What is Ischial Bursitis?

Chronic and continuous irritation of the bursa is what causes ischial bursitis most often in individuals with sedentary lifestyles. Ischemic irritation is commonly caused by prolonged pressure on the ischium.

Sitting on a hard surface for long periods of time, direct trauma to the area, or injury to the hamstring muscle or tendon through activities such as running or bicycling can cause ischial bursitis. Other common causes include Inflammation (rheumatoid arthritis and spondyloarthropathies), Infection, etc. 

Clinical presentation of Ischial Bursitis: 

  • Symptoms of ischial tuberosity pain that can also radiate to the lower leg.
  • Pain is aggravated by prolonged sitting.
  • Pain with straight leg raise.
  • Tenderness may occur over the ischial tuberosity.
  • Inability to sleep on the affected hip.
  • Regional muscle dysfunction.
  • Swelling and limited mobility. 

Physiotherapy Management of Ischial bursitis: 

  • Cold Therapy 
    • Cold therapy contains ice application with cold packs usually for about 20-30 minutes. or
    • Cryo-air for only 3-5 minutes.
  • Improving the healing process 
    • Combo therapy
    • High-intensity class 4 laser therapy 
  • Heat Treatment 
    • It increases blood flow and oxygen tension.
    • Two treatments are administered twice a day for 30 minutes each.
  • TR-therapy 
  • Friction Massage 
    • In addition to breaking down scar tissue, it increases extensibility and mobility of the structure, encourages normal orientation of collagen fibers, increases blood flow, reduces stress levels, and promotes healing.
  • Stretching Exercises for example 
    • Hamstring stretching to increase the flexibility of tight hamstrings muscle and reduce pressure on the bursa and achieve painless motion.
    • Among all stretching methods, static stretching is the least likely to lead to injury. Perform 30 second stretches once a day. Examples of static stretching exercises is
      • Gluteal stretch: Bend your affected knee upward while lying on your back. Put both hands on the back of your knee and slowly pull it toward your chest. This should be held for 5 to 10 seconds, followed by 6 to 10 repetitions. 
      • Piriformis stretch: If you are lying on the floor, bend your affected knee and cross it over the other leg, placing the foot alongside the knee. Lift the good leg off the floor by pulling it in toward you with your hands. Your affected buttock and outer thigh should feel stretched. You should hold this position for 10-30 seconds.
  • Strengthening Exercises 
    • To correct muscle imbalance
    • Strengthening of hip rotators.