Obturator Internus: The OTHER Pain in the Butt
Do you have posterior hip pain? Posterior pelvic girdle pain? Or just old fashion pain in the butt??
Have you been told that it’s your piriformis or the more intense sounding piriformis syndrome? Have you had multiple practitioners work on your piriformis and it hasn’t resolved, or it has improved 50-65%, but won’t go away? It may not be your piriformis.
The piriformis muscle is a posterior pelvis/hip muscle that performs external rotation. The obturator internus (OI) is a hip muscle that originates deep within the pelvis, wraps out and inserts on the posterior aspect of the head of the femur (the thigh bone). The OI’s main function is to rotate the leg externally but is also has a major role in stabilizing the head of the femur into the hip socket for activities such as walking.
In my clinical experience I have seen many people who had tried it all stretching, injections, sitting on lacrosse balls, etc and their pain or decreased muscle activation won’t go away or stay gone. That’s because they aren’t dealing with problem or all of the problem. The OI and piriformis work together and sometimes it can be chicken and the egg situation where after a while you don’t know which was having difficulty first, but now they both are and only one is getting the attention. The OI can also refer pain to the vaginal canal, the urethral area or even down the thigh from the pelvis. So these may be diagnosed as UTI or sciatica. See how confusing it can be?
There is only a sliver of the OI muscle that can be palpated or treated externally, the vast majority of the muscle is deep inside the pelvis. Now that doesn’t mean that it can’t be worked on and helped. You just need to find the right expert for the job, like a Pelvic PT. We can assess both the OI and piriformis, see where the problem is and make sure they are working together and with the rest of your pelvis.