Pelvic Floor Referral Patterns 101


You might be thinking to yourself, “my back, hip, buttock, or thigh pain won’t go away…now what?” “Do I just have to live with this pain for the rest of my life?” As a pelvic floor physical therapist, I hear this all too often. Well, the answer to this question is NO! You likely don’t have to. Traditional orthopedic physical therapy might make you feel better temporarily or part of the way but not completely cure you and here’s likely why. Your pelvic floor muscles may actually be the true culprit of your pain. This is why I’d highly recommend trying pelvic floor physical therapy before going under the knife for a surgery you may not need and then another round of PT postoperatively.

Let’s talk about your pelvic floor muscles and their referral patterns. First of all, let’s define what a referral pattern is. This is when pain is referred to as a different area other than the source of pain and that area is perceived as the location of the pain.  Let’s take for example one of the common first identifiers of a heart attack. Someone may complain of pain in their left arm when the source of their pain is their heart. In this example, the left arm is the referral pattern for the heart, which is actually the true source of the problem.

The layers of pelvic floor muscles:

You have 3 layers of pelvic floor muscles. There are also some deep pelvic wall muscles that stabilize the hip from inside and outside the pelvis. The first layer muscles are primarily concerned with sexual function and climax. If these muscles are problematic pain may occur at any time during or after intercourse or sexual climax. They may also be responsible for difficulty or pain with the climax. The second layer muscle is primarily concerned with maintaining continence, urgency/frequency of urination, and bladder pain symptoms. The third layer musculature also plays a role in sexual function.


Pelvic Floor muscles are no exception to referral patterns. In fact, these muscles have been known to refer symptoms to many sites around the pelvis, back, abdomen, bladder, buttocks, and even down the back of the same leg. This is due to their connections to fascia layers (connective tissue) and locations within the pelvis. Take for example the unrelenting sciatic pain that hasn’t subsided. Your symptoms may actually be a referral pattern of pelvic floor musculature rather than an irritation of the sciatic nerve. When a muscle is overactive or dysfunctional, trigger points may be present. Trigger points not only are painful areas when touched, but they also impair range of motion, tissue extensibility/ health, and strength. So until these areas are addressed referral patterns and pain will persist. This could be why your hip pain isn’t going away because the source of your symptoms is still an issue.  Let us get to the bottom of your pain so that you can to back to living your life to the fullest.


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SouthOCPT May 14, 2020

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