What causes ischial tuberosity pain (butt pain)?

hi I'm Danielle vana the Prolotherapy at

curing medical and I'm going to talk to

you today about

ischial tuberosity pain or butt pain as

a lot of people call it so in order to

explain this we're just gonna go over a

couple of crucial anatomy things so this

here is the human pelvis so this is the

front like where your pubis is these are

like your hip sockets and then if we

kind of flip it around this is your

tailbone like your sacroiliac joints of

your low back and then these right here

these kind of bony prominences are your

issue tuberosities so these are actually

like what you sit on when you sit in a

chair people that kind of have like what

they say is I have a pain in my butt

oftentimes like it will have pain at

this issue a tuberosity area and they

might say oh I had just tight hamstrings

I stretch them out all the time or I

foam roll like crazy or you know I've

done cortisone shots things like that

but this pain keeps coming back and so

there might be a couple of different

reasons why that is so sometimes

patients will come in and they truly

have like a hamstring issue your

hamstring tendons attached here at this

issue a tuberosity if you have a tear or

degeneration it's going to hurt when you

put your whole body weight on it to sit

down sometimes however patients will

come in with a chronic issue a

tuberosity pain that doesn't get better

with anything and they've tried because

the pain is coming from elsewhere so if

we think about it kind of back to this

Anatomy like you've got your sacroiliac

joints here right kind of big

stabilizers of your pelvis and you have

these connective tissues that go down to

that issue tuberosity so you could

actually have like a secret iliac

instability that moves this bone up and

down that tugs on your hamstring you

could do all the hamstring treatment in

the world it's not gonna get to the root

cause if it's an underlying sacroiliac

issue which is actually more common than

you would think the other thing is

especially in runners that have like a

hamstring issue or maybe they say oh I

pull my hamstring all the time and then

I rest and then I pull it again well

likely you know if you're doing

treatments that the hamstring and it's

not working we got to evaluate your hip

cuz a lot of runners again if we think

about it like here's your hip socket

here's your issue

roughy I mean they could not be closer

and if you have a hip issue like a

labral tear or an instability it's gonna

cause you to use more force of your

hamstring activate that more which might

actually be causing pain like in your

butt part of the workup when people come

here for a chronic like butt pain or

hamstring issue or is sheild tuberosity

issue is we have to look at all these

areas you know is it solely your

hamstring and it's attachments is that

your back is it your hip is it a

combination of all of those because that

getting to that root cause is what's

gonna help you get better and again like

I said Kahneman and runners to actually

have a subtle hip issue that maybe you

know the average human wouldn't notice

but their marathon runners they put a

lot of pressure on their body so any

kind of subtle instability would be more

prominent to them most treatment plans

for something like this do involve like

routine treatments again you've had this

issue maybe for a while and it's

degenerating about this degenerating

condition we've got to stop it in

reverse it we've gotta stop the

degeneration and get these tissues to

regenerate and be strong so it does take

several treatments in order to do that

you know the average person may be

between four and six and that could

involve dextrose Prolotherapy or even

using cells from your cells like drawing

some blood concentrating the growth

factors out of it which is called PRP or

platelet-rich plasma and that just

depends on the severity of the case you

know the patient their activity level

and so forth so that's something that's

decided when you're here in the office