What is Iliopsoas Tendinitis and Iliopsoas Syndrome?
Discover what causes iliopsoas tendinitis and how to treat it.
by Brad Walker | Updated July 31, 2024
- Iliopsoas tendinitis refers to inflammation of the iliopsoas muscle and tendon, but can also affect the bursa located underneath the tendon of the iliopsoas muscle.
- Whereas iliopsoas syndrome refers to a stretch, tear or complete rupture of the iliopsoas muscle and / or tendon.
What Causes Iliopsoas Pain?
- Iliopsoas tendinitis is predominately caused by repetitive hip flexion or overuse of the hip area, resulting in inflammation.
- Iliopsoas syndrome, on the other hand, is caused by a sudden contraction of the iliopsoas muscle, which results in a rupture or tear of the muscle, usually at the point where the muscle and tendon connect.
Athletes at risk include runners, jumpers, and participants of sports that require a lot of kicking. Also at risk are those who participate in strength training and weight lifting exercises that require a lot of bending and squatting.
Anatomy of the Iliopsoas Muscle
Iliopsoas muscle pain caused by iliopsoas tendinitis and iliopsoas syndrome are conditions that affect the iliopsoas muscle located in the anterior region (or front) of the hip.
The iliopsoas muscle is actually made up of two separate muscles located in the anterior (or front) of the hip area. In the diagram to the right you can see the Iliacus labeled on the left and the Psoas Major labeled on the right (in capitals). These two muscles are responsible for lifting the upper leg to the torso, or flexing the torso towards the thigh (as in a sit-up).
Although the two muscles start at different points (the psoas originates from the spine, while the iliacus originates from the hip bone) they both end up at the same point; the upper portion of the thigh bone. It is at this point; the insertion, that most iliopsoas injury occurs.
Symptoms of Iliopsoas Tendinitis
Pain and tenderness deep in the abdomen are common symptoms of both conditions; however the onset of pain associated with iliopsoas tendinitis is gradual and tends to build up over an extended period of time, whereas the pain associated with iliopsoas syndrome is sudden and very sharp. Weakness is also a common symptom associated with both conditions.
Iliopsoas Muscle Pain Treatment
Iliopsoas tendinitis and iliopsoas syndrome is a soft tissue injury of the iliopsoas muscle and therefore should be treated like any other soft tissue injury.
- Immediately following an injury, or at the onset of pain, the R.I.C.E.R. regimen should be employed. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis. It is critical that the R.I.C.E.R. regimen be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery.
- The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy techniques. The most common methods used to do this include ultrasound, TENS, heat and massage. The application of heat and massage is one of the most effective treatments for removing scar tissue and speeding up the healing process of the muscles and tendons.
- Next, start to incorporate some very gentle range of motion exercises for the large muscle groups around your hips. The lower back, buttocks, hamstrings, quadriceps and groin are a good place to start.
- Once most of the pain has been reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase is to regain the strength, power, endurance and flexibility of the muscles and tendons that have been injured.
Beware of bad advice!
A while ago I came across a website promoting a new product to help with hip pain. I’m always interested to see what other people are doing in the field of stretching & flexibility, so I thought I’d check it out. Click on the video below to see what I found…
Preventing Iliopsoas Tendinitis
There are a number of preventative techniques that will help to prevent both iliopsoas tendinitis and iliopsoas syndrome, including modifying equipment or sitting positions, taking extended rests and even learning new routines for repetitive activities. However, there are a few preventative measures that I feel are far more important and effective.
- A thorough and correct warm-up will help to prepare the muscles and tendons for any activity to come. Without a proper warm-up the muscles and tendons will be tight and stiff. There will be limited blood flow to the hip area, which will result in a lack of oxygen and nutrients for the muscles. This is a sure-fire recipe for a muscle or tendon injury. Before any activity be sure to thoroughly warm-up all the muscles and tendons that will be used during your sport or activity.
- Rest and recovery are extremely important; especially for athletes or individuals whose lifestyle involves strenuous physical activity. Be sure to let your muscles rest and recover after heavy physical activity.
- Strengthening and conditioning the muscles of the hips, buttocks and lower back will also help to prevent iliopsoas tendinitis and iliopsoas syndrome.
- Flexible muscles and tendons are extremely important in the prevention of most strain or sprain injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. When this happens, strains, sprains, and pulled muscles occur. Get videos and photos of quad and hip flexor stretches here.
Research and References
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Wikipedia contributors. (2019, February 6). Iliopsoas, In Wikipedia, The Free Encyclopedia.
- Sajko, S. Stuber, K. (2009). Psoas Major: a case report and review of its anatomy, biomechanics, and clinical implications. Journal of the Canadian Chiropractic Association, 53(4): 311–318.
- Rauseo, C. (2017). The rehabilitation of a runner with iliopsoas tendinopathy using an eccentric-biased exercise: A case report. International Journal of Sports Physical Therapy, 12(7): 1150–1162.
- Johnston, C. Wiley, J. Lindsay, D. Wiseman, D. (1998). Iliopsoas bursitis and tendinitis. Sports Medicine, 25(4), 271-283.
- Thorborg, K. Bandholm, T. Zebis, M. Andersen, L. Jensen, J. Hölmich, P. (2016). Large strengthening effect of a hip-flexor training programme: a randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 24(7):2346-52.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
