blessings to your studies and efforts to be of help. Mukunda