The Obturator Internus Muscle & Pelvic Pain: What You Need to Know

Clinically reviewed by Alison Hayman, PT and Ariel Wynne, PT  

If you’re pregnant or postpartum and navigating new aches and pains, there’s a small but mighty muscle you’ve probably never heard of that could be the source of a lot of discomfort. Say hello to the obturator internus.

This hip muscle is a part of the back wall of your pelvic floor and it plays a big role in stability, mobility, and even how your pelvic floor functions. When it’s tight or not functioning well, it can contribute to pelvic pain, hip issues, or even affect your nervous system. But here’s the good news: there are ways to stretch it, treat it, and release it, especially through physical therapy.

Let’s break it down.

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What is the Obturator Internus muscle?

The obturator internus is a deep hip muscle that starts at the inner wall of the pubic bone, runs behind the sit bone (ischium), and attaches to the back of the thigh bone (femur head). Individually it works to rotate your hip out (external rotation) and move the leg out to the side (abduction). Functionally, it works together with your other hip muscles to stabilize the pelvis and hip joint to keep you upright and balanced while you are moving around throughout the day. 

The internal part of the obturator internus connects to your pelvic floor muscles. This gives it a unique relationship to any pelvic floor dysfunction you might be experiencing, whether that is pain or weakness.   

Symptoms of Obturator Internus dysfunction

When the obturator internus muscle isn’t functioning properly, it can create a cascade of issues that affect your whole body, from your musculoskeletal system to your central nervous system.

You might experience:

• Pelvic pain (especially deep in the hip or buttocks)
• Pain with sitting, squatting, or crossing legs
• Pain during or after sex
• Groin or tailbone pain
• Tingling or numbness in the buttocks, genitals, or perineum due to pudendal nerve irritation or tingling or numbness in inner thigh due to obturator nerve irritation
• Postpartum discomfort that just won’t go away

Obturator Internus treatment

Treatment for the obturator internus depends on what’s causing the dysfunction, but a great first step is connecting with a pelvic floor physical therapist. These specialists understand how the obturator internus, and surrounding muscles work together to support the pelvis.

Physical therapy for Obturator Internus pain

Physical therapy is often the most effective and sustainable option for managing obturator internus dysfunction. A skilled therapist will assess alignment and muscle imbalances, identify movement patterns that strain the pelvic floor, use manual therapy to release tension, and guide gentle, targeted exercises to improve hip and pelvic stability. 

The therapy often includes internal release, which sounds intense but is done with care and consent. It involves applying pressure to the muscle through the vaginal or rectal wall to relieve tightness and improve blood supply from the internal pudendal artery.

Treatment plans will be customized to each patient but will often include:

1. Myofascial release (internal and external)

The myofascial system is like a web of connective tissue that surrounds muscles. When the obturator internus is tight or strained, this fascia can become restricted.

• External release involves hands-on techniques around the sit bones, glutes, and inner thigh to soften surrounding tissue and improve muscle mobility.
• Internal release is often performed vaginally (or rectally, if needed) to access the muscle directly. The therapist applies slow, sustained pressure to tender points in the pelvic wall, which helps release tension and reduce nerve compression (especially around the pudendal nerve).

Myofascial release may sound intimidating, but many clients report it as surprisingly relieving, and often the missing link in resolving stubborn pelvic pain.

2. Tender point therapy

Tender points are tight “knots” in the muscle fibers that refer pain elsewhere. This pain is often felt deep in the hip, pelvic floor, or even down the leg.

• Your pelvic floor therapist may locate these points through palpation (external or internal).
• Gentle, sustained pressure is applied until the muscle “lets go.”
• It’s often paired with guided breathing to calm the nervous system and reduce reflexive muscle guarding.

Tender point therapy can reduce chronic pain patterns and improve blood flow to the area from the internal pudendal artery.

3. Strengthening of supporting muscles 

If the obturator internus is overworking, it’s usually because nearby muscles aren’t pulling their weight. Likely contenders for lazy neighbors include:

• The Deep six: a group of muscles located deep within the hip joint
• The levator ani: the primary muscles of your pelvic floor
• The transverse abdominis (TrA): a deep abdominal muscle that plays a crucial role in stabilizing the trunk and supporting internal organs.

Your pelvic floor therapist might guide you through strengthening exercises that target these synergistic muscles, such as:

• Side-lying leg lifts for the gluteus medius located on the side of your hip
• Bridges with pelvic floor cues
• Core and balance exercises to support your skeletal system and spine
• Breath-based work to support the respiratory system and regulate your central nervous system

The goal isn’t to strengthen the obturator internus in isolation, but rather to get all your muscles working together again.

4. Postural and mobility retraining

Pregnancy and postpartum often shift our alignment: hello, swayback and clenching! Over time, this overloads certain muscles like the obturator internus.

A physical therapist will assess:

• How you sit, stand, and move
• Your core engagement and breathing patterns
  Compensation from muscles like the gluteus maximus, gluteus medius, and quadratus femoris

You'll work together to re-train movement patterns and reduce strain on your pelvic floor and hip stabilizers.

5. Breathing techniques 

Chronic pelvic pain isn’t just about muscle tension; it often involves an upregulated nervous system and breathing techniques can help to regulate the respiratory system and calm the nervous system. Your physical therapist may integrate:

• Diaphragmatic breathing to downshift the stress response
• Vagus nerve stimulation through vocalization, humming, or certain breath patterns
• Nervous system education to help you feel safe and supported in your body again

Breathing techniques can beespecially helpful if your pain has been lingering postpartum or feels tied to anxiety or overwhelm.

How to internally release the Obturator Internus

An internal release should always be done by a trained provider, such as a pelvic floor physical therapist. During the session:

• You'll be guided through breathwork to relax the muscle fibers
• The therapist will use gentle, sustained pressure to reduce tightness
• This may be combined with trigger point therapy and gentle stretching

This can bring significant relief for postpartum people experiencing unresolved pelvic or spinal cord-related pain.

How to stretch the Obturator Internus at home

If you’re looking for at-home support, try these gentle stretches:

1. Seated Figure 4 Stretch

Sit tall, cross one ankle over the opposite knee, and gently press down on the top leg. You should feel a stretch in the deep hip region.

2. Happy Baby Pose

Lie on your back, grab the outside edges of your feet, and gently pull your knees toward your armpits. Great for pelvic floor release.

3. Pigeon Pose

This yoga pose opens up the hip and stretches the obturator internus and surrounding muscles. Modify with props as needed, and remember that comfort is key.

4. Seated Knee hug stretch

Sit on the floor with both legs out straight like this. Bend one knee up to your chest and cross that foot to the outside of your opposite knee. Hug the knee to your chest until you feel a deep stretch in your gluteal muscles. 

Your pelvic floor and hip muscles are incredibly interconnected. The obturator internus may be hidden deep within the body, but when it’s out of balance, it can make its presence known in a big way. If you’re experiencing unexplained pelvic pain, don’t hesitate to reach out to a pelvic floor physical therapist to help you reconnect with your body, reduce pain, and feel more like yourself again.