Hello Obturator!

Understanding the Obturator Internus: The Hidden Muscle Behind Hip and Back Pain

When we think of muscles that impact the hips or lower back, we often imagine the glutes, hamstrings, or hip flexors. But one lesser-known player in this complex system can be a major source of discomfort: the obturator internus. Despite its small size and deep location, this muscle can contribute significantly to hip instability, pelvic floor dysfunction, and nagging back pain.

What Is the Obturator Internus?

The obturator internus is a deep pelvic muscle that originates on the internal surface of the obturator membrane (a bony structure of the pelvis) and exits the pelvis through the lesser sciatic foramen. From there, it wraps around to attach on the greater trochanter of the femur (the outer part of the hip bone).

It is one of the six deep lateral rotators of the hip and is part of both the pelvic floor complex and the hip stabilizing system.

What Does It Do?

The obturator internus plays a few essential roles:

• Hip external rotation: It helps rotate the thigh outward, especially when the hip is flexed.
  
  

• Pelvic stabilization: It supports pelvic floor function by contributing to the closure and stability of the pelvic outlet.
  
  

• Hip and back coordination: It helps stabilize the femur in the hip socket during movement, supporting spine and pelvic alignment.
  
  

When Things Go Wrong

When the obturator internus becomes tight, overactive, or weak, it can cause a cascade of problems:

• Hip pain or deep buttock pain: Often felt as a deep, hard-to-pinpoint ache near the sit bone or inner glute.
  
  

• Lower back discomfort: Especially during activities involving rotation or single-leg movements.
  
  

• Pelvic floor dysfunction: Since it shares fascial connections with pelvic floor muscles, tension in the obturator internus can contribute to issues like pelvic pain, urinary urgency, or pain with intercourse.
  
  

• Sciatic-like symptoms: Due to its proximity to the sciatic nerve, dysfunction can mimic nerve pain.
  
  

Common Causes of Obturator Internus Dysfunction

• Prolonged sitting or poor posture
  
  

• Childbirth or pelvic trauma
  
  

• High-impact sports or repetitive hip rotation
  
  

• Chronic pelvic tension or pelvic floor disorders
  
  

How to Treat It

Treatment of obturator internus dysfunction often involves:

• Pelvic floor physical therapy: A specialist can assess internal pelvic muscle tone and function.
  
  

• Manual therapy: Myofascial release and trigger point work (both internally and externally).
  
  

• Targeted stretching and strengthening: To improve balance between hip rotators and the surrounding musculature.
  
  

• Neuromuscular re-education: To retrain the brain-muscle connection and promote healthy movement patterns.
  
  

Final Thoughts

The obturator internus may be hidden deep in the body, but its influence is far-reaching. If you're experiencing stubborn hip, pelvic, or back pain that hasn’t responded to typical treatment, it may be time to look deeper—literally. Working with a trained pelvic floor or orthopedic physical therapist can help uncover and address the true source of your pain.