Iliopsoas Bursitis & Inflammation

Iliopsoas Bursitis

The iliopsoas muscle is a powerful hip flexor used to bring the knee up at speed when running. Inflammation of the tendon, or the bursa (small sack of fluid) can cause gradual onset pain deep in the groin area.

The muscle or tendon itself can become inflamed causing groin pain and a feeling of tightness and swelling.

Symptoms

Iliopsoas bursitis symptoms and iliopsoas tendon inflammation have similar symptoms and may be difficult to distinguide between the two. 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. Pain usually gets worse as activity increases. Pain is felt on resisted hip flexion and passive hip extension (taking the leg backward).

Overuse and repetitive activities such as running can make this injury more likely to develop. The bursa reduces friction between tissues and bones so when this becomes inflamed, pain flares up in this area.

Causes of Iliopsoas bursitis

It is sometimes also called Iliopectineal 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 such 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 corticosteroid injection may be given.
  • Surgery to release the iliopsoas tendon is the last resort.