Iliopsoas Tendinopathy/Bursitis
The iliacus and psoas muscles, sometimes known as the hip flexors, play a crucial role in hip movement. They are essential for flexing the hip and are involved in activities like walking, bending, running, and providing body support.
Underneath these muscles are small, fluid-filled sacs called bursae. These act as cushions to minimise the amount of contact between the hip flexor muscles, their tendons (which link muscles to bones) and the hip joint.
Iliopsoas tendinopathy/bursitis arises when these bursae or tendons get inflamed and irritated, leading to pain and difficulty with physical activity.
Symptoms
The main symptom of iliopsoas tendinopathy is pain, typically described as a dull, aching discomfort in the front of the groin or thigh. In some cases, the pain may radiate down the thigh, reaching the knee and buttocks. Other common symptoms include:
- Pain triggered by activities like walking, exercising, climbing stairs or standing up from a seated location
- Sensitivity in the front of the thigh or groin
- A snapping feeling in the hip
Causes
Iliopsoas bursitis in athletes normally results from too much use of the iliopsoas muscles and nearby tissues. Sports involving repeated movements can lead to chronic strain, hence increasing deterioration of the bursa and tendons. Additionally, athletes who have tight hip flexor muscles are at a higher risk, as the added pressure on these structures can lead to irritation and inflammation.
This condition is normally seen in people participating in sports such as:
- Running
- Ballet dancing
- Swimming
- Soccer
- Martial arts
When to See a GP
If you have persistent pain in your hip or groin lasting over a few days, you should consult a doctor. During your visit, you will be required to explain your symptoms in detail, including the physical activities and sports you participate in.
The GP will perform a comprehensive physical examination to assess your hip’s strength and range of motion. More tests may be conducted in order to help rule out other possible causes of pain. In some cases, X-rays or other imaging tests might be recommended to help identify the source of the symptoms.
Treatment
Non-surgical options:
Managing iliopsoas tendinopathy/bursitis typically involves resting from activities that strain the iliopsoas muscles, including running and swimming. Non-surgical treatment options are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen to reduce pain and inflammation
- Corticosteroid injections administered under imaging guidance to relieve pain and promote recovery
- Physical therapy focused on strengthening muscles and improving flexibility
Surgical options:
In cases where conservative treatments fail to provide relief, your doctor may suggest surgery to free the iliopsoas tendon. This procedure aims to reduce tension and alleviate pain.
Recovery
Recovery typically takes 6 to 8 weeks, during which your doctor may recommend limiting physical activity to allow the iliopsoas muscles and bursae to heal properly. Your GP or physical therapist will create a personalised workout and stretching routine to help you regain strength and flexibility, preparing you for a full return to activity.
Conclusion
Iliopsoas bursitis/tendinopathy can be painful and limit your ability to stay active. Early diagnosis and proper management are necessary for preventing long-term complications and getting back to your favourite activities.
Book an appointment with a healthcare professional today. Our team is here to help you find relief and get back to moving comfortably.