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Are you hip to it? Hip pain and the pelvic floor

Women bumping hips
Women bumping hips

We’ve all heard that song – hip bone’s connected to the thigh bone. But you’ve probably not heard the latest version: the pelvic floor’s connected to the obturator internus!

The what?!

In plain English, the pelvic floor is connected to your hips, baby.

The obturator internus is a muscle deep inside your hip. It’s part of the cool club of hip muscles that helps you take a step to the right or bring your knees in tight (when doing the Time Warp).

It’s one of the many wonderful muscles that helps you turn your leg out from the hip joint and it also helps you keep your pelvis steady when you’re walking, running, or foxtrotting.

But unlike some of the other hip muscles that help us groove to the music, the obturator internus has a special friendship with the pelvic floor muscles – it’s directly attached.

So, what does it mean if you’ve got pain in your hips? Could it actually be connected to the pelvic floor?

First of all, there can be a HUGE range of different reasons for pain in the hips. Our hips are doing a lot for us all the time, whether it be sitting, walking or doing the Nutbush. Plus, within the hips themselves there’s nerves, bones, the ball and socket of the hip joint, as well as a host of muscles.

But the relationship of the pelvic floor and the obturator internus can also be a source of pain, and there are ways that a pelvic floor physio can help.

What sorts of pain or other things should get you to the pelvic floor physio?

There’s a range of different things you might notice if your obturator internus and pelvic floor are in need of help.

Some things you might notice in the pelvic area are:

  • You have pain in the pelvic area when you’re sitting
  • You often find that you suddenly, urgently have to pee
  • You feel like you need to pee all the time
  • Wee leaks out when you cough, laugh or at random times
  • You have pain during penetrative or other kinds of sex, or you have a hard time orgasming

Some things you might notice in the hips and back:

  • Deep hip or lower back pain
  • Pain in your groin
  • Pain around the ‘sit bones’ (the boney bits of your bum where you sit)
  • Pain in or around your tail bone
  • Pain in your vagina or rectum

How does the pelvic floor physio check whether your hip pain is caused by your obturator internus?

A pelvic floor physio can check how strong and happy your obturator internus is through an internal exam. Because the obturator internus is so deep within the hip, a pelvic floor physio does this by putting their finger into your vagina and gently feeling the muscle through the wall of the vagina.

Can you just go to an everyday physiotherapist for hip pain?

You certainly can! And there’s a lot that a general physiotherapist can do to help you manage pain, build strength, stability, flexibility and movement in the hips (bring on the Macarena!) All this can help manage pain and get you back to doing things you love (whether that’s line dancing or sashaying about the house to Whitney Houston).

But there are issues that a general physio doesn’t have the training or skills to help with. Things like that connection of the pelvic floor to the obturator internus – that’s something only a pelvic floor physio is trained to check and treat.

If you have been seeing a general physio for hip pain and its not getting better – get along to a pelvic floor physio!

“Well, I’ve had hip pain for a while, and I’ve just been getting on with it. Should I still see a pelvic floor physio?”

Yes! Hip pain can have knock on effects.

Basically, if you’ve been living with hip pain for a while your body might have been protecting you from pain by spreading the strain to a different part of the hip.

This could cause strain on the muscles of the pelvic floor. So, if you’ve been living with hip pain and now are finding that you’re having problems holding in wee or having pain with penetrative or other kinds of sex – get your arse (or should I say, pelvis) to a pelvic floor physio immediately!

Shake it like a polaroid picture!

When you shake it on the dance floor, a whole interconnected system of muscles is engaging – you’re not just shaking your hips: your pelvic floor is part of the party too.

The pain you might experience in your hips could be the result of something going on in the pelvic floor.

Our main message here: Help is out there! A pelvic floor physio can help you stay hip, with it and pain free!



Victoria Garrett, The Missing Link: Hip Pain & Pelvic Floor.

Physio-pedia, Obturator Internus.