pelvic hip pain

Hips and the Pelvic Floor

April 29, 2024

Hip Dysfunction: Is Your Pelvic Floor the Missing Link?

Hip structure and function directly impact the pelvic floor. Based on proximity alone, the pelvis and hips are closely related. Their muscle groups are interconnected and overflow into each other. Hip dysfunction can contribute to pelvic floor dysfunction and vice versa. Pelvic floor muscles are smaller, serve to promote continence, and support our internal organs. Hip muscles are larger and help us produce movement to ambulate throughout our life. If hip muscles are underactive, they can cause the pelvic floor to become overactive by not providing the stability it needs.

Hip strength is vital for pelvic floor function.Hip range of motion is also important to pelvic floor function. Hip flexibility is a good indicator of pelvic floor muscle activity and continence. If hip flexibility is decreased, pelvic floor muscles will not be working in their fullest capacity. In pelvic floor physical therapy, we work to assess what contributions are occurring from the joint above (low back) and below (hips). Someone who experiences pelvic floor dysfunction likely have some dysfunction in the low back or hips.

Conversely, someone who experiences back pain or hip problems will likely have an underlying pelvic floor dysfunction based on the proximity of these regions. Patients with hip problems (or those post-hip replacement) may report a deep, aching hip pain that does not resolve with only external treatments. This is pain potentially stemming from hip muscles that can be accessed within the pelvic floor. If we neglect pelvic floor contributions to hip pain, how would we expect our patients to get back to 100%?

Pelvic floor physical therapy can resolve hip-related dysfunctions by assessing the pelvic floor, hips, and low back to determine the best plan of care for a patient. We address hip mobility and strength, core strength, pelvic floor muscle tone and coordination, and pain management strategies to give you a holistic treatment method. Physical therapy can be considered a conservative treatment for those who may need a hip replacement. Reach out to us if you have any questions regarding treatments and approaches to the pelvic floor. Pelvic floor physical therapy may be the missing link to you living a pain-free life.

Cibulka MT, Sinacore DR, Cromer GS, Delitto A. Unilateral hip rotation range of motion asymmetry in patients with sacroiliac joint regional pain. Spine (Phila Pa 1976). 1998;23(9):1009-1015. doi:10.1097/00007632-199805010-00009

Ike, Hiroyuki MD; Dorr, Lawrence D. MD; Trasolini, Nicholas MD; Stefl, Michael MD; McKnight, Braden MD; Heckmann, Nathanael MD Spine-Pelvis-Hip Relationship in the Functioning of a Total Hip Replacement, The Journal of Bone and Joint Surgery: September 19, 2018 – Volume 100 – Issue 18 – p 1606-1615 doi: 10.2106/JBJS.17.00403

Reiman MP, Matheson JW. Restricted hip mobility: clinical suggestions for self-mobilization and muscle re-education. Int J Sports Phys Ther. 2013;8(5):729-740.

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