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Hip Pain, Iliopsoas Muscle Pain and Iliopsoas Injury

Fix hip and iliopsoas muscle pain caused by iliopsoas tendinitis and iliopsoas syndrome.

by Brad Walker | First Published December 6, 2005 | Updated September 28, 2018

Hip Pain and 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.

(Due to the over-whelming response I received from last month’s article, Piriformis Syndrome, I’ve decided to stick with conditions that affect the hip area. Apparently, there are a lot of people suffering with hip pain.)

If you suffer from hip pain or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help. To get started on a safe and effective stretching routine that’s just right for you, check out the Ultimate Guide to Stretching & Flexibility.

Hip Pain, Iliopsoas Muscle Pain and Iliopsoas Injury

What is Iliopsoas Tendinitis (or Iliopsoas Syndrome)?

Technically, they are two separate conditions, but it’s not uncommon to hear the term iliopsoas tendinitis or iliopsoas syndrome being used to describe the same thing.

Iliopsoas tendinitis refers to inflammation of the iliopsoas muscle and 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.

Anatomy of the Hip Joint

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 labeled on the right. 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 injury occurs.

Iliopsoas Muscle picture used from Principles of Anatomy and Physiology

What Causes Iliopsoas Tendinitis and Iliopsoas Syndrome?

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.

Symptom of Iliopsoas Tendinitis

Pain and tenderness 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.

Hip 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 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.

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 false advice

A while ago I came across a website promoting a new stretching 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…

Hip Pain Prevention

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 four preventative measures that I feel are far more important and effective.

Firstly, 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. Click here for a detailed explanation of how, why and when to perform your warm up.

Secondly, 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.

Thirdly, strengthening and conditioning the muscles of the hips, buttocks and lower back will also help to prevent iliopsoas tendinitis and iliopsoas syndrome.

And fourthly, (and most importantly) 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.

To keep your hip, quads and iliopsoas muscles flexible and supple, it is important to get started on a few effective iliopsoas stretches.

Kneeling Quad and Thigh Stretch (1:20) Kneel on one foot and the other knee. If needed, hold on to something to keep your balance. Push your hips forward. Regulate the intensity of this stretch by pushing your hips forward. If need be, place a towel or mat under your knee for comfort. Hold the stretch position for a minimum of 20 seconds and then repeat with the opposite leg.

Standing Quad and Thigh Stretch (1:21) Stand upright while balancing on one leg. Pull your other foot up behind your buttocks and keep your knees together while pushing your hips forward. Hold on to something for balance. This position can put undue pressure on the knee joint and ligaments. Anyone with knee pain or knee injury should avoid this stretch. Hold the stretch position for a minimum of 20 seconds and then repeat with the opposite leg.

Lying on-your-side Quad and Thigh Stretch (1:28) Lie on your side and pull your top leg behind your buttocks. Keep your knees together and push your hips forward. This position can put undue pressure on the knee joint and ligaments. Anyone with knee pain or knee injury should avoid this stretch. Hold the stretch position for a minimum of 20 seconds and then repeat with the opposite leg.


Brad Walker - AKA The Stretch CoachAbout the Author: Brad 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 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 100's of testimonials. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.

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