Excellent! I particularly appreciate all you share specifically concerning your practice with clients - what you do, how you do it and why. So glad I found you!
Had total hip replacement 2016.I have a lot of pain on the inside near the groin in the bend of my leg. Had an examination for hernia not found. This sounds like what it might be. Thanks a million for your video.
Yea I always tell people DO NOT get any type of replacement surgery, it destroys the joint you're trying to fix ( they can't reattach muscle to titanium) get stem cell or other regenerative treatments and blood flow (movement)
Really interesting and well presented - thank you. I discovered my obturator internus last week after walking/jogging - could hardly walk for a couple of days. It's recovering, but I have no idea how it happened, so don't know how to mitigate for the future. Any suggestions? Squats have helped.
Hi Diane, thankyou for your comment, appreciate it. Good to hear its recovering, they can be tricky little injuries, as they are so deep under all the other hip muscles ect. Typically the deep hip stabilizer injurie are a result of a, End range of movement ballistic movements with rotation (kicking with twist), or end range of movement static postures held over long periods of time (sitting crossed legged on a chair), b Pelvis instability, often post a lower back injury and or post partum (the orientation of the femur and pelvis is slightly off), C traumatic injury, fall, ( missing a step and the leg fully extends and gets jammed) D, idiopathic....ie no one really knows, sometimes we just get hurt. In either case if pain still persists id get it check by either a good physio or chiropractor. In terms of future mitigation I'm a big fan of Pilates (depending on the instructor), functional strength training, depending on your preference ect. Hope that helps, please let me know if I can provide any further assistance. Cheers Drew
Thanks so much for that comprehensive reply - really helps my understanding . I'm going to try a recommended sports physio. I'm more yoga than Pilates, but will give P a shot!
Amazing video! I’ve had a hip impingement on my left side with a pinch in the front crease of the hip. Been working on my gluts doing shallow squats and have felt/heard clicking across by sit bone. It doesn’t hurt but was wondering if it could be the ligaments around the obturator. When I point my toes out during the squat the clicking goes away. Am I doing any harm if it keeps clinching?
Great to see you enjoyed the video :). Sounds like you are doing the right adjustments to your squat to me. Depending on your structure of your hip joint, many folks do feel better with a slightly wider stance, with feet turned out a little. There is no one absolute correct position, so it does take a little testing. The clicking across the sit bones is probably more tightness through the hamstrings / Glutemax, but could aso be the ligaments for sure. combining squats with some good mobility and glutes / hamstring stretches can help alot..as you get stronger across the hips you'll find that the clicking may just go away. Some of my clients with Hip impingement issues do respond well to heel elevated squats as it increases the ROM and joint angles. We typically do this using 1-2 weight plates on the floor, heels on the edge of the plates. hope that helps. Cheers Drew
Thank you so much for the information. I have obturator externis muscle pain on my left side. I am presently doing physiotherapy with a pelvic floor physiotherapist who works with me internally to relieve some of the pain. Is there any type of exercise I can do externally at home myself to ease the pain of the obturator externis muscle.
Hi Peggy, cheers for your question. Good to see you are working with a pelvic floor physio :). In terms of exercise its always a little tricky prescribing exercise without first assessing ect. However to get those pelvis rotator muscles working well I'm a big fan of clinical based Pilates as there's an integration of the core - pelvic floor - pelvic stabilizers and pelvic rotators. So if you have a Pilates studio close by I'd consider that. In terms of a simple exercise you can trial your self at home the basic "clam shell" exercise has some good variations on how to "isolate" the hip rotators. Another good option, if a little stronger is sidelying hip circles....imagine you are drawing a small circles with your big toe, with the circle movement coming from the hip, not the ankle. If you have any other questions please feel free to ask :) Drew
@@andrewdowler4479 Thank you, I will definitely give those exercises a try. How about yoga moves? Are there any poses that would help isolate the obturator externis muscle?
