Obturator Internus and it's affect on the Bladder, Hip, Pelvic Floor and Sex

By Shannon Strauch, PTA, STMT-1 on 10/23/2023

The obturator internus (OI) is a little known deep hip external rotator. While it is not a direct pelvic floor muscle, attachment sites to the Arcuate Tendon Levator Ani (ATLA) of the levator ani muscle group show how important this muscle is to pelvic floor function.

Facial connections also connect the OI to the bladder and urethra, which can cause symptoms of urinary urgency or frequency, bladder pain, or pelvic pain. The OI forms part of Alcock's Canal, which houses the pudendal nerve. Therefore, a tight obturator internus can also put pressure on the pudendal nerve, which can cause sharp, shooting, tingling pain or urinary burning.

Tightness in the obturator internus may also cause pain in the low back, groin, hip, or hamstring insertion at the sit bone (ischial tuberosity). Sometimes people might describe this pain as "LOW low back pain", or pain in the rectum/butt. People with OI issues may also have pain with sex (Dyspareunia), difficulty with orgasms (Anorgasmia) or painful orgasms (Dysorgasmia)

Unlike at a regular orthopedic clinic, a trained pelvic floor therapist can release the obturator internus both externally and internally. If any of these symptoms sound familiar, or if you have been treated for chronic piriformis syndrome or hamstring pain without much results, come to Pelvic Health and have one of our pelvic floor therapists assess and find the true root of your problem.

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