Tendinitis of the Iliopsoas Muscle and Pelvic Pain

Injuries to the pelvis and hip constitute a smallchanges due to overuse, known as tendinosis.
percentage of sporting injuries with groin pain being theThe most common traumatic event usually involves a
most common presentation. Muscular and tendinouscontraction of the muscle while it is trying to lengthen
problems (especially where the tendon and the muscleand overuse occurs where hip flexion is repeatedly
meet) are the typical areas of complaint. The iliopsoas,performed such as running, dancing, rowing and many
a hip muscle deep in the pelvis, can be irritated by asports. The iliopsoas muscle may become tight which
traumatic event or by overuse from repeated hipincreases the forces exerted on it and tilts the pelvis
flexion (bending). This condition is not well diagnosedanteriorly, with other negative effects in the leg during
and may often be missed, with young persons moreactivity. Typical onset is slow and gradual and people
likely to present and females somewhat more often.note that the pain comes on with the problem activity
The two muscles, iliacus and psoas, have their originand eases off soon as they get warmed up. As it
respectively from the pelvis and lumbar spine, cominggets worse the pain will remain during the active period
together to make the combined iliopsoas muscle whichas ease after the activity is stopped, progressing to
becomes a tendon and inserts into a small area ofcontinuous pain if no action is taken. Pain will be in the
bone on the inside of the upper thigh, the lessergroin area but can radiate down the front of the thigh.
trochanter. The bursa between the musculo-tendinousPhysiotherapy acute management involves rest, ice
junction of the iliopsoas and the nearby pelvic bone isand gentle movements to allow the pain and
the largest in the body and in some cases runs into theinflammation to settle. Stretching can be gradually
hip joint itself. Acute trauma may cause damage tointroduced, starting with very gently techniques and
the tendon resulting in inflammation which can then besteadily progressed to return full range of movement,
termed tendinitis and this can be longer term or chronic.strength and endurance. Gradual return to the low
Inflammation may occur around the tendon instead orintensity sport related hip flexion should allow the
the tendon fibres themselves may show degenerativeiliopsoas to tire without overstraining.