Anatomical Structure and Location of the Sacrotuberous Ligament

Description

Arising from the lateral margins of the sacrum and coccyx, the sacrotuberous ligament courses inferolaterally to insert on the ischial tuberosity, forming a stout band along the posteroinferior pelvis. Positioned posterior to the pelvic floor musculature, it lies deep to the gluteus maximus and in close relationship to the gluteus maximus tendon as it approaches the iliotibial tract and gluteal tuberosity. Medially, the ligament borders the posterior pelvic outlet; laterally, it helps define the ischioanal region and the posterior contour of the hip bone. The sacrum and coccyx anchor the proximal attachment, while the ischium provides the distal bony landmark. Clinically, this ligament matters because together with the sacrospinous ligament it converts the greater and lesser sciatic notches into the greater and lesser sciatic foramina, framing the passage of the sciatic nerve, pudendal nerve, and internal pudendal vessels around the ischial spine. That anatomy is central when teaching deep gluteal pain syndromes and when mapping routes of pudendal nerve entrapment, which can occur between the sacrospinous and sacrotuberous ligaments near the ischial spine. It is also a key stabilizer of the sacroiliac articulation, resisting nutation of the sacrum during load transfer. Small structure, big consequences. Use this artwork in pelvic anatomy and pelvic floor modules, orthopedic and sports medicine texts covering sacroiliac pain, and surgical education on posterior pelvic approaches and perineal or pudendal nerve procedures where ligamentous landmarks guide safe dissection. It also suits radiology teaching that correlates ligament planes with MRI evaluation of deep gluteal and perineal pain. Anatomical accuracy verified by SciePro's Medical Advisory Board.