Deep groin pain and deep hip pain are commonly seen in pelvic floor dysfunction while many think of pelvic floor dysfunction as incontinence and pain in the pelvis. But if pelvic floor dysfunction was the name of a book, there are many chapters and incontinence is simply one of the any chapters. Deep groin pain and deep hip pain are commonly seen with issues related to a major pelvic floor player (muscle) called Obturator. Obturator muscles are on both sides of the pelvis, the inside and outside, and play a role in hip stabilizers.
Where is the Obturator Muscle?
If you think of the pelvis, from the outside, just to the outside of the pubic bone and in the groin area is a soft spot which is the Obturator Externus. From the inside, the muscle is referred to as Obturator Internus. Both of these muscles get their nerve supply from the nerves coming off the second, third, and fourth vertebra in the lower back.
Once exiting the spine, this nerve goes along the rim of the pelvis, through a hole called Obturator foramen going to the inner thigh muscles. It makes those muscles move and provides sensation to the inner thigh as well as the inner part of the knee.
Obturator muscle (courtesy of https://oac.med.jhmi.edu/)
Why is the Obturator Muscle Important in Pelvic Floor Dysfunction?
The Obturator Internus is very close to the Pudendal nerve and any trigger points in this muscle can cause irritation of the pudendal nerve. This means that any of the 3 branches of the pudendal nerve become fair game. You should check out my blog: “Who diagnosis and treats Pudendal Neuralgia’ for more details about Pudendal nerve, and know that pudendal nerve issues can be felt around the:
- Vagina/penis
- Rectum
- And/or the tissue in between
Now, it is not an easy nerve to treat and it is best to avoid anything that leads to its irritation to say the least. Common occasions when the Obturator muscle gets injured are:
- Running
- Biking
- Disc disease
- Spinal stenosis
- Scars
- Hip injuries
- Lack of mobility
Any occasion that leads to an imbalance of the pelvis is grounds for all muscles of the pelvis, including the Obturator muscle, to become problematic. The Obturator internus and its trigger points can cause symptoms such as urinary frequency and burning. Other common symptoms include itching, tingling, and shooting pains in the groin, abdomen, and other areas such as the hip, low back, and groin pain.
If you have been experiencing deep hip and groin pain and your attempts to get rid of it have not worked, give us a call.
Dr. Shakib