@@peggygillis3456 the trick with using yogga asana is to connect the posterior pelvic tilt with hip external rotation....and the best asana posture to practice is bridge (dvipadaptham) and baddha konasana (bound angle). In bridge try to create the posterior pelvic tilt (back flattens into floor) first by enage the deep butt muscles with a gentle contraction. The hip external rotators including, obturator exeternis will work synergistically to rotate the femur in the pelvis laterally. You know this is happening as your knees will naturally turn outward. The trick is to not to empasise the big butt muscles, but rather feel the movement starting from "deep" in the hip joint...with practice youcan get the feel. This also should be coordinated with the exhale, as exahlation facilitates posterior pelvic tilting....breath centric asna is the key. Once you have the feelin bridge, then try it in bound angle. On the inhale grow tall through spine feeling the weight in your ischial tuberosity (sit bones), create a natural anterior tilt (lower back arches) on the exale reverse the movement create slight lumber flexion and posterior tilt, this facilites the hip external rotation.....visualise you are drawing your knees down toward the floor by enageging the "deep" hip / but muscles The techniques is subtle but with practice you can devekop the feel. The hip external rotators are designed to work in concert with pelvic posterior tilt + exhalation (deepening on the natural shape of your hip joint). Once you "get it" you can apply these principles to pretty much all asana invlving the hip andexternal rotation (tip...totally changes your asana practice). Let me know how you, cheers Drew
Hi thankyou for your question. Rehab post THR typically has three phases. The post op phase occurs int he hospital straight after surgery. Then following outpatient rehab (going to hospitals for physical therapy sessions 2-3 times pw for 12 weeks, then into a Individualized Exercise Program for ongoing. There are some orthopedic surgeons who dont belive in rehab, i know this as i ve sat in the room with my mum when she was having her THR where they told her no rebab was necessary. In my opinon rehab is very necesary, but please consutl with your doctor on this. One way to look at a THR surgery is to thin of it as a fracture (they literally remove bone), and bone healing is 12 weeks initially with an 18 month remodeling phase. considering the hip joint in the largest int he body, and is fully load bearing, we want the bone to heal really well. The best way to get bones stronger is with resistance training, so In my opinion post rehab is essential. Additionally depending on the techniques used (there are four methods) the deep hip rotators, including the obturators, gemellis, glute medius and pirifromis may be cut, and then reattached to the new hip joint. These are then tendon injuries, essentially grade 4 "off bone" types, which typically take 10 months to heal. Additionally the best way to rhab tendons is with graded resistance training, particularly eccentric training. This really requires a movement professionals to guide you through the process, and a bit out of the scope of the comments sections here. Needless to say, I higly recommend a graded exercise progam to retore the hip function, whihc would take a minimum of 12 months. Unfortunately many people are given totally inadequate rehab, which can result in poor outcomes.
Hi, thanks for the question. Yes it is possible it can conttibute to pelvic/bladder paind. The nerve that connect to the obturator muscles is the "Posterior branch of the Obturator nerve". Its pathway threads from L3/4 (lower back), down the front of sacram, and around the edge of pelvic inlet, which is the big circualr ring where the internall orgrans, like the bladder sit. So pelic/bladder pain can be caused form the lower back, or poor alignemtn of the pelvis and femur. Both the obterator internus and externnus are lateral rotators of the femur, which if too tight can contribute foor turn out as lateral rotatioj of the femur will turn the foot out 9little toe is more on theoutside, usuall on an angle). Hope that helps
yes, they will be effect by the hip angle, which could be the Q angle, or weather there is a retrograde AF joint where the femur - acetublumn is anatomically more positioned into external rotation or internal rotation. Then the position if the pelvis itself then dictates the alignment of these angles...so its gets tricky. However the adductors, hip flexors, and deep glutes have a more powerful role on hip angle and position, so typically focus on those first.
Hello, ahh sorry to hear that, im sure its frustrating. If exercise in itself isnt fixing the issue there may be some other structural issues, such as Sacroilliac Joint dysfunction, or Acetabular - femoral Impingement syndrome (where the femur is jamming into the pelvis, or whats called a Cam Impingement. These conditions can inhibit the obturators from working functionally. These conditions need some hands on assessment from a Physical Therapist, Chiro, osteo, physiotherapist, and typically requires some imaging (CT, Xray, MRI) to identify any structural issues which are the problem....sometimes its functional. othertime the issues is simply the anatomy of your joints. Hope that helps, please feel free to ask any other questions.
Excellent! I particularly appreciate all you share specifically concerning your practice with clients - what you do, how you do it and why. So glad I found you!
great to hear you are finding the channel helpful
Outstanding, you rule.nailed it.
Had total hip replacement 2016.I have a lot of pain on the inside near the groin in the bend of my leg. Had an examination for hernia not found. This sounds like what it might be. Thanks a million for your video.
