The ischial area, commonly known as the “sits bones” or “sitting bones,” refers to the lowest part of your pelvis. This region forms the base of support when you are seated, bearing a significant portion of your body weight. Understanding this area can help in identifying the sources of discomfort and finding effective ways to manage pain.
Anatomy of the Ischial Area
The ischial tuberosity is the prominent, rounded bony structure located at the bottom and back of the hip bone, forming the ischium. These two tuberosities, one on each side, function like the body’s own built-in chair, absorbing pressure when you sit. A thick layer of fibrous tissue and a fat pad cover these structures, helping to cushion and reduce friction during movement.
The ischial tuberosity serves as an attachment point for muscles and ligaments. The hamstring muscles, located at the back of the thigh, originate from this bony prominence. The sacrotuberous ligament, which connects the sacrum to the ischium, also attaches here, contributing to pelvic stability. The sciatic nerve travels in close proximity to the ischial tuberosity as it descends from the lower back through the buttocks and down the back of the thigh.
Common Sources of Pain
Pain in the ischial area often arises from direct pressure or inflammation. Prolonged sitting, especially on hard surfaces, can cause discomfort on the ischial tuberosities. This pressure can irritate underlying structures, leading to a dull ache that worsens with continued sitting.
Ischial bursitis occurs when the bursa, a fluid-filled sac cushioning the ischial tuberosity, becomes inflamed. This bursa reduces friction between the bone and surrounding tendons and muscles. Inflammation results in a deep, dull ache in the lower buttock, which increases with prolonged sitting or direct pressure.
Hamstring tendinopathy involves irritation or degeneration of the hamstring tendons where they attach to the ischial tuberosity. This condition develops gradually from repetitive stress, such as running, cycling, or activities involving deep hip flexion. Symptoms include localized pain at the sit bone, which may radiate down the back of the thigh, and are aggravated by prolonged sitting or stretching the hamstrings.
Managing Discomfort
Adjusting sitting habits and posture can reduce ischial pain. Maintaining proper sitting posture, where weight is evenly distributed between both ischial tuberosities, helps to offload pressure. Using ergonomic chairs or specialized cushions, such as those made of memory foam or gel with cutouts, can provide targeted support and alleviate pressure on the sit bones.
Regular movement and stretching are beneficial for managing discomfort. Taking frequent breaks from sitting, approximately every 20-30 minutes, helps to improve blood circulation and reduce sustained pressure on the area. Simple hamstring and glute stretches can improve flexibility and reduce tension in the surrounding muscles.
Seek medical advice if pain is severe, persistent, or accompanied by additional symptoms. If the pain radiates down the leg, or if you experience numbness, tingling, or weakness, a medical professional should be consulted. These symptoms could indicate nerve involvement or other underlying conditions that require a precise diagnosis and tailored treatment plan.