Avulsion fracture of ischial tuberosity - Buttock pain

The ischial tuberosity is a swollen portion of the ischium, which is one of the components of the pelvis; the hamstring muscles attach to this structure. This structure helps to support the body when an individual is in a seated position. An avulsion fracture occurs when a fragment of bone is pulled away from the rest of the bone by a ligament or tendon as a result of trauma.

Causes of an avulsion fracture of the ischial tuberosity

The most common cause of this injury is trauma; this may include a car accident, high speed impact or contact with other people, objects or surfaces or a fall. Falling heavily or awkwardly are common causes of this type of injury in sport; this is often seen in gymnastics and hurdlers. Younger athletes are more at risk of this injury as the apophysis component of the ischial tuberosity has not fully developed.


Common symptoms include pain in the buttocks, which may become heightened during movement and may radiate to the groin; in many cases, the pain will be long-lasting. The area around the injury may also become tender to touch and swollen.


Treatment is dependent on the severity of the injury; in most cases, a prolonged period of rest is recommended; during this time, the patient will also take medication to control swelling and manage pain; it is also beneficial to apply ice to the injury regularly. If the sciatic nerve has been damaged or non-surgical treatment has not eradicated symptoms, surgery will almost always be required. Once healing is well underway, a programme of physiotherapy will help to speed up recovery and strengthen the area.

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