Glad you found the video helpful.
Yea I always tell people DO NOT get any type of replacement surgery, it destroys the joint you're trying to fix ( they can't reattach muscle to titanium) get stem cell or other regenerative treatments and blood flow (movement)
Really interesting and well presented - thank you. I discovered my obturator internus last week after walking/jogging - could hardly walk for a couple of days. It's recovering, but I have no idea how it happened, so don't know how to mitigate for the future. Any suggestions? Squats have helped.
Hi Diane, thankyou for your comment, appreciate it. Good to hear its recovering, they can be tricky little injuries, as they are so deep under all the other hip muscles ect. Typically the deep hip stabilizer injurie are a result of a, End range of movement ballistic movements with rotation (kicking with twist), or end range of movement static postures held over long periods of time (sitting crossed legged on a chair), b Pelvis instability, often post a lower back injury and or post partum (the orientation of the femur and pelvis is slightly off), C traumatic injury, fall, ( missing a step and the leg fully extends and gets jammed) D, idiopathic....ie no one really knows, sometimes we just get hurt. In either case if pain still persists id get it check by either a good physio or chiropractor. In terms of future mitigation I'm a big fan of Pilates (depending on the instructor), functional strength training, depending on your preference ect. Hope that helps, please let me know if I can provide any further assistance. Cheers Drew
Thanks so much for that comprehensive reply - really helps my understanding . I'm going to try a recommended sports physio. I'm more yoga than Pilates, but will give P a shot!
Great video! Really appreciate this. What anatomy app do you use?
glad you liked it :). The App is called 3D4medical, highly recomend it
great great video, thank you for the info
you are most welcome
Amazing video! I’ve had a hip impingement on my left side with a pinch in the front crease of the hip. Been working on my gluts doing shallow squats and have felt/heard clicking across by sit bone. It doesn’t hurt but was wondering if it could be the ligaments around the obturator. When I point my toes out during the squat the clicking goes away. Am I doing any harm if it keeps clinching?
Great to see you enjoyed the video :). Sounds like you are doing the right adjustments to your squat to me. Depending on your structure of your hip joint, many folks do feel better with a slightly wider stance, with feet turned out a little. There is no one absolute correct position, so it does take a little testing. The clicking across the sit bones is probably more tightness through the hamstrings / Glutemax, but could aso be the ligaments for sure. combining squats with some good mobility and glutes / hamstring stretches can help alot..as you get stronger across the hips you'll find that the clicking may just go away. Some of my clients with Hip impingement issues do respond well to heel elevated squats as it increases the ROM and joint angles. We typically do this using 1-2 weight plates on the floor, heels on the edge of the plates. hope that helps. Cheers Drew
Thank you so much for the information. I have obturator externis muscle pain on my left side. I am presently doing physiotherapy with a pelvic floor physiotherapist who works with me internally to relieve some of the pain. Is there any type of exercise I can do externally at home myself to ease the pain of the obturator externis muscle.
Hi Peggy, cheers for your question. Good to see you are working with a pelvic floor physio :). In terms of exercise its always a little tricky prescribing exercise without first assessing ect. However to get those pelvis rotator muscles working well I'm a big fan of clinical based Pilates as there's an integration of the core - pelvic floor - pelvic stabilizers and pelvic rotators. So if you have a Pilates studio close by I'd consider that. In terms of a simple exercise you can trial your self at home the basic "clam shell" exercise has some good variations on how to "isolate" the hip rotators. Another good option, if a little stronger is sidelying hip circles....imagine you are drawing a small circles with your big toe, with the circle movement coming from the hip, not the ankle. If you have any other questions please feel free to ask :) Drew
@@andrewdowler4479 Thank you, I will definitely give those exercises a try. How about yoga moves? Are there any poses that would help isolate the obturator externis muscle?
