When we think about the pelvic floor, many people might picture the more commonly discussed muscles and structures. However, the obturator internus muscle plays a crucial yet often overlooked role in pelvic health. This deep muscle, located within the pelvis, is integral to various bodily functions, including urinary control and comfort during sitting. Understanding its significance and the potential issues arising from its dysfunction can shed light on various health concerns, including urinary urgency and pelvic pain. In this post, we’ll explore the obturator internus muscle, how its dysfunction can lead to certain symptoms, and how pelvic floor physical therapy can provide effective treatment.

What is the Obturator Internus Muscle?

The obturator internus muscle is a thin, flat muscle situated in the pelvis, primarily involved in the lateral rotation of the hip joint. It originates from the inner surface of the obturator membrane and the surrounding bone and inserts onto the greater trochanter of the femur. While it is not one of the primary pelvic floor muscles, it plays a vital role in pelvic stability and function.

In addition to its primary function of hip movement, the obturator internus muscle is closely associated with the pudendal nerve, which runs through it. The pudendal nerve is responsible for innervating various pelvic structures, including the pelvic floor muscles, the external genitalia, external urethral spinchter and the anal sphincter. This connection is essential for understanding how dysfunction in the obturator internus can impact urinary function and pelvic pain.

How Dysfunction in the Obturator Internus Affects Urinary Urgency

Dysfunction in the obturator internus can lead to various issues, including urinary urgency. This urgency is often due to the pudendal nerve’s compromised function, which can result from the muscle’s tightness or trigger points. When the obturator internus becomes tense or develops trigger points, it can exert pressure on the pudendal nerve, leading to:

1. Increased Urgency: As the pudendal nerve is responsible for signaling the bladder’s fullness and managing the pelvic floor’s relaxation during urination, any interference can result in an exaggerated urge to urinate.

2. Overactive Bladder Symptoms: Individuals may experience frequent urges to urinate, nocturia (waking up at night to urinate), or incontinence, affecting their daily life and overall well-being.

3. Pelvic Pain: The interconnected nature of pelvic muscles means that dysfunction in the obturator internus can contribute to pelvic pain, making it uncomfortable for individuals to engage in daily activities, including sitting.

Pain with Sitting: The Impact of Obturator Internus Dysfunction

Pain with Sitting: The Impact of Obturator Internus Dysfunction

For many individuals, sitting can become a painful experience due to issues with the obturator internus muscle. When this muscle is tight or dysfunctional, it can lead to several discomforts, including:

1. Localized Pain: Tightness in the obturator internus can lead to referred pain in the pelvic region or on the ischial tuberosity (i.e. the “sits bones) making it uncomfortable to sit for prolonged periods.

2. Pressure on Surrounding Structures: As the obturator internus is situated near other vital pelvic structures, dysfunction in this muscle can affect neighboring areas, leading to discomfort in the hips, lower back, and even the sacroiliac joint.

3. Nerve Compression: Dysfunction may result in compression of the pudendal nerve or other surrounding nerves, exacerbating pain and discomfort while sitting.

The Role of Physical Therapy in Treating Obturator Internus Dysfunction

Pelvic floor physical therapy is an effective treatment approach for addressing dysfunction in the obturator internus and alleviating symptoms such as urinary urgency and pain with sitting. Here’s how pelvic floor physical therapy can help:

1. Comprehensive Assessment

A skilled pelvic floor physical therapist will conduct a thorough assessment of your pelvic health. This may include evaluating your muscle tone, range of motion, and strength in the pelvic region. By identifying tightness or dysfunction in the obturator internus, the therapist can tailor a specific treatment plan.

2. Manual Therapy Techniques

Manual therapy can be an effective way to release tension in the obturator internus and surrounding muscles. Techniques such as myofascial release, trigger point therapy, dry needling and deep tissue massage can help alleviate muscle tightness, improve blood flow, and promote relaxation.

3. Pelvic Floor Exercises

Strengthening and stretching exercises targeting the pelvic floor can enhance muscle coordination and function. A therapist may teach specific exercises to help strengthen the pelvic floor muscles while ensuring that the obturator internus is not overactivated or strained.

4. Education and Awareness

Understanding the role of the obturator internus and its connection to urinary urgency and pelvic pain is crucial for patients. Physical therapists provide education on proper body mechanics, posture, and movement patterns to minimize strain on the pelvic floor.

5. Home Exercise Program

To complement in-clinic treatment, your physical therapist may provide a personalized home exercise program. This program can include exercises designed to improve flexibility, strengthen the pelvic floor, and promote relaxation of the obturator internus muscle.

6. Lifestyle Modifications

Therapists may suggest lifestyle modifications to support pelvic health, including hydration strategies, dietary changes, and stress management techniques. These adjustments can significantly influence urinary function and overall well-being.

The Benefits of Pelvic Floor Physical Therapy

The Benefits of Pelvic Floor Physical Therapy

Engaging in pelvic floor physical therapy can lead to numerous benefits for individuals dealing with obturator internus dysfunction:

Improved Bladder Control: Many individuals report reduced urinary urgency and improved bladder control following physical therapy interventions.

Pain Relief: Addressing tightness and trigger points in the obturator internus can lead to decreased pain during sitting and overall improved comfort.

Enhanced Quality of Life: By alleviating symptoms, individuals can return to their regular activities without the burden of pelvic pain or urinary issues.

Conclusion

The obturator internus muscle plays a vital role in pelvic health, impacting urinary function and comfort during daily activities. Dysfunction in this muscle can lead to significant challenges, including urinary urgency and pain while sitting. Fortunately, pelvic floor physical therapy offers a comprehensive and effective approach to addressing these issues.

If you are experiencing urinary urgency or discomfort while sitting, consider seeking the expertise of a pelvic floor physical therapist. Through a combination of assessment, manual therapy, targeted exercises, and education, you can regain control of your pelvic health and improve your overall quality of life. Remember, taking care of your pelvic floor is an essential part of maintaining your overall well-being. Don’t hesitate to reach out to a physical therapist to start your journey toward better pelvic health today! Contact us to get started!