I have an obturator internus?

By Bryn Zolty, PT

​I hear this question all day. You are in the majority if you have no idea where this muscle is! I didn't know I had an obturator internus muscle until becoming a pelvic therapist.  ​

The reason most people do not know the obturator internus is because this muscle is the lateral border of the pelvic floor. ​

The obturator internus sits inside the pelvis and travels around out the back of the pelvis to the femur (thigh bone). This muscle rotates the hip out, moves the leg wide when it’s forward, and stabilizes the hip.  ​

The obturator internus can become tensioned or spasmed from overworking, muscle imbalances, injuries, and postural changes.  

Some symptoms of obturator internus muscle tension include:

• Hips that feel tight and your feet always seem to be rotated out
• Lateral hip pain, can be mistaken for IT band syndrome/bursitis
• Pain in the tailbone
• Pain in the groin
• Sit bone pain

The obturator internus has many pain referral sites. So symptoms can vary from one day to the next.

Other symptoms that would indicate that you should be checked for tension in the pelvic muscles include:

• Urinary urgency
• Urinary frequency
• Urinary incontinence 
• Painful intercourse 

I commonly see high-level athletes hold tension in the obturator internus muscle. Gymnasts, horseback riders, spin class cyclers, runners, and dancers tend to have spasms here. In any post-operative hip surgery in which rotation is limited, as with a hip replacement, this muscle can be a source of pain or contribute to the onset of urinary incontinence.

I find that many patients have gone to traditional PT and had no relief. Some have had X-rays, MRI, and injections. 

During an internal pelvic floor evaluation, when the muscle is pressed on by the therapist, it often reproduces the pain the patient has been experiencing. Many patients are relieved to find out where the pain is coming from and that it is easily treated.  

I think back to my orthopedic treating days and wish I could have sent all of my patients with hip pain not finding relief with traditional methods, and referred them to a pelvic PT. Besides a Gynecologist or Urogynecologist, a pelvic PT is the only person checking manually to see if the obturator internus is a source of pain.

I have a special interest in the obturator internus because of personal experience with symptoms. Always having a tendency towards muscle tension, after pregnancy and abdominal diastasis weakness, my usual exercises resulted in pain. Pain in the hip, painful sitting, and when enough tension builds I am scared to sneeze! But these muscles can be stretched and released, and the muscle imbalances restored.  

If you have any of these symptoms, seek a pelvic physical therapist. A quick evaluation of the pelvic muscles can rule in or out the obturator internus and a treatment plan can be made for you.