Why Hip Pain Can Be Caused By Having Had An Episiotomy Or Tear During Childbirth – Even If That Was Years Ago!

This is a super interesting one for you today. Something we need to share because it could be affecting you now or in the years to come. We are also seeing loads of this happening in the clinic

Hands up if you’ve had an episiotomy?

Hands up if you tore during childbirth?

If so, please pay attention as this bit of information GOLD may help you in the years to come. Your pelvic floor is connected to your hips by muscles and fascia and because of this, injuries or weakness to your pelvic floor can be the cause of your hip pain. The impact on your hips may not be apparent immediately after delivery but are often felt in the years to come.

Why the scars can influence your hip

Now, bear with me one moment as I explain why. First, please can you imagine a tent, beautifully erected in the field. Imagine its guy ropes keeping it up in a strong wind. Imagine the tent poles giving the shape and structure. Now, imagine what would happen if you tore the fabric of your tent. Not just a little hole big enough for a fly but a big tear. It would change the shape of your tent with a change in tension on the ropes and poles, exerting a different influence. Now imagine you sewed that fabric up. Again, the tension on the poles and ropes would change again as the fabric perhaps puckers and is shorter and less pliable than it was.

Ok, now back to your pelvic floor. That is what happens when you tear during childbirth or have an episiotomy. The best seamstress in the world is still going to alter the tensions on all the tissue down there….unless you actively do something to sort out your scars and the impact it has on your surrounding anatomy. This isn’t solely your pelvic floor either. You need to think a bit wider at the influence your pelvic floor has on your hips. Get it?

Stay with me!

How the hip and pelvic floor are connected

So, anatomy can be a bit “dry” for want of a better word! The main thing you need to consider is that everything is connected to other stuff by what we call “fascia”. This is a connective tissue which doesn’t lengthen and shorten like muscles but can influence the body like the tent analogy.

Your pelvic floor muscles connect directly to some of your hip muscles via this fascia.

Now hopefully you can start seeing how a scar from a tear or episiotomy can have an impact on your hip. Fascia needs to be able to stretch and move in all different directions. Muscles need to lengthen and shorten. When they don’t, or can’t, it affects how the muscles work and control your hip. This can commonly lead to hip pain as other muscles and structures load more and then get grumpy about it!

It goes even further than your hip

There are lots of bands of fascia that run throughout your body. The one linking all this stuff together starts in the base of the toes and goes all the way up to your inner thigh, through your pelvic floor and pelvis and then all the way to your jaw! This is one of the reasons why any trauma to your pelvic floor during childbirth can impact your body in places you wouldn’t even think! BUT don’t forget it can take years for the true impact to take effect in your body!

What we see in clinic

The reason this is relevant to you is that your pelvic floor scars will impact how your pelvic floor and hip muscles work together. Not only with things like controlling your bladder and bowel but also how your hip functions when you walk, run, climb stairs, squat, breathe and move in all manner of ways. Everything needs to do its bit and when something can’t or isn’t, it will have an impact on other stuff.

A lady we recently saw had been getting hip and pelvic pain when running and doing yoga. She’d also had some pelvic floor weakness for years which she’d try to combat with pelvic floor exercises. Sadly, she wasn’t doing them right and was using her inner thigh muscles a lot. She also had an episiotomy 20+ years ago and it was the lack of mobility in the scar that was stopping her working her pelvic floor properly. This caused those inner thigh muscles to get tighter and tighter and caused her hip to not move and perform properly when running and doing yoga.

Thankfully she is now pain free, back running, yoga-ing, and working her pelvic floor properly all thanks to a rather awesome team approach and a treatment plan involving pelvic floor, hip and body training. Hooray!

Why you need to know this

This is such a common problem we see. Hip pain with a history or tears or episiotomy during childbirth. The moral of the story is this;

o Don’t assume that you are doing your pelvic floor exercises right (even if you aren’t leaking…..yet!). You could just be getting away with it by using a bunch of other muscles. This will impact you later down the line in some way.

o If you had an episiotomy or tear, no matter how long ago, make sure your scar can move and is allowing your pelvic floor and hip muscles to work properly.

o If you’ve got hip pain that isn’t going away and you have a pelvic floor scar, it’s time you considered seeing a pelvic health physio to get some answers.

Next Steps

If this blog made you think and you’d like to find out more, we offer a FREE Discovery visit or phone call with our Pelvic Health therapist, Wendy. This is your opportunity to find out if we can help you with your particular problem and a bit more about the process. If this sounds interesting or you have any other questions, please don’t hesitate to call or email on 01548 852355 or [email protected].