29 Obturator Nerve Decompression
This module teaches the release of muscles affecting the obturator nerve, which controls the adductor muscles of the inner thigh.
Step 1
Understanding the Problem
The obturator system sits deep within the pelvis and hip, forming a critical junction between:pelvic stabilityhip rotationinner thigh function
When the obturator muscles enter spasm:
👉 they compress the obturator nerve
👉 they disrupt function of the entire adductor chainThis creates a pattern where:
👉 the inner thigh cannot fully relax
👉 the hip becomes restricted
👉 deep pelvic tension persists
Step 2
The Clinical Problem
Clients may report:
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deep pain in the buttock
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discomfort when sitting
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inner thigh tightness
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groin pain
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restricted hip movement
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pulling sensation into the knee
A very specific and common description:
👉 “It feels like a golf ball under my butt cheek”
This is a key indicator of:
👉 obturator involvement
Step 3
Why This Happens
The obturator internus and externus form a deep muscular tunnel through which the obturator nerve passes.
When these muscles are in spasm:
👉 they compress the nerve directly
This leads to:
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loss of signal to the adductors
-
compensatory tightening of the inner thigh
-
persistent dysfunction that does not resolve locally
Step 4
Anatomy
The obturator nerve becomes impinged by the obturator muscles when they are in spasm. This makes release of the adductors impossible without releasing the obturator muscles first. The logic of sequencing is key to success with releasology!
Obturator Internus
Origin: inner surface of obturator membrane
Insertion: greater trochanter
Location: inside pelvis, exiting posteriorly
👉 connects via fascial raphé to levator ani (pelvic floor)
Obturator Externus
Origin: outer obturator membrane
Insertion: trochanteric fossa
👉 sits deep in anterior hip
Obturator Nerve
travels through obturator region
innervates the adductor group
👉 when compressed:adductors cannot fully relax
👉inner thigh remains in dysfunction
The Five Adductors
1. Pectineus
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upper inner thigh
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assists hip flexion and adduction
2. Adductor Brevis
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deep,
-
shorter stabilizer
3. Adductor Longus
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midline inner thigh
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primary hip adductor
4. Adductor Magnus
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assists in both:
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adduction
-
hip extension
-
-
large,
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powerful
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causes cellulite by blocking deep drainage, via compression of the deep lymphatic channels and deep veins of the thigh
5. Gracilis
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long,
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thin
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crosses knee
👉 contributes to medial knee tension5.
System Insight
👉 obturator muscles control the nerve supply to the entire adductor chain
Step 5
Palpation & Tissue Assessment
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Position:
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client prone or side-lying
Primary Palpation — Obturator Internus
Location:
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deep under glute
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near ischial region
In spasm:
👉 feels like:
-
a dense, round mass
-
“golf ball under the butt cheek”
Secondary Palpation — Inner Thigh
Assess adductors:
-
pectineus
-
adductor brevis
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adductor longus
-
adductor magnus
-
gracilis
In dysfunction:
👉 they feel:
-
tight
-
resistant
-
unable to fully release
Tissue Quality
In spasm:
-
deep
-
dense
-
resistant
-
clearly defined
Healthy:
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soft
-
adaptable
Step 8
Worksheet Exercise
Download the worksheet below.
Using a red drawing tool on your phone or tablet:
Draw:
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obturator internus
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obturator externus
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obturator nerve
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all five adductors
Label:
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origin
-
insertion
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movement
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nerve supply
Save the image to your device.
Upload the completed worksheet in the next step.
Mastery of anatomy is required for precise clinical work.
Step 9
Practice Assignment
Clinical Skill Development
Position client:
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start prone - obturator internus only
-
then, supine for all other muscles
Technique Flow
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Locate obturator internus
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release it with a Yang-Yin pulse
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Turn client to supine position
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Locate obturator externus
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Apply slow, deep pressure to locate
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stretch the thigh into abduction
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Use a yang-yin pulse to release it
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Repeat process for each sdductor
Focus
👉 treat the source (obturator)
👉 not just the symptoms (adductors)
Step 12
Knowledge Check & Module Completion
To pass:
👉 80% or higher
You Must Understand:
-
obturator anatomy
-
adductor anatomy
-
adductor-obturator relationship
-
how to locate these muscles through palpation
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how to release these muscles and what order to go in
Key Insight (Refined)
👉 the obturator muscles lock the function of the entire inner thigh through nerve compression when they are in spasm
1. Which muscles directly compress the obturator nerve in this modality?
A. Piriformis
B. Hamstrings
C. Gluteus maximus
D. Obturator internus and externus
2. Why do all adductor muscles become involved when this nerve is compressed?
A. They are weak
B. They are all innervated by the obturator nerve
C. They stabilize posture
D. They increase circulation
3. What is a key symptom of obturator nerve compression?
A. Shoulder pain
B. Neck tension
C. Wrist stiffness
D. Severe hip, groin, and leg pain with difficulty walking
4. What is the Releasology approach to resolving this condition?
A. Stretching the adductors
B. Releasing the obturator muscles at the nerve passage point
C. Strengthening the hips
D. Rest
5. What is the expected result after proper release?
A. Increased stiffness
B. Immediate improvement in walking and reduction of pain
C. Muscle fatigue
D. Skin tightening