Did you know that the function of your hips affects the function of your pelvic floor muscles?!
The pelvic floor muscles are directly connected the muscles of the hip. One of the deep rotators of the hip, the obturator internus (OI), attaches the hip to the pelvis via the pelvic floor muscles. The pelvic floor muscles sit at the base of your pelvis spanning from pubic bone to tailbone and sitz bone to sitz bone. These muscles provide support to your internal organs, play a role in postural stability, make up a portion of the deep core system, and are important for bladder, bowel, and sexual function.
When muscle imbalances are present in the hips or the pelvic floor, pain, dysfunction, and other compensations can occur! Low back pain is also a common complaint that often occurs along with hip pain or pelvic floor dysfunction. A study done by Eliasson, et al. in 2008 found that 79% of women with recurrent low back pain also experienced urinary incontinence.
When it comes to hip pain or low back pain, it's important to also assess and treat the pelvic floor muscles. Also, when it comes to pelvic floor issues, it's important to assess and treat the hips and low back. It is very common for women to come into see me that complain of hip pain and painful intercourse or hip pain and urinary incontinence. This is due to this connection of the pelvic floor and hip muscles.
Improving Hip Range of Motion for Happier Hips & Pelvic Floor!
One of the most common limitations I see is limited hip internal rotation (where the knee moves in, and the foot moves out). Hip internal rotation opens the pelvic outlet (bottom of the pelvis) and helps to lengthen the pelvic floor muscles. This can be especially helpful for individuals who tend to have increased tension in the pelvic floor muscles.
You can test yourself by lying down on your back with your knees and hips elevated to a 90/90 position. Rotate your knee inwards as your foot moves outwards. Try both sides. Are they equal? Are you more limited on one side or the other? Do you get pain or pinching in the hip?
"Normal" hip internal rotation is ~35 degrees. However, everyone's "normal" is different. This is why I always recommend comparing side to side. So, if you do the test and notice one hip moves a lot better into hip internal rotation than the other, then that's a sign that you may need to work on improving your hip internal rotation on the limited side. This might be especially important if you are also experiencing symptoms such as hip pain, low back pain, painful intercourse, tailbone pain, or urinary incontinence.
Here are a couple exercises that might help improve hip internal rotation range of motion:
Improving Hip Strength for Happier Hips and Pelvic Floor!
The hip muscles have a very important role in stabilizing and controlling the pelvis and facilitating proper function of the hip joint. With every step that you take, the outer glute muscles are helping to stabilize your pelvis so your opposite hip doesn't drop or you don't fall over. When the hip muscles are weak or aren't functioning properly, the pelvic floor might take on extra stress to try and stabilize the pelvis. This might lead to an over-worked and tense pelvic floor. Ultimately, we want to make sure the hip muscles are strong and doing their job properly so that the pelvic floor muscles can work effectively as well.
Hip Airplanes are an exercise that helps teach you how to use your outer hip muscles to control the pelvis through rotation.
Glutes, glutes, glutes! We need glutes that can fully lengthen & contract. Strong, properly functioning glutes are crucial to a happy pelvic floor!
Happy Hips = Happy Pelvic Floor!! If you are someone that has experienced pelvic floor dysfunction (leaking urine, painful intercourse, constipation or difficulty with peeing or bowel movements, etc.) and you were just told to "do kegels" without improvement, there is SO much more to pelvic floor issues than kegels. We have to look at the whole picture because everything is connected. So, if you've tried kegels and your symptoms didn't improve or worsened, then you likely need something different! Sometimes we have to look beyond the pelvic floor to get to the root cause of someone's symptoms!
If I can help you, please send me an email at restore.physicaltherapy614@gmail.com and I'd be happy to talk with you about how we can work together!