Iliopsoas Bursitis

Iliopsoas bursitis is inflammation of the bursa which sits under the Iliopsoas muscle at the front of the hip. It is sometimes also called Iliopectineal bursitis.

Symptoms of Iliopsoas Bursitis

Iliopsoas bursitis symptoms include pain at the front of the hip which may radiate down to the knee or even into the buttocks. There will be tenderness at the front of the hips and possibly in the front of the quadriceps muscles. A snapping sensation may be felt in the hip. In the mornings pain and stiffness could be felt which eases as the body gets warmed up. With Iliopsoas bursitis pain usually gets worse as activity increases. Pain on resisted hip flexion and passive hip extension (taking the leg backwards).

Causes of Iliopsoas bursitis

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.

Iliopsoas bursitis 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.