Hip pain? Ever considered there may be a connection to your pelvic floor? Double take. Yes, your pelvic floor. What is my pelvic floor, you may ask, and what does it have to do with my hip?
The pelvic floor is a functional unit of muscles that form a lovely sling at the base of your pelvis. They work alongside your abdominal, spinal and hip muscles to provide stability to the trunk and pelvis for movement. They also control urination, bowel movements, work for sexual function and venous and lymphatic return. If they aren’t working properly you may have symptoms like leaking urine, constipation or pain anywhere from ribs to knees!
How are the Hip and the Pelvic Floor Related?
The pelvic floor shares a direct connection to the hip musculature. This occurs by way of a tendinous attachment to the deep muscle of the hip, the obturator internus. This muscle provides stability through its function as an external rotator. Alongside some other deep hip muscles, the obturator internus provides a static stability for the hip for functional activities. If your pelvic floor is too tight or very weak, the obturator internus does not have a solid anchor to pull from. This can cause instability at the hip through asymmetrical pull across the joint by muscles, leading to tissue injury and pain.
What Happens When the Hip Muscles Aren’t Functioning Properly?
When your deep hip muscles are not functioning properly (too tight or too weak) you also may see issues with the pelvic floor. If OI is too tight, that tension feeds into the muscles of the pelvis, causing tension and poor recruitment for stability. If OI is very weak, the pelvic floor does not have a strong anchor from which to pull and may result in poor support for our organs or leaking of urine.
In closing, it is important to consider the pelvic floor as a possible mediator in your symptoms. Hip pain can be very directly tied to pelvic floor dysfunction and vice versa. If you are seeing a provider, ask them to consider the pelvic floor. If you see a Physical Therapist, ask them to consider what is going on with your pelvic floor in relation to your hip. Our bodies do not move in single segments. There is a connection within all muscles, fascia and tissues. Rarely can we find an answer in one single joint or muscle.
My favorite part of my job is teasing out all the possibilities that could be a player in the pain or dysfunction that patients feel. Every person is different, and a puzzle to dissect to resolve their concerns. At Foundational Concepts Specialty Physical Therapy that is what we do. Our specially trained therapists are here to get to the bottom of your pain, and find the driver to help you heal.
Sarah Dominguez PT, MSPT, CLT, WCS