The obturator internus does not get the same respect and care that the quads, pecs and abs receive for 2 reasons — 1. The muscle cannot be seen or flexed in the mirror. 2. Most people in the rehabilitation and fitness world do not understand its anatomy and function. To make this simple, the obturator internus, piriformis, levator ani and coccygeus form the pelvic diaphragm and are intimate with the organs and glands of the pelvis. These muscles also play an important role in sports performance via stabilization of the pelvis.
Obturator Internus Muscle
The obturator internus is a fan shaped muscle that originates on the medial surface of the pubis around the obturator foramen, runs posterior-lateral and attaches to the inner surface of the greater trochanter of the femur; not to mention all of its many, important fascial connections. The obturator internus along with 5 other muscles are categorized as the “deep six’ creating external rotation of the hip, flexion or extension, abduction and is an important stabilizer of the hip joint.
The Pudendal Nerve And Alcock’s Canal
The internal pudendal vessels and pudendal nerve cross the obturator internus and are enclosed in a special canal called Alcock’s canal formed by the obturator fascia. The pudendal nerve is from the branches of S2, S3 and S4. It provides motor innervation to the muscles of the perineum and is the primary sensory innervation to the genitalia. The pudendal nerve often gets “trapped” by the fascia of the obturator internus causing all sorts of strange pelvic symptoms. Several of you may be having “ah ha moments now.”
Pudendal Nerve And Neuralgia
To respect the obturator internus as well as the pudendal nerve and how it can cause pelvic symptoms, we need to take this further. The pudendal nerve branches into 3 smaller nerves: 1. The inferior rectal nerve — supplying the rectum, skin and anal sphincter 2. The perineal nerve — supplying the perineum, vagina, urethra, male scrotum and labia 3. The dorsal never — supplying the clitoris or penis. The sensory symptoms could manifest as itching, burning, tingling, cold sensations or shooting pains into the groin, abdomen, legs or buttocks. The pudendal nerve is the only nerve that has both somatic (body) and autonomic fibers; meaning the person may not just suffer the issues above, but also things like increased heart rate, blood pressure, constipation and overall sense of malaise.
Treatment Of Obturator Internus
If you are experiencing any of the above symptoms it is important to find a manual therapist that knows how treat the area. However, “YOU” are always your best therapist. So, hopefully the manual therapist can also show you how perform myofascial stretching of the obturator internus to affect all of its many fascial attachments. The obturator internus also needs to be reinforced with exercise. It can be reinforced in an open chain position which is great for sports performance and in a closed chain position which is amazing for pumping and having a positive affect on the organs and glands of the pelvis.
Obturator Internus Myofascial Stretch
As you can tell, the obturator internus is very complex and a skilled therapist should be consulted. However, I would like to leave you with a photo of a proper myofascial stretch of the obturator internus.
There are many intricacies to this stretch, so please contact Hellman Holistic Health at 954.566.0585 or email us at firstname.lastname@example.org to set up your free consultation or receive a referral for a practitioner in your area.
Better Body. Better Obturator Internus. Better Life.
Dan Hellman, MSPT, C.H.E.K Faculty