psoas

Iliopsoas Impingement

The iliopsoas muscle runs along the front of the hip, connecting the spine to the femur.  It is made up of two parts – the iliacus and psoas major and is involved in hip flexion – i.e lifting and bending the leg toward the front of the body.

With iliopsoas impingement, the muscle and tendon of the iliopsoas become tight. In many cases, this is associated with a “snapping hip,” in which the iliopsoas tendon snaps over the labrum and femoral head. The tightness of the iliopsoas causes rubbing against the labrum which can cause irritation and tearing

Symptoms may include groin pain that is aggravated with bending and flexing the hip against resistance or attempting straight-leg rising from the hip. It is aggravated when attempting to rotate the leg outwards or putting the leg in or out of the car or rising from the chair with straight leg. The pain may be worse during activity and may be almost absent during rest.

Non-operative treatment is often successful but requires particular physiotherapy exercises to successfully stretch and lengthen the muscle so that it is no longer so tight.
Sometimes corticosteroid and/or local anaesthetic injections are helpful to provide sufficient pain relief so that physiotherapy can be achieved.

Surgery may be considered to effectively lengthen the tendon. Careful post operative rehabilitation is then required to ensure that the tendon is correctly lengthened and to prevent it from healing back in a tight position.