Sacrotuberous ligament is a complex structure in the buttock.
It is usually irritated in high hamstrings injuries and can cause deep buttock pain.
So what is a Sacrotuberous Ligament? What does it do? How do you get a Sacrotuberous Ligament injury? And how can you fix it?
What is a Sacrotuberous Ligament? What does it do?
The Sacrotuberous Ligament connects the Sacrum to the Ischium. Essentially it joins the bottom of the spine to the bottom of the pelvis on the sit bone.
It’s this second function that usually causes Sacrotuberous Ligament injuries.
How do you get a Sacrotuberous Ligament injury?
Most Sacrotuberous Ligament injuries are the result of hamstrings overload pulling on the secondary anchor.
If the hamstrings are overloaded when the hip is in a neutral or extended (leg behind you) position, the Sacrotuberous Ligament is usually not involved.
This is because the bulk of the hamstring forces are transferred to the main anchor points on the Iscium (sit bone).
Sacrotuberous Ligament injuries occur when the hip is in a flexible forward position with the knee almost straight.
This position causes the Sacrotuberous Ligament to be pre-tensioned, then the additional hamstring loading adds the sudden overload.
So it will feel like a hamstring strain with the muscle in a stretched position.
After the initial hamstring symptoms settle – these might be muscle soreness or tendon soreness – there is a residual deep in the buttock.
That residual ache is the Sacrotuberous Ligament (ST) injury.
How do you fix ST Ligament injuries?
The fix for ST ligament injuries involves doing two exercises…and avoiding two others!
Lets start with what to avoid – the ST ligament hates prolonged stretch. So hamstring stretches are out as they only contribute to the irritation.
The other “avoid” is direct pressure. Although it may feel relieving for a short time, trigger point balls and direct massage aren’t helpful.
Now the good stuff – the exercises to fix Sacrotuberous Ligament injuries.
The ligament responds well to loading in lengthened positions, as long as it’s only causing discomfort and not pain.
So a single leg deadlift is a worthy addition. You can gradually progress the depth of the deadlift, then add weight, and lastly add speed to the movement.
The second exercise needs to build strength in the muscles that support the hamstrings. This helps spread the load elsewhere.
For this one, you can use a Bulgarian Squat with a shorter stride length or a single leg hip bridge.
These exercises can build gluteal strength with a mild degree of hamstrings loading.