Iliopsoas Bursitis/Tendonitis Causes, Symptoms & Treatment

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 anterior hip discomfort.

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 or tendonitis occurs when the bursa or tendons become irritated and inflamed. This condition can be painful and make physical activity difficult.

In athletes, iliopsoas bursitis/tendonitis is often caused by overuse of the iliopsoas muscles and surrounding tissues. Sports that involve repetitive motions can cause chronic wear and tear on the bursa and tendons. Athletes with tight flexor muscles are also at greater risk because of increased pressure on the tendons and bursa, which can irritate, sometimes leading to an inflamed hip tendon.

Iliopsoas bursitis/tendonitis is most common in these sports:

• Running
• Swimming
• Ballet Dancing
• Martial Arts
• Soccer

The primary symptom associated with iliopsoas bursitis/tendonitis is pain. A dull, achy pain is usually felt in the front of the thigh or groin. It can sometimes extend down the thigh and to the knee and buttocks. Common symptoms also include:

• Groin pain associated with activity, such as walking, climbing stairs, exercising, or standing from a seated position
• Tenderness in the front of the thigh or groin
• A snapping sensation in the hip (also known as snapping hip)

You should see your doctor if you experience hip flexor pain or pain in the groin area for more than 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. He/She 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.

Treatment of iliopsoas bursitis or tendonitis usually involves rest from sports and other activities that stress the iliopsoas muscles, such as running or swimming. Conservative treatments also include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, to relieve pain
• Corticosteroid injections guided by x-rays or other imaging tools to relieve pain and speed recovery
• Physical therapy exercises to strengthen muscles and improve flexibility

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Iliopsoas Bursitis

In rare cases, when conservative treatments are not effective, your doctor may recommend surgery to release the iliopsoas tendon.

Your doctor may advise limited activity during your recovery period, which can range from six to eight weeks to give your iliopsoas muscles and the bursae time to fully heal. Your doctor and physical therapist will work with you to develop an exercise and stretching program to get you ready for a full return to play.