Hip Pain And Pelvic Floor Connection
Hip pain isn't just a minor inconvenience – it can significantly affect daily life and well-being. Research highlights its prevalence in both athletic and older populations, with athletes often dealing with groin pain, and older adults commonly facing diagnoses like osteoarthritis, a leading cause of global disability.
In the context of hip pain, there are several diagnoses, each seeking to customize the most effective treatment plan. Typically, a visit to the doctor involves a physical examination, imaging such as x-rays or MRIs, and lab tests. However, these approaches may miss potential causes of pain stemming from nearby structures, such as the pelvic floor.
The pelvic floor, consisting of three layers of muscles, serves a vital role in supporting pelvic organs, ensuring trunk stability, and influencing bowel, bladder, and sexual functions. Deep pelvic muscles like the levator ani, coccygeus, and obturator internus are key players in this intricate system. Dysfunction in the pelvic floor can extend its impact to seemingly unrelated parts of the body.
Understanding the intricate relationship between hip pain and the pelvic floor sheds light on the importance of a comprehensive approach to diagnosis and treatment, ensuring that no underlying causes are overlooked and that individuals can regain a pain-free, active lifestyle
And that's not all – when we think about pelvic floor issues, the mind often goes to familiar symptoms like urinary incontinence or bowel discomfort. But guess what? The connection goes beyond that and includes the hip joint.
While the pelvic floor comprises a set of muscles located at the base of the pelvis, it's important to note that, although these specific muscles may not directly intertwine with the hip, there is a small yet influential hip muscle known as the Obturator internus that resides near the pelvic floor muscles. Working alongside other external rotators of the hip, the Obturator Internus acts as a secondary supporter for the pelvic floor. This muscle not only controls hip motion and rotation but also influences pelvic positioning and pelvic floor function. Moreover, the nerve responsible for innervating a significant portion of the pelvic floor, along with adjacent blood vessels, runs alongside the Obturator internus, providing nerve supply to the pelvic floor and its surrounding area.
So, what does all this mean? If you're dealing with pelvic floor issues, you might also notice some hip pain, and the reverse is true too. Here are some common signs of hip pain connected to pelvic floor issues:
A deep, dull ache on the outside of the hip
A similar ache near the sit bones
Tailbone pain
Groin pain
Feeling tight in the hip or having trouble moving around
A weird "pinching" sensation in the hip
Here at Foundation Physical Therapy, we like to look at the big picture and figure out where the trouble started, and how everything connects. If you want to know more about how we can help you – whether it's virtually or in person at our Palo Alto and Redwood City, CA office – set up a FREE 20-minute phone chat here.
Frequently Asked Questions:
Do tight hips mean tight pelvic floor?
Tight hip flexors can generate tension on the pelvic floor, causing strain on the lower back and pelvis. This strain may result in various issues, including knee pain, foot pain, bladder leakage, prolapse, and more.
Can weak pelvic floor muscles cause hip pain?
If the Obturator Internus undergoes strain, tightness, or weakness, you might encounter pain on the outer side of the hip, close to the sitting bone, or deep within the pelvis. Symptoms may extend into the lower abdomen or groin region.
How can I determine if my pelvic floor muscles are compromised?
Impaired pelvic floor muscles may manifest through:
Urinary challenges, such as painful urination or frequent urges to urinate
Lower back pain
Discomfort in the pelvic region, genital area, or rectum
Constipation or difficulty with bowel movements
Pelvic muscle spasms
Pressure sensations in the pelvic or rectal area
Uncomfortable sensations during sexual intercourse for women
References
Prather H, Colorado B, Hunt D. 2014. Managing hip pain in the athlete. Physical Medicine and Rehabilitation Clinic of North America, 45(4), 789-812.
Cross M, Smith E, Hoy D, et al. 2014. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Annals of the Rheumatic Diseases, 73(7), 1323-1330.
Osteoarthritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930.
Continence Foundation of Australia. Pelvic Floor Muscles. Retrieved from: https://www.continence.org.au/pages/how-do-pelvic-floor-muscles-help.html.
Drake R, Vogel AW, Mitchell AWM. 2009. Grey’s anatomy for students. Elsevier Health Sciences.
Pelvic Floor Dysfunction. (Physiopedia, March 31, 2020). Retrieved from https://www.physio-pedia.com/index.php?title=Pelvic_Floor_Dysfunction&oldid=234370.
Obturator Internus. (Physiopedia, February 10, 2020). Retrieved from https://www.physio-pedia.com/index.php?title=Obturator_Internus&oldid=230399.