Can Tight Hip Flexors Cause Frequent Urination?
Introduction
It seems like we all have tight hip flexor muscles and there are endless videos online about the “right” way to stretch them out. If you also struggle with frequent urination, the link between your symptoms and your tight hip flexors may be more obvious than you think.
So, can tight hip flexors cause frequent urination? There is no direct link that says tight hip flexors = frequent urination, but understanding the connection between your hips, bladder, and pelvic floor muscles can be the key to fewer bathroom breaks. Stiffness in the hip flexors and surrounding fascia can lead to bladder irritation and the feeling of constantly “needing to go.”
What are the hip flexors?
The hip flexors are a set of muscles along the front of the hips. There are 3 muscles generally considered to be primary hip flexors:
Iliopsoas: The biggest, strongest hip flexor that runs from your lower spine to the top of your leg.
Rectus femoris: One of the 4 quadriceps muscles, it runs from your pelvis to the top of your knee.
Sartorius: The longest single muscle in the body. It is a thin muscle that runs from your pelvis down to the inside of your knee. To see the actions of the sartorius muscle, pretend to look at a piece of gum on the bottom of your shoe.
Hip flexors help move the entire leg forward during walking and running. They are also an important part of core/trunk stability. Because of their location in the front of the hip, sitting for too long can make those muscles stiff and sore when getting back into standing.
Can Tight Hip Flexors Cause Frequent Urination?
Because of the path of the hip flexors over the front side of the hip labrum and the close connection with the pelvic floor, bladder irritation and hip flexor tightness often go hand in hand.
Indirect connection from the hip flexors to the pelvic floor can create a hypertonic (or tight) pelvic floor. Hypertonicity in the pelvic floor is a cause of urinary frequency.
When muscles of the hip get tight or have difficulty coordinating, it can lead to an overactive bladder and general feeling of discomfort or an urge to pee. Sometimes the hip tightness can cause hip pain as well, only making those overactive pelvic floor muscles try to clench even tighter.
Tight hip flexors work against your glute muscles, whose job is to extend your hip and keep you upright. Over time this can alter pelvic mechanics, which can create pelvic floor dysfunction and/or glute weakness.
Women with urinary frequency were shown to have weaker hip abductors and external rotators compared to controls. Hip strength = bladder happiness.
Hip flexor tightness contributes to urinary frequency by making glutes weaker and irritating sensitive structures in and around your bladder.
How Hip Flexors and the Pelvic Floor Are Connected - Step by Step
Hip flexors and your pelvic floor share attachment points along the bones of your pelvis
These muscles work as a team to support the hip and bladder like a sling.
A deep muscle in the pelvis called the obturator internus, which is connected to the hip flexor complex, stabilizes the hip and also helps with pelvic floor support.
If any part of this muscular system isn’t working right (like hip flexor tightness), it can irritate the systems around it.
Your bladder may be physically reacting to an overactive or overworked pelvic floor.
This chain of events happens often enough that a new syndrome called “Myofascial Urinary Frequency Syndrome” is present in ⅓ of individuals with urinary frequency.
Symptoms That May Suggest Tight Hip Flexors Are Contributing
Urinary frequency or urgency without an active infection
Hip stiffness
Urinary frequency and hip stiffness that showed up postpartum
Urinary frequency and hip stiffness that showed up in perimenopause
Pain in the front of your hips during or after exercise
Pain with prolonged sitting
Pain with sex along the front of your hip
Groin pain
Other Causes of Frequent Urination
Reach out to your doctor if any of the following are of concern to you:
Overactive bladder
Urinary tract infection
Benign Prostatic Hyperplasia
Diabetes
Interstitial Cystitis
Pregnancy
How Pelvic Floor Physical Therapy Can Help
A pelvic floor PT can assess:
Hip strength
Hip mobility
Bladder mobility and irritation
Pelvic floor mobility
Pelvic floor tension and strength
Posture
Movement patterns
Lifestyle factors influencing hip and bladder irritation
Pelvic floor PT is so much more than Kegels.
Treatment May Include:
Manual therapy
Pelvic floor muscle relaxation techniques
Hip mobility exercises
Hip flexor myofascial work
Hip flexor dry needling
Strengthening programs
Bladder retraining strategies
Nervous system down-training
Education on bladder habits and lifestyle factors
When to See a Pelvic Floor Physical Therapist:
You should consider seeing a pelvic floor physical therapist if:
Urinary frequency doesn’t seem to go away and is affecting your daily life
You’ve been told things seem “normal,” but you’re continuing to have symptoms
You want to prevent nagging issues before they become chronic
You stopped exercising because of symptoms
Symptoms return every time you try to be active
You also experience pelvic pain with movement or urination
You experience pain with sex
If you’re wondering “can tight hip flexors cause frequent urination?” you are definitely not alone.
Pelvic floor physical therapy can help you get back to the things you love without hip flexor tightness or urinary symptoms holding you back.
Revive Rehab in Columbia, Missouri, is a pelvic health practice that specializes in urinary symptoms such as: frequency, urgency, pain and/or leakage.
If you are in the Columbia, Jefferson City, Fulton, Boonville, or mid-Missouri area, we’d love to work with you! Click here to learn more about our in-person services.
We offer hour-long, one-on-one, individualized appointments with a physical therapist to get to the root cause of your concerns. We provide a holistic approach for your care. Click the link below if you’d like to book an appointment with us, we’d love to help you on your wellness journey!
Written by: Dr. Sarah Miller, PT, DPT
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