Ischial tuberosity pain (sit bone pain) can make it very difficult for one to sit comfortably. The name of this condition stems from its bony location found in the pelvis called the ischial tuberosity. This area is located at the bottom portion of the pelvic bone and is essentially a bony protrusion that carries much of the body weight when in the seated position. This area is also known as the sitting bone or stiz bone (stemming from the from German verb “sitzen,” meaning “to sit”).
The ischial tuberosity has many different muscle connections that make developing ischial tuberosity syndrome more common in athletes that take part in sports such as hurdling, cycling, running, skating, and soccer. Extended periods of forceful muscle pulling of this area can lead to pain development of ischial tuberosity pain.
The ischial tuberosity is located near the lateral boundary of the pelvic outlet. This bony protuberance is covered by the gluteus maximus muscle when standing but shifts behind it when sitting. The gluteus maximus is a broad, thin, and outermost muscle of the buttocks involved in rotation and extension of the thigh.
The ischial tuberosity is divided into two parts:
Extended periods of exercise and activity involving the legs can overload this area of the body, leading to ischial tuberosity pain. It can also be caused by direct injury to the sitting bones or accidental overstretching of muscles surrounding it. When this occurs, pain is felt in the lower area of the buttocks while walking, running, or just sitting.
Injuries to the following areas can lead to ischial tuberosity pain:
Additionally, sitting for prolonged durations, especially on hard surfaces, can damage the ischial tuberosity and lead to a condition called ischial bursitis. This is a fluid-filled sac that acts as a cushion between the pelvis and the nearby tendons. The formation of a bursitis is to prevent additional damage but it tends to be painful in nature.
If proper care is not taken to help remedy a case of ischial tuberosity syndrome, inflammatory swelling may occur in this area, further exaggerating pain. This inflammation may also have an effect on the sciatic nerve, which passes the greater trochanter and ischial tuberosity. This can lead to the development of symptoms that extend down the leg.
Symptoms may vary from patient to patient, as the type of injury or ailment leading to ischial tuberosity pain syndrome can differ. However, pain is a defining characteristic that may carry subtle nuances and it is up to the diagnosing physician to pinpoint where the pain originates from. Additional symptoms of ischial pain syndrome can include:
Ischial tuberosity pain treatment involves managing and further preventing symptoms. At home, treatment is recommended before seeking the aid of a medical professional and thankfully most remedies are easy to perform. The following are various treatment options to help reduce ischial tuberosity pain.
Because your body is interconnected through muscles and tendons, various exercises that target the ischial tuberosity area can improve strength and flexibility, helping to reduce strain on the sitting bones. The following are suggested exercises that should only be performed if able. If you are experiencing increased levels of pain, it is recommended to see a physiotherapist to instruct you further.
Experiencing pain in the buttock region should prompt you to be concerned about a serious injury that may have occurred. Not being able to sit comfortably should be the initial warning letting you know that something is not right.
If you are having difficulty sitting for more than 15–20 minutes at a time or are experiencing pain while walking, running, playing sports, or during moderate stretching, seeking professional medical attention for an expert evaluation of your pain should be done. This is especially true if pain symptoms persist for more than a few days.