Obturator internus pain: causes, symptoms, exercises

A deep, aching pain in your butt, hip, or pelvic area can be frustrating, especially when it’s hard to pinpoint exactly where it’s coming from. It can also make it more challenging to treat and stay active.

In many cases, this type of discomfort may be related to the obturator internus, a small but important muscle deep in your pelvis that plays a key role in hip movement and pelvic stability. “It’s something I think about with many patients who have hip or pelvic pain,” says Brea Rhein, PT, DPT, a physical therapist with Hinge Health.

When it comes to obturator internus pain, movement is medicine — it can help you manage symptoms. Learn how to manage obturator internus pain, especially with targeted exercises recommended by Hinge Health physical therapists.

What is the obturator internus muscle?

The obturator internus is a deep hip muscle located inside your pelvis. It helps rotate your hip outward and stabilize your pelvis during movement.

“It’s not technically a pelvic floor muscle, but it works very closely with that group,” explains Dr. Rhein. “It runs from the inside of your pelvis and attaches the outside of the pelvis to your hip joint.”

Because of its location and function, obturator internus pain is often mistaken for other conditions, like sciatica or sacroiliac joint issues. “It can also show up as hip or low back pain, which can make it harder to identify as the source of pain,” says Dr. Rhein.

Causes of obturator internus pain

Obturator internus muscle pain can occur due to a number of factors, many of which can be addressed with regular movement and targeted exercises, says Dr. Rhein. 

Common contributors include:

• Pelvic floor tension or dysfunction. Because the muscles of the pelvic floor and the obturator internus work closely together, changes in pelvic floor function can affect the obturator internus. “If the pelvic floor is tight or not functioning well, it can increase strain on this muscle,” says Dr. Rhein.

• Prolonged sitting or pressure. Sitting for long periods of time or sitting with sub-optimal posture can also lead to stiffness and discomfort in this muscle. 

• Hip overuse or repetitive movements. This muscle helps stabilize your hip and pelvis during activity. Repeated strain — especially without enough recovery — can irritate it. “If you push it beyond its movement sweet spot, or the level of activity it's prepared to do without strain, it can feel sensitive,” says Dr. Rhein.

• Pregnancy. During pregnancy, your pelvic muscles take on more load and adapt to your growing belly. These changes are normal and can increase strain on surrounding muscles like the obturator internus.

• Injury or trauma. This muscle can be strained (or in severe cases, torn) during activities that involve quick direction changes, such as in sports like soccer. It may also become strained during vaginal delivery.

• Stress or anxiety. Stress and anxiety can lead to muscle spasms or tension anywhere in your body. “In some cases, you may subconsciously clench your obturator internus muscle when you’re under a lot of stress or feeling anxious,” says Dr. Rhein. This can lead to discomfort in the area. 

Symptoms of obturator internus pain

“Obturator internus pain can feel similar to other conditions, such as sciatica or hamstring issues, which is why it’s sometimes overlooked,” says Dr. Rhein. Not everyone will experience the same symptoms, but the most common ones often include: 

• Deep aching or sharp pain in the butt, hip, or pelvic area

• A “pinching” or pressure-like sensation deep in the pelvis

• Pain with sitting, especially on hard surfaces

• Discomfort around your sit bones

• Pain that radiates to the groin, inner thigh, or back of the leg

• Discomfort with movements like crossing your legs or getting in and out of a car

• Symptoms that overlap with pelvic floor issues, such as discomfort with bowel movements, urination, or intercourse

How movement can help with obturator internus pain

When you’re dealing with deep hip or pelvic pain, it’s understandable why you might feel reluctant about moving — or worry that physical activity might make things worse. But in most cases, the right kind of movement, and at appropriate doses, can actually help calm symptoms and improve how your body feels and functions.

The obturator internus works closely with your hip muscles and pelvic floor, so when it becomes irritated or overactive, it can affect how these areas move together. Targeted exercises can help restore that balance — improving strength, flexibility, and coordination.

Movement also helps increase blood flow to tender areas, which supports tissue health and can reduce muscle tension. Just as importantly, it can help your nervous system become less sensitive to pain over time.

“It’s not just about stretching or strengthening one muscle,” says Dr. Rhein. “It’s about helping the whole system work better together.”

That’s why a combination of mobility work, relaxation techniques (like diaphragmatic breathing), and gradual strengthening tends to be most effective. Finding your movement sweet spot can help you stay consistent and build confidence as you recover.

