Iliopsoas Bursitis

Symptoms of Iliopsoas Bursitis

• Pain at the front of the hip.
• Pain may radiate down towards the knee.
• Tenderness at the front of the hip and upper quads.
• Pain may even refer to the buttocks or lower back.
• A snapping sensation may be present at the front of the hip.
• Pain on resisted hip flexion and passive hip extension (taking the leg backwards).
• Pain and stiffness in the mornings or after rest.
• Pain gets worse as activity continues.

Causes

A bursa is a pouch of fluid which helps to reduce friction between soft tissues and the bone underneath. Iliopsoas bursitis is an overuse injury which occurs due to repetitive rubbing of the Iliopsoas tendon on the bursa. For this reason it is most common in people who perform repetitive activities auch as running or swimming.

Iliopsoas tendonitis may also result in iliopsoas bursitis due to the close proximity of the two structures.

A big contributor to the development of iliopsoas bursitis is having tight hip flexor muscles. This puts more pressure on the front of the hip and causes more friction between the tendons and the bursa.

Treatment

What can the patient do?

• Rest from repetitive activities or those that cause pain.
• Apply ice to ease pain and inflammation.
• Gently stretch the hip flexor muscles, provided this is pain free.
• Visit a sports injury specialist.

What can a sports injury specialist do?

• Refer you for a CT scan or MRI if necessary to confirm the diagnosis.
• Prescribe or advise on anti-inflammatory medications.
• Design a rehabilitation programme to correct any muscle imbalances.
• This most frequently involves stretching the hip flexors and strengthening the abdominals and glutes.
• Check biomechanics and the need for orthotics etc.
• If conservative treatment is not successful, a corticosteriod injection may be given.
• Surgery to release the iliopsoas tendon is the last resort.