Pelvic pain experienced during functional movements like squatting often signals an underlying issue within the body’s stabilizing system. Squatting, whether in exercise or daily tasks such as getting out of a chair, requires the coordinated effort of numerous muscles and joints throughout the lower body and torso. When pain appears, it indicates that a specific anatomical structure is being overloaded, compressed, or strained beyond its current capacity.
Understanding the Mechanics of Squatting and the Pelvis
The squat is a complex movement that places significant biomechanical demands on the pelvic girdle, requiring precise coordination between the hips, spine, and core musculature. During the descent phase, the pelvic floor muscles (PFM) play a dynamic role, stretching and lengthening to accommodate increasing hip flexion. The PFM, along with the diaphragm, abdominal wall, and deep back muscles, form a cylindrical unit that manages intra-abdominal pressure (IAP) to stabilize the spine and pelvis.
A healthy squat requires the femur to rotate slightly within the hip socket, a movement limited by bone structure and surrounding soft tissues. As the squat reaches greater depth, the pelvis may naturally tilt backward (posterior pelvic tilt), known as “butt wink.” This movement allows for additional hip flexion but also increases mechanical stress on the lumbar spine. The ability to manage IAP and control this pelvic motion is directly linked to the strength and reflexivity of the PFM.
Common Sources of Pelvic Pain During Movement
One frequent source of pain is Pelvic Floor Dysfunction, often presenting as hypertonicity, where the PFM are chronically tense or unable to fully relax. When a tight pelvic floor is forced to lengthen rapidly during a deep squat, the resulting strain can cause sharp, localized pain in the pelvic region or tailbone. This constant state of contraction can also manifest as pain in the hips or low back because the PFM share connective tissue and movement patterns with surrounding hip stabilizers.
Pain may also originate from the Sacroiliac Joint (SIJ), which connects the sacrum to the two iliac bones of the pelvis. Squatting creates significant shearing and compression forces across the SIJ. Pain can arise from either too much movement (hypermobility) or too little movement (hypomobility) within this joint. SIJ discomfort is felt as a sharp or dull ache localized to one side of the lower back or buttock, sometimes radiating down the leg. This pain is exacerbated by the uneven loading of the squat.
A primary mechanical cause is Hip Joint Pathology, such as Femoroacetabular Impingement (FAI) or a labral tear, which restricts the deep hip flexion necessary for squatting. FAI involves abnormal contact between the thigh bone and the hip socket. Attempting a deep squat forces these structures to collide, resulting in a pinch or deep groin pain. Gluteal and Hip Muscle Weakness also contributes to pelvic pain by failing to stabilize the pelvis during the movement. This weakness leads to compensatory tilting or excessive internal rotation of the femur.
Actionable Strategies for Pain Reduction and Recovery
Immediate relief can be found through modifying the squat to reduce mechanical strain on the pelvis. Reducing the depth of the squat is the most direct modification, ensuring the movement stops before the point of pain or before the pelvis begins to tuck under. Widening the foot stance and increasing the external rotation of the feet can also help open the hip joint, accommodating structural limitations and decreasing impingement symptoms.
Long-term recovery focuses on therapeutic exercises aimed at correcting underlying muscular imbalances. For a hypertonic pelvic floor, the strategy involves down-training the muscles using diaphragmatic breathing techniques, which pair an inhale with a gentle relaxation of the PFM. This relaxation can be practiced in a modified deep squat position, often supported by a block, to encourage the PFM to yield and stretch under a controlled load.
Improving hip mobility, particularly internal rotation, is important for a pain-free squat since restricted rotation forces the pelvis to compensate. Exercises like the 90/90 hip rotation drill can restore necessary joint range of motion. Strengthening the deep stabilizing muscles of the torso and pelvis is also crucial, using exercises like the dead bug, bird dog, and side plank variations to build lumbopelvic control. These stability exercises teach the core to brace effectively and maintain a neutral pelvic position under dynamic conditions.
Identifying Serious Symptoms and Consulting a Specialist
While many causes of pelvic pain during squatting are mechanical and respond well to conservative physical therapy, certain symptoms warrant immediate medical consultation. Seek urgent care if the pain is sudden and severe, or if it is accompanied by systemic signs such as fever, chills, or unexplained nausea and vomiting. These symptoms can indicate an infection or an acute medical event that requires prompt attention.
Additional red flags include sudden or unexplained loss of bladder or bowel control, significant radiating nerve pain, or numbness that travels down the leg. If pain persists, worsens significantly, or remains present even with movement modifications, consulting a Pelvic Health Physical Therapist is advisable. These specialists are trained to assess the complex interplay between the pelvic floor, hips, and spine, providing a precise diagnosis and a targeted treatment plan.