Iliopsoas Bursitis/Tendonitis Causes, Symptoms & Treatment
Iliopsoas bursitis/tendonitis involves inflammation of the iliopsoas bursa or tendon near the hip joint. It often results from overuse, repetitive hip flexion, or strain. Common symptoms include groin pain, hip stiffness, and discomfort when walking or climbing stairs. Treatment usually includes rest, stretching, anti-inflammatory medication, and physical therapy.
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Find Relief TodayOverview
Often referred to as hip flexors, the iliacus and psoas muscles are important hip muscles. These muscles are key to hip flexion. They are necessary for walking, running, bending, and supporting the body. When irritated, they can be a common source of hip flexor pain and pain in the front of the hip.
Bursa are small, fluid-filled sacs located beneath these muscles. They act as cushions, reducing friction between the hip flexor muscles, their tendons (soft tissues that connect muscles to bone), and the hip.
Iliopsoas bursitis/tendonitis occurs when the bursa or tendons become irritated and inflamed. This condition can be painful and make physical activity difficult.
What causes Iliopsoas Bursitis/Tendonitis?
In athletes, iliopsoas bursitis or tendonitis typically develops from overuse of the hip flexor muscles and surrounding tissues. Sports involving repetitive hip movement can lead to chronic strain, irritation, and inflammation of the iliopsoas tendon or bursa. Athletes with tight hip flexors are at higher risk, as constant tension increases pressure on the area, resulting in pain and limited mobility.
How the Injury Occurs
- This condition often arises when the iliopsoas muscle is repeatedly activated during running, jumping, or kicking. Over time, friction between the tendon and bursa causes inflammation. Sudden increases in training intensity, improper warm-ups, or poor posture can also trigger the injury.
- Common Everyday Causes: Iliopsoas bursitis or tendonitis can also occur from daily activities that involve repetitive bending or hip flexion, such as climbing stairs, cycling, or prolonged sitting. It may also affect individuals who suddenly increase physical activity levels, have poor posture, or perform heavy lifting without proper technique.
Iliopsoas Bursitis/Tendonitis Is Most Common in These Sports:
- Running: Repetitive hip flexion during long runs strains the iliopsoas tendon and bursa.
- Swimming: The flutter kick constantly engages the hip flexors, increasing friction and irritation.
- Ballet Dancing: High leg lifts and turnout positions continuously stress the hip flexor bursa region.
- Martial Arts: Kicking and rapid directional changes overload the iliopsoas muscle.
- Soccer: Frequent sprinting and kicking movements cause repetitive flexion, leading to inflammation.
Symptoms
The main symptom of iliopsoas bursitis or tendonitis is pain, typically described as dull, aching discomfort in the front of the thigh or groin. Depending on the severity of inflammation, this pain may radiate down to the thigh, knee, or even the buttocks.
Common symptoms include:
- Groin pain during activity: Discomfort that worsens with walking, climbing stairs, exercising, or standing up from a seated position.
- Tenderness: Sensitivity or soreness felt when pressed in the front of the thigh or groin area.
Snapping sensation in the hip: A feeling or sound of the hip “snapping” during movement.
When to see a doctor
You should see your doctor if you experience hip flexor pain or pain in the groin area for over a few days. Describe your symptoms during your visit and the types of sports and physical activities you engage in. Your doctor will conduct a thorough physical examination to check your hip for range of motion and strength.
They may perform some physical examination tests to exclude other causes of your pain. X-rays and other imaging tests may be ordered to help rule out other sources of your symptoms, especially if other hip-related conditions, such as hip arthritis, are suspected.
Non-operative treatment
Most cases of iliopsoas bursitis or tendonitis can be effectively treated without surgery. The key is to rest from activities that strain the iliopsoas muscles, such as running, swimming, or repetitive hip flexion movements. Taking time off helps reduce inflammation and prevent further irritation.
Conservative treatment options include:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can help relieve pain, reduce inflammation, and improve comfort during recovery.
- Corticosteroid Injections: Image-guided injections deliver medication directly into the inflamed area, easing pain and accelerating healing.
- Physical Therapy: Specific stretching and strengthening exercises help restore hip flexibility, improve muscle balance, and prevent recurrence of the condition.
Try these exercises to help address your condition:
Below is a PDF of the Exercise Program
Surgical Treatment
Surgery for iliopsoas bursitis or tendonitis is rarely needed and is considered only when conservative treatments fail to provide relief. The procedure typically involves releasing the iliopsoas tendon to reduce tension, minimize friction, and alleviate pain around the hip joint. This helps restore normal movement and prevent further inflammation.
Recovery
Recovery after iliopsoas surgery or non-operative treatment generally requires six to eight weeks of gradual healing. During this period, your doctor may recommend limited physical activity to allow the muscles and bursa to recover fully. A personalized rehabilitation program, including stretching, strengthening, and range-of-motion exercises, will be developed by your doctor and physical therapist to help you regain flexibility and safely return to full activity or sports participation.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
Is it normal to feel a snapping sensation in the hip with this condition?
Yes, many people experience a snapping hip feeling due to the tendon movement over the bone. It’s a common and manageable symptom of iliopsoas inflammation.
What are the first signs of an inflamed hip tendon or iliopsoas bursitis?
You may notice a dull ache or anterior hip discomfort, especially when walking or climbing stairs. Early treatment helps prevent worsening.
Can athletes recover fully from iliopsoas bursitis or tendonitis?
Absolutely. With guided therapy and time, most athletes regain full strength and mobility, even after dealing with anterior groin pain or hip flexor strain.
Are there gentle ways to ease iliopsoas-related pain at home?
Yes! Ice, gentle stretches, and modified activity can reduce inflammation in the hip tendon and may enable long-term recovery without more aggressive treatments.