An Overview of Iliopsoas Syndrome

Iliopsoas syndrome is one of several conditions that affect the hip joint or iliopsoas. Common conditions that affect this part of the body include iliopsoas bursitis and iliopsoas tendinitis. These conditions are common among gymnasts, dancers, and track and field athletes who perform repeated hip flexion movements.

The iliopsoas (pronounced​ ill-ee-oh-so-as) muscles are the anterior hip muscles. They are made up of the psoas major, psoas minor, and the iliacus. The main function of this joint is hip flexion. Within the hip joint are bursae: small, fluid-filled sacs that lie between bones and soft tissues. Bursae reduce friction and provide cushioning.

There are two types of bursae in the hip that can become inflamed: the greater trochanter and the iliopsoas bursa. Iliopsoas bursitis, more commonly known as hip bursitis, occurs when the iliopsoas bursa, which is located between the iliopsoas tendon and the inside of the hip, becomes inflamed and irritated. Iliopsoas tendonitis, or hip tendonitis, occurs when the iliopsoas tendon, which attaches the thigh bone to the muscle, becomes inflamed and irritated.

The primary symptom of iliopsoas bursitis and iliopsoas tendinitis is a pain in the hip. Typically doing anything that requires the use of the hip worsens pain symptoms. Other symptoms include:

• Pain and/or stiffness in the hip and thigh area
• Pain that starts sharp and intense but becomes more dull and aching
• Clicking or snapping in the hip or groin that may or may not cause pain
• Pain that worsens upon doing anything that bends the hip: walking, climbing stairs, squatting, sitting, etc.
• Tenderness in the hip and groin area

Hip bursitis can affect people of all ages, but it is most common among women and the elderly. Risk factors for developing this condition include:

• Prior hip injury and/or surgery
• Scoliosis, spinal arthritis, and other spinal issues
• Legs that are different lengths
• Rheumatoid arthritis
• Bone spurs or calcium deposits
• Overuse of the joint (running, cycling or standing for long periods of time)

A physician is able to diagnose iliopsoas syndrome based on symptom history and a hip examination. Imaging tests such as MRIs and x-rays are rarely used. Most treatment for hip bursitis and hip tendinitis does not involve surgery.

Anti-inflammatory medication can be used to alleviate pain and reduce inflammation. Sometimes steroid injections are used to relieve symptoms and it can be done right in the doctor's office. If symptoms persist or return, additional steroid injections can be administered as necessary.

After pain and swelling subside, you may need to see a physical therapist or your doctor may start you on a mild exercise program to gradually improve hip strength and flexibility. Canes and crutches provide additional support.

As is the case with all overuse injuries, iliopsoas syndrome is caused by doing too much, too soon. It's important to start small and build up gradually, whether you are an exercise beginner or trying to amp up your fitness routine. Follow the 10 percent rule to avoid falling into this trap.