Ischial Bursitis

What is Ischial Bursitis?

• Ischial bursitis, also known as ischiogluteal bursitis or weaver's bottom, is a condition characterized by inflammation of the bursa located between the hamstring tendon and its bony origin at the ischial tuberosity (the bony prominence in the buttocks).

• The bursa is a small fluid-filled sac that helps to reduce friction and cushion the area between bones, tendons, and muscles.

• It may exist in isolation or in conjunction with hamstring origin tendinopathy.

Ischial Bursitis Presentation

• Individuals with ischial bursitis typically experience pain and tenderness in the buttock area, specifically at the base of the pelvis where the ischial tuberosity is located.

• The pain can radiate down the back of the thigh and may be worsened by activities such as sitting, running, or climbing stairs.

Ischial Bursitis Symptoms:

• Pain in the buttock area, particularly near the ischial tuberosity. 

• Tenderness and swelling over the affected bursa.

• Pain that worsens with prolonged sitting or activities that involve pressure on the buttocks.

• Pain that may radiate down the back of the thigh.

• Pain with stretching

• Inability to sleep on affected hip

• Reduced mobility

Ischial Bursitis Management

Ischial Bursitis Treatment

• Cold/heat therapy: to help reduce pain and inflammation in the affected area. 

  • Icing for around 20mins on/off  

  • Heat treatment to promote blood flow to the affected area 

• Manual therapy: reduces muscle tension, improve blood circulation, and alleviate pain in the affected area. 

  • Massage: targeted at the hamstring muscle group  

  • Trigger point: hip/glute muscles  

  • Dry needling 

• Ischial Bursitis Exercises: These exercises can help improve flexibility, reduce muscle imbalances, and promote healing. 

  • Strengthening: targeted at hamstrings and hips  

  • Stretching:  

    • Foam roller: hamstring/calf muscles  

    • Static: glute, piriformis, calf  

• Postural education: Proper posture is important in managing ischial bursitis. Guidance on correct sitting and standing postures, as well as ergonomic modifications to reduce stress on the bursa. 

• Activity modification: Modifying or avoidance education for activities that exacerbate symptoms, such as sitting for prolonged periods or engaging in high-impact exercises.