Ischial Tuberosity: Bursitis or Hamstring Pain

The Ischial Tuberosity is the rounded bone that you feel when sitting on a hard chair. The sits bones or the ischial tuberosity of the ischium part of the pelvis that causes pain in your buttocks after sitting too long. This ischial bursa is a fluid-filled sac between the hamstrings and the ischial tuberosity bone.  Pain in the tuberosity is usually caused by an inflamed bursa, called ischial bursitis or ischial tuberosity pain syndrome. Bursitis Is the most common nontraumatic cause of pain directly on the ischial tuberosity, while avulsion fracture would be the most common traumatic cause.

What is Ischio-Gluteal Bursitis?

A bursa is a fluid-filled sac that reduces pressure like a cushion between a bone and tendons. The bursa lies between the gluteus maximus and ischial tuberosity and is reduced compression during tendon movement and during sitting. When inflammation occurs in the ischial bursa, Ischial bursitis occurs.

Symptoms include:

  • Pain in the pelvis that is achy
  • Buttock pain during sitting
  • Pain and difficulty sleeping on the same side
  • Swelling or redness at proximal hamstring or sit bone


Ischial tuberosity bursitis can be quickly diagnosed by a proper physical assessment including hamstring muscle testing, palpation of a bursa, and if needed radiology special tests such as X-ray, MRI, or ultrasound.

Before beginning therapy, it’s important to assess for other conditions mimicking pain over the ischial tuberosity, including sciatic nerve pain, hamstring tendonitis, pudendal neuralgia, lumbar disc herniations, and inferior cluneal nerve pain.


Ischial bursitis can resolve with time without any treatment, but over-the-counter pain can be helpful. In some severe cases, a corticosteroid injection can be needed, but the majority of ischial tuberosity pain can be relieved by manual therapy and rehab exercises for the glutes, hamstrings, and pelvic floor.


YOU should be able to move the way you’d like to move without experiencing pain. YOU should be able to experience freedom and energy knowing there’s nothing holding back from giving your life 110%. Dr. Dean would like to learn more about your challenges with a quick phone or email before beginning treatment. Contact him today.