@@peggygillis3456 the trick with using yogga asana is to connect the posterior pelvic tilt with hip external rotation....and the best asana posture to practice is bridge (dvipadaptham) and baddha konasana (bound angle). In bridge try to create the posterior pelvic tilt (back flattens into floor) first by enage the deep butt muscles with a gentle contraction. The hip external rotators including, obturator exeternis will work synergistically to rotate the femur in the pelvis laterally. You know this is happening as your knees will naturally turn outward. The trick is to not to empasise the big butt muscles, but rather feel the movement starting from "deep" in the hip joint...with practice youcan get the feel. This also should be coordinated with the exhale, as exahlation facilitates posterior pelvic tilting....breath centric asna is the key. Once you have the feelin bridge, then try it in bound angle. On the inhale grow tall through spine feeling the weight in your ischial tuberosity (sit bones), create a natural anterior tilt (lower back arches) on the exale reverse the movement create slight lumber flexion and posterior tilt, this facilites the hip external rotation.....visualise you are drawing your knees down toward the floor by enageging the "deep" hip / but muscles The techniques is subtle but with practice you can devekop the feel. The hip external rotators are designed to work in concert with pelvic posterior tilt + exhalation (deepening on the natural shape of your hip joint). Once you "get it" you can apply these principles to pretty much all asana invlving the hip andexternal rotation (tip...totally changes your asana practice). Let me know how you, cheers Drew
Would you comment what happens after a Hip Joint Replacement and how best training is handled
Hi thankyou for your question. Rehab post THR typically has three phases. The post op phase occurs int he hospital straight after surgery. Then following outpatient rehab (going to hospitals for physical therapy sessions 2-3 times pw for 12 weeks, then into a Individualized Exercise Program for ongoing. There are some orthopedic surgeons who dont belive in rehab, i know this as i ve sat in the room with my mum when she was having her THR where they told her no rebab was necessary. In my opinon rehab is very necesary, but please consutl with your doctor on this. One way to look at a THR surgery is to thin of it as a fracture (they literally remove bone), and bone healing is 12 weeks initially with an 18 month remodeling phase. considering the hip joint in the largest int he body, and is fully load bearing, we want the bone to heal really well. The best way to get bones stronger is with resistance training, so In my opinion post rehab is essential. Additionally depending on the techniques used (there are four methods) the deep hip rotators, including the obturators, gemellis, glute medius and pirifromis may be cut, and then reattached to the new hip joint. These are then tendon injuries, essentially grade 4 "off bone" types, which typically take 10 months to heal. Additionally the best way to rhab tendons is with graded resistance training, particularly eccentric training. This really requires a movement professionals to guide you through the process, and a bit out of the scope of the comments sections here. Needless to say, I higly recommend a graded exercise progam to retore the hip function, whihc would take a minimum of 12 months. Unfortunately many people are given totally inadequate rehab, which can result in poor outcomes.
could this cause pain in the bladder/pelvic pain?. And could this cause hip/foot to turn out only on one side.
Hi, thanks for the question. Yes it is possible it can conttibute to pelvic/bladder paind. The nerve that connect to the obturator muscles is the
"Posterior branch of the Obturator nerve". Its pathway threads from L3/4 (lower back), down the front of sacram, and around the edge of pelvic inlet, which is the big circualr ring where the internall orgrans, like the bladder sit. So pelic/bladder pain can be caused form the lower back, or poor alignemtn of the pelvis and femur. Both the obterator internus and externnus are lateral rotators of the femur, which if too tight can contribute foor turn out as lateral rotatioj of the femur will turn the foot out 9little toe is more on theoutside, usuall on an angle). Hope that helps
@@andrewdowler4479 Hello again. Do you know how to release them muscels :)?
Are the hip rotations affected by hip angle?
yes, they will be effect by the hip angle, which could be the Q angle, or weather there is a retrograde AF joint where the femur - acetublumn is anatomically more positioned into external rotation or internal rotation. Then the position if the pelvis itself then dictates the alignment of these angles...so its gets tricky. However the adductors, hip flexors, and deep glutes have a more powerful role on hip angle and position, so typically focus on those first.
I have obturator internus syndrome. Reading the comments how to heal it. Im regularly Pilates, Yoga practice and it doesn’t fix the pain. 😢
Hello, ahh sorry to hear that, im sure its frustrating. If exercise in itself isnt fixing the issue there may be some other structural issues, such as Sacroilliac Joint dysfunction, or Acetabular - femoral Impingement syndrome (where the femur is jamming into the pelvis, or whats called a Cam Impingement. These conditions can inhibit the obturators from working functionally. These conditions need some hands on assessment from a Physical Therapist, Chiro, osteo, physiotherapist, and typically requires some imaging (CT, Xray, MRI) to identify any structural issues which are the problem....sometimes its functional. othertime the issues is simply the anatomy of your joints. Hope that helps, please feel free to ask any other questions.