Groin and Low back Pain Caused by the Iliopsoas Muscle
By Juliette Woodruff
The term iliopsoas refers to a group of muscles which primarily bend the hip.
Iliopsoas is comprised of three muscles: the psoas major, psoas minor, and
iliacus. These muscles attach to both the spine and thigh bone and work in
opposition to the gluteal (buttock) muscles. These muscles in balance provide
the basic strength required for hip movement activities like walking, as well as
playing a significant role in maintaining upright posture. Tightness or shortening
of this muscle can produce groin, and low back pain, as well as creating a series
of other symptoms.
What causes iliopsoas pain?
 An overactive iliopsoas muscle: When your spine and legs are
continuously in a flexed position (e.g., sitting at a desk or in a vehicle for
prolonged periods of time or from repeatedly lifting heavy objects, etc.) the
iliopsoas muscle may shorten and the gluteal muscles at the back of the
hip may stretch. Pain is caused from the over activity in the iliopsoas
muscle and the alterations to the body’s movement patterns resulting in a
variety of musculoskeletal conditions.
 Iliacus Tunnel Syndrome: This usually occurs after surgery to the pelvis
(e.g. hernias, etc.) causes a shortening of the muscles (contracture) and a
build up of scar tissue in the iliopsoas muscle. Sometimes this scar tissue
can trap the femoral nerve and cause iliacus tunnel syndrome causing
feeling to be lost from the inner thigh down to the foot. If may also
become difficult to straighten the knee due to a lack of strength in the thigh
muscles.
 Meralgia Paresthetica: is a condition that irritates the sensory nerve
called the Lateral Cutaneous. This results in a loss of sensation or
burning along the outer aspect of the thigh. Tight clothing, direct trauma
(e.g. seat belt trauma), abdominal surgery, obesity, or deep bruising are
all common causes which can lead to a shortening of the iliopsoas
muscle (contracture) and tension on the Lateral Cutaneous nerve. Over
the long term compression of this nerve can cause skin changes as well
as a loss of hair on the affected leg.
What are symptoms of an over active iliopsoas muscle?
 Pain in your groin area when executing thigh muscle intensive activities
(e.g., walking, hockey, soccer, running, gymnastics, ballet, etc.)
 Pain across your back or down the front of your leg
 A feeling of heaviness in your legs
 Clicking or pain in your groin
 Difficulty straightening your leg
 Pain after sitting for long periods of time
How should iliopsoas pain be treated?
Physiotherapy and massage treatment are beneficial to rehabilitate the gluteal
muscles and to reduce the reoccurrence of tight psoas muscle. Exercises should
be directed at building the abdominal muscles to stabilize the spine. Massage
therapy assists in the rehabilitation although injury occurs due to an imbalance of
structures, strengthening the muscles that are weak are an essential part of
recovery. The specific structures which should be addressed are dependant on
the condition and the strength of the muscles.
Treatment of a tight Iliopsoas can also benefit other conditions (e.g.,
degenerative disc disease, lordosis, scoliosis, faulty posture, etc.). The
lengthening of this muscle helps to re-align the spine, allowing the hip to extend
more fully and to reduce faulty posture.
Massage can aid in a quicker recovery from injury and decrease pain. It allows
the client to perform exercises in less discomfort which enables them to move
better and have an increase in range due to the lengthening of the tissue.
Massage therapy can also allow the muscle to gain power if the trigger points
(irritable area within a muscle) are worked out of the muscle. Many athletes as
well as other clients can get a physiological aspect to their injuries such as
depression which will have a negative impact on their healing process. Massage
therapy treatments aid in reducing stress and improving tissue quality. is
beneficial to enhance circulation to assist in the healing process, increase range
of motion, decrease pain and reduce adhesion formation in the injured tissue.
For further information on massage therapy and iliopsoas treatment please
contact Juliette Woodruff R.M.T who has over five years experience.