Iliopsoas tendonitis is the inflammation of the iliopsoas tendon that attaches the iliopsoas muscle to the front of the femur, or upper leg bone. The iliopsoas muscle flexes the hip, raises the leg forward and also rotates it outwards; the tendon assists this muscle action by anchoring it to the bone for increased strength.
The Cause and Risks of Iliopsoas Tendonitis
Injury and over-use, by repeated flexion or outward rotation of the hip, are the main causes of iliopsoas tendonitis. Injury can also occur by sudden or forceful contraction of the iliopsoas muscle.
This is an injury more commonly found in young people, particularly those who play certain sports or are involved in certain activities. Resistance training can cause iliopsoas tendonitis as can ballet and other types of dancing. Rowers, runners, gymnasts, soccer players and track and field enthusiasts are also at risk of this condition.
The Symptoms of Iliopsoas Tendonitis
As with most types of tendonitis, the main symptom of iliopsoas tendonitis is pain. The pain is felt in the groin or the front of the hip and is usually first noticed immediately after an action or activity that involves the use of the iliopsoas muscle.
If not treated, the pain extends to be felt during activity, commonly kicking, running and jogging. Patients report that they experience pain doing simple actions like putting on shoes, walking upstairs or standing from a seated position.
The pain of iliopsoas tendonitis often starts as short-term tenderness but progresses to continuous, severe pain. It may be felt radiating down the front of the thigh and even in the front of the knee. Sometimes there is a quite audible click or snapping sound in the hip when the leg in raised or rotated.
The pain is caused by inflammation of the iliopsoas tendon where tiny tears have occurred near where the tendon attaches to the femur. As well as pain, there may be some redness, swelling and heat in the area.
The best initial treatment for iliopsoas tendonitis is rest, together with the application of ice packs every 2 hours, for between one and four days. To reduce inflammation, NSAIDs, anti-inflammatory medication, is helpful; the ice packs also help to reduce swelling. Any action that causes pain should be avoided.
Once the initial severe pain has subsided, light movements can be introduced, to prevent muscle tightness developing. Gentle walking and light stretches are recommended. Relative rest is still required, where use of the iliopsoas muscle is avoided but other movements can be performed. Gentle stretching of the iliopsoas tendon is beneficial, in a low forward lunge with the opposite leg straight on the floor behind. This stretch should be pain-free and held for twenty seconds; after a thirty second rest, the stretch is repeated; up to five repeats are sufficient. Always stretch both sides.
If the pain continues or is severe, your doctor may recommend an ultrasound-guided cortisone injection. Surgery is seldom required for this type of tendonitis.
As recovery progresses, more challenging stretching and strengthening exercises can gradually be introduced. These treatments are best done under the guidance of a trained physical therapist.
The Prevention of Iliopsoas Tendonitis
One of the best methods for the prevention of iliopsoas tendonitis is following best practice guidelines for warming up and cooling down before and after exercise.
It is important to fully prepare your muscles and tendons for the work ahead, so never skip this vital stage. Stretches form part of the warm-up; take special care to stretch the iliopsoas muscle and tendon as well as the other stretches you normally do.
Having strong abdominals and hamstrings also helps to prevent this type of tendonitis by maintaining the correct pelvic tilt, which takes undue pressure off the iliopsoas muscle. Wear the correct footwear for the sport or activity you are involved in, as activity-specific shoes are made to support and cushion the ankles and feet to help prevent injuries.