Over time, this approach can make everyday activities like sitting, walking, or getting in and out of a car feel more comfortable.

These exercises work together to improve flexibility, reduce tension, and support muscle coordination. Hip-opening movements like happy baby, butterfly, and deep squat help release tightness, while figure four and pigeon target your deeper hip rotators. Reverse Kegels help retrain your body to relax these muscles — which is just as important as strengthening.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for obturator internus pain

Obturator internus pain treatment usually consists of at-home treatments such as physical therapy with targeted exercises, activity and lifestyle modifications, heat or ice, and complementary treatments. Here’s what Hinge Health physical therapists recommend.

• Try physical therapy and targeted exercises. Targeted exercises, such as the ones above, can help release tension from your obturator internus, and surrounding muscles. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. “Gentle movement like walking will help to maintain your obturator internus muscle’s function as it heals,” explains Dr. Rhein. Even light stretching and doing everyday movements like household chores can increase blood flow to tender areas.

• Apply heat or ice. If obturator internus pain is due to a recent strain or injury, try applying ice or cold therapy for the first 48-72 hours to reduce inflammation and swelling, says Dr. Rhein. After that, moist heat can encourage blood flow to the area and relax your tight obturator internus muscle. Try both methods, or stick to the one that works best for you. 

• Take over-the-counter (OTC) medication as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have obturator internus pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.

• Modify your activities. If you have obturator internus pain, you may find it hard to do activities where you have to swing your leg, like getting out of the car or out of bed, says Dr. Rhein. Your PT can show you ways to adjust how you do these activities temporarily.

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for obturator internus pain relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce obturator internus pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How to prevent obturator internus pain

Reducing strain on your obturator internus comes down to supporting how your hips, core, and pelvic floor work together. A mix of strength, mobility, and mindful movements can help keep this muscle from becoming overworked or irritated. Here’s what Hinge Health physical therapists recommend:

• Pair strength with mobility. Building strength in your hips and core helps support your pelvis, but flexibility matters too. “It’s important to strengthen these muscles without letting them become too tight,” says Dr. Rhein. A combination of strengthening and stretching can help your muscles stay balanced and move more efficiently.

• Tweak your sleep position. Small adjustments can reduce overnight strain. “If you’re a side sleeper, placing a pillow between your knees can help relax the muscles around your hips and pelvis,” says Dr. Rhein.

• Take movement snacks often. Sitting for long periods can keep your lower-body muscles in a contracted, tense position. Taking a movement snack break, such as refilling your water bottle or doing some desk stretches, every hour or so helps restore blood flow to tense areas and reduce stiffness.

• Address pelvic floor symptoms early. Because the obturator internus works closely with your pelvic floor, changes like urinary urgency, leakage, or constipation can be early signs that something’s off. A pelvic floor physical therapist (PT) can help assess and address these issues before they lead to more persistent pain.

• Use supportive seating when needed. If sitting is uncomfortable, a donut or coccyx cushion can help reduce direct pressure on the area and make it easier to stay comfortable throughout the day.

• Pay attention to how you move. Habits like clenching your muscles, holding tension, or pushing through discomfort can keep the area irritated. Practicing relaxed, controlled movement — including steady breathing — can help reduce unnecessary strain.

When to see a doctor

Obturator internus pain often improves on its own with simple management. But if your pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Severe pain with bowel movements, urination, or sexual activity

• Loss of bladder or bowel control 

• Numbness, tingling, or weakness in your leg or pelvic area

• Symptoms that significantly interfere with your ability to sit, walk, or do other daily activities

PT tip: try muscle release techniques 

Gentle, targeted pressure can help your obturator internus and pelvic floor muscles relax and ease tension. There are a few ways to do this, depending on your comfort level:

• Externally: A lacrosse ball or similar firm ball can be used to apply pressure to tight spots around your hip and glutes. Simply sit on the ball with it positioned just inside your sit bone, pressing into any areas that feel tense.

• Internally: A pelvic wand is a curved tool designed to release tension in deeper pelvic muscles. It can be a helpful option when external methods aren't reaching the source of discomfort.

"Both approaches can help decrease tension in the hip and pelvic muscles," says Dr. Rhein. A physical therapist can help you figure out which option — or combination — works best for your needs and comfort level.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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