Ischial Tuberosity Pain: Why Sitting Hurts and What You Can Do About It

If you’ve ever experienced a deep ache or sharp discomfort while sitting, particularly in the lower buttock, you may be dealing with ischial tuberosity pain—sometimes referred to as “sits bone” pain. This condition affects the area where the hamstring tendons attach to the ischial tuberosity, a bony prominence at the base of the pelvis.

Whether you're an athlete, cyclist, or desk-bound worker, pain in this region can interfere with both movement and rest. It may feel like a dull bruise, a stabbing pain when standing up, or a chronic ache that worsens after prolonged sitting. Recognising the signs early and addressing the root causes can help you stay active, comfortable, and pain-free.

The Broad Impact of Ischial Tuberosity Pain

The ischial tuberosities bear significant weight during sitting and serve as a key anchor point for the hamstring muscles. Pain in this area may reflect tendon irritation, bursitis, or hamstring overuse, and is often linked to poor biomechanics or muscle imbalances.

Pain at the sits bones can impact:

• Comfortable sitting and driving

• Hamstring flexibility and function

• Running and walking mechanics

• Exercise capacity and sports performance

• Overall quality of life due to discomfort during rest

Over time, unaddressed pain in the ischial region can alter gait and lead to compensatory issues in the hips, lower back, or opposite leg.

Causes and Symptoms of Ischial Tuberosity Pain

Pain in this region may arise from several conditions, including proximal hamstring tendinopathy, ischial bursitis, or even referred pain from the lumbar spine or sacroiliac joint.

Common causes include:

• Overuse injuries in runners or cyclists

• Prolonged sitting on hard surfaces

• Poor pelvic posture or anterior pelvic tilt

• Sudden increase in activity or training load

• Previous hamstring strain or incomplete rehabilitation

Symptoms often include:

• Deep ache or sharp pain at the lower buttock

• Pain when sitting, especially on hard chairs

• Discomfort when walking uphill or climbing stairs

• Tenderness to touch at the hamstring origin

• Reduced flexibility or weakness in the hamstrings

At MSK Doctors, we use advanced tools like MAI-Motion™ and onMRI™ to evaluate soft tissue condition, functional loading, and postural alignment—key to accurate diagnosis and tailored treatment.

Side Effects and Complications of Ignoring Sits Bone Pain

Without proper care, ischial tuberosity pain can become chronic and debilitating. Over time, the body may compensate by altering hip and lumbar spine movement, resulting in:

• Hamstring tendinopathy

• Gluteal deactivation or imbalance

• Lower back strain

• Pelvic instability

• Reduced performance or inability to train

For athletes, this condition may linger and reappear unless properly rehabilitated, often misdiagnosed as sciatica or piriformis syndrome.

Rehabilitation and Recovery: Relieving Ischial Tuberosity Pain

Effective treatment involves restoring balance between the hamstrings, glutes, and pelvis, alongside reducing tendon overload. The approach depends on the cause (e.g. tendon vs. bursa), chronicity, and activity level.

Key Strategies for Ischial Pain Relief:

• Load Management – Reduce running, squatting, or prolonged sitting initially

• Hamstring Strengthening – Start with isometrics (e.g. long lever bridges) and progress to eccentrics (e.g. Nordic curls)

• Glute Activation – Bridges, clamshells, and hip thrusts to support pelvic mechanics

• Postural Correction – Address anterior pelvic tilt or lumbar hyperextension

• Shockwave Therapy or Regenerative Injections – In persistent cases, biological treatments can stimulate healing

A physiotherapist or musculoskeletal specialist will tailor your plan, often using imaging or motion analysis to monitor tendon health and recovery trajectory.

Preventive Measures and Early Intervention

The earlier you address sits bone pain, the better the outcome. Minor irritations can quickly turn into chronic conditions if stress continues without intervention.

Prevention Tips:

• Avoid sitting for long periods—stand, stretch, or use a cushion

• Gradually increase training loads—avoid sudden intensity spikes

• Warm up thoroughly before exercise

• Strengthen both hamstrings and glutes for balanced support

• Monitor posture, especially pelvic tilt and lumbar position

• Address any previous hamstring or pelvic injuries fully before resuming high-impact activity

At MSK Doctors, we combine regenerative medicine, diagnostic imaging, and advanced rehab strategies to provide holistic care—without delays or GP referral.

Frequently Asked Questions (FAQs)

1. What is ischial tuberosity pain?
It’s pain arising from the lower part of the pelvis where the hamstring attaches. It’s often linked to tendinopathy, bursitis, or sitting-related compression.

2. How is this different from sciatica?
While both can cause buttock pain, ischial pain is more localized to the bony sits bone and worsens with sitting. Sciatica typically involves nerve pain radiating down the leg.

3. Can I still exercise with ischial tuberosity pain?
Low-impact activities like swimming or walking may be tolerated. Avoid exercises that load the hamstrings or involve prolonged hip flexion until pain improves.

4. How long does it take to heal?
Mild cases may resolve in a few weeks. Chronic tendinopathy may require 8–12 weeks or longer, especially if regenerative therapies are used.

5. What treatments are available at MSK Doctors?
We offer shockwave therapy, guided injections (e.g. PRP, exosomes), onMRI™ diagnostics, and MAI-Motion™ rehab planning to support optimal recovery.

6. Should I be concerned if the pain doesn’t go away?
Persistent pain could indicate tendon degeneration or bursal inflammation. An accurate diagnosis is essential to rule out more serious conditions and guide treatment.

Conclusion: Don’t Sit in Pain—Take Action Today

Ischial tuberosity pain may seem minor at first, but left untreated, it can become a chronic condition that limits comfort and movement. Whether caused by sports, sitting habits, or muscle imbalance, the good news is that with the right diagnosis and rehabilitation, full recovery is achievable.

At MSK Doctors, we help patients regain pain-free sitting, walking, and performance using cutting-edge diagnostics and evidence-based therapies. No GP referral needed—just clarity, care, and a personalised plan.

Take the pressure off—book your expert assessment today.