Pelvic Floor and Pelvic Wall Overactivity
We know that the pelvic floor muscles are a hammock-like group of muscles within our pelvis that extend from our tailbone to our pubic bone and fan out to our sit bones. These pelvic floor muscles exist to support our pelvic organs as well as to provide pelvic stability and support for our spine.
Another group of muscles exist within the pelvis and are referred to as the pelvic wall muscles. These include muscles named coccygeus and obturator internus. The pelvic floor muscles stick onto these two pelvic wall muscles.
- Coccygeus attaches from the tailbone and spreads out towards the sit bones. It is one of the muscles that tightens in those of us called 'butt grippers'. It is the muscle we are trying to relax when we say "widen your sit bones".
- Obturator internus attaches from within the pelvis (inside the base of your pelvic bowl) and heads down toward the top of the leg bone at the hip. This makes it an outward rotator of the hip. This muscle switches on when we are rolling the leg out in exercises like the 'Leg roll out and in' and 'the clam'.
If someone has pelvic pain or a long-standing hip pain, there is often a dysfunction within the pelvic floor muscles and/or the pelvic wall muscles. Sometimes the strength of these muscles is not the main issue, but rather that they are already switched on or are contracting even when we are relaxed or at rest. If these muscles stay switched on for long periods of time and especially during episodes of pain, they can start to spasm and develop trigger points and tightness, which can continue the cycle of pain.
Because the obturator internus muscle has nerves that pass by it, you may develop pain or numbness in the front thigh when the muscle is in spasm. Some people may have bladder pain or strong urges to empty their bladder. Increased frequency to empty their bladder is another common side effect of this muscle over-activity. It can often produce a burning sensation in the inner areas of your pelvis if it is in spasm.
Sometimes if these pelvic wall muscles spasm, the pelvic floor muscles can also spasm because all these muscles are joined together. So even though you may have weakness in your pelvic floor muscles, you can also have spasm and trigger points along them. This is no different to muscle 'knots' or trigger points in the large neck and shoulder muscles that we can all feel after long bouts sitting at the computer.
Managing this type of pain and over activity is therefore no different to seeking treatment from your physio or masseur for your neck pain and tightness. Just like having treatment to release tight muscles in the neck, these pelvic floor and pelvic wall muscles need to be released.
This is best done by seeing a Women's Health or Men's Health Physiotherapist.