Iliopsoas Tendonitis
Using Massage to Treat Hip Tendonitis

Iliopsoas tendonitis is also known as hip tendonitis or groin tendonitis. The condition is common in athletes who participate in sports that require running, jumping, and/or kicking. Weight lifters and dancers also get the condition. It can occasionally occur in people in other professions also. Massage therapy and stretching can help ease the pain associated with this form of tendonitis.

Hip tendonitis occurs as a result of the overuse of the iliopsoas tendon. It can sometimes present as a snapping sound or snagging feeling in the joint when it moves. Let's look at the anatomy of the condition and how it can be treated.

Anatomy

In the picture, you can see the psoas major and illacus clearly marked. At the bottom, these muscles attach to the lesser trochanter of the femur. They originate at different points though. The illiacus originates in the pelvis or hip bone and the psoas originates from the spine. Though they have different points of origin, they end up in the same place. The injury causing the pain associated with iliopsoas tendonitis occurs at the point of insertion where the tendons of both muscles connect to the femur.

These two muscles are responsible for lifting the leg or bending the torso towards the leg. This action is called hip flexion. It is also involved in some spinal rotation and some lateral rotation of the hip.

Tendons are normally slippery so that they can slide easily over muscles, bones and other tendons. When the tendon is injured it swells and becomes less slippery. It no longer glides easily and this causes pain.

The pain associated with iliopsoas tendonitis is gradual. It doesn't happen all at once. You can feel it start to happen and as time goes by it continues to get worse and worse. That's why it needs to be treated. You must rest the area and take some action to help it heal. Ignoring it will not make it go away. It will only get worse.

If your pain occurs suddenly it isn't tendonitis. It could be iliopsoas syndrome which occurs from a sudden injury. In that case, the tendon is severely stretched, torn or even ruptured.

Symptoms

If you have iliopsoas tendonitis, you'll have the following symptoms.

• pain in groin area when walking
• pain in groin area when running
• pain in groin area when walking up or down stairs
• lower back pain
• pain in the groin when laterally rotating your hip

If these symptoms sound familiar, you probably have this iliopsoas tendonitis. Don't try to diagnose yourself though. You should always get the advice of a medical professional in these situations.

Traditional Treatment

Traditional treatments for any form of tendonitis are usually pretty much the same. You'll be advised to rest. This is very good advice. Your tendon needs time to heal. If you continue to do the same activities again and again, you'll constantly re-injure it and won't get any better.

Medications can be given to reduce the pain and swelling. These anti-inflammatory medications are great for addressing the symptoms, but don't deal with the root cause of the problem. They also have side effects that you probably don't want to deal with.

Cortisone injections are also anti-inflammatory. They get rid of the pain in the joint and bring down swelling. Just like oral medication though these injections only address the symptoms and not the cause. They also compromise the stability of the joint because they make the tendon rubbery and more prone to injury. Once the shot wears off you'll have to get another.

Surgery is rarely performed for iliopsoas tendonitis.

Massage and Self Care

A profession massage therapist can help release any tension in your psoas major and illacus muscles. Massaging the area will increase the blood flow to the muscles helping to speed healing time. These muscles lie deep in the body. In order the reach them your therapist will work through your abdomen. You will lay on your back with your knees bent in a comfortable position and the therapist will have you breathe deeply. As you exhale the therapist will sink deeper and deeper into your abdomen until the affected muscles are reached.

Before working on you a good therapist will have you fill out an intake form. Then the therapist will do some tests to see if you actually have iliopsoas tendonitis.

This is a difficult area to reach because it is surrounded by organs, major arteries and nerves. Make sure you work with a therapist who has experience working on the psoas and illacus. A therapist who practices a form of therapeutic massage, like medical massage, neuromuscular therapy, rