The iliopsoas is a complex constituted of three different muscles, the iliacus, the psoas major and the psoas minor. Generally speaking, the psoas originates from the lower part of the spine and the iliac fossa (part of the pelvic girdle) and attaches to the anterior-medial aspect of the femur (lesser trochanter). The main function of this muscle group is to flex the hip, secondary functions include hip rotations and pelvic-spine stabilisation. Psoas syndrome is an umbrella term utilised to indicate a musculoskeletal disorder affecting the iliopsoas and the surrounding tissues, including conditions often described as iliopsoas bursitis, snapping hip, impingement, and tendinopathy. This condition is more common in patients who participate in activities that significantly stress the anterior aspect of the pelvis and hip area through repetitive hip flexions and extension motions (e.g.: kicking, sprinting, dancing, etc.). Despite being more common in the athletic population, the general population can develop this syndrome too. Patients affected by this condition typically report pain in the anterior-medial aspect of the hip, often related to functional activities that require flexing the hip joint (e.g.: walking, running, kicking, etc.) a sensation of catching in the groin, and potential “weakness” of the area.
Management
Patients affected by iliopsoas syndrome typically respond well to non-surgical treatment, with some rare cases needing surgical intervention (e.g.: arthroscopic lengthening of the tendon, psoas tendon release, etc.). Rehabilitation is the main non-surgical intervention prescribed, with optimal outcomes reported in the literature. In Isokinetic, after being visited by one of our specialised doctors who will provide immediate injury assessment through a thorough clinical, and instrumental (e.g.: ultrasound) examination, you will be prescribed a recovery plan tailored to your specific needs. Your rehabilitation journey will take place in up to four different environments depending on your condition: the pool, the gym, the movement analysis and retraining room, and our pitch. In the early stages, the main goals are to restore homeostasis by reducing pain and swelling, recovering mobility, and gradually restoring lower limb functioning. In the mid-stage of rehabilitation, core and lower limb strength recovery becomes the priority, together with the optimisation of the general movement quality to learn how to effectively distribute the load among different joints. Finally, to complete the recovery process, on-field rehabilitation plays a fundamental role in allowing our patients to return to participate in their favourite activities, maximising the outcomes and reducing the likelihood of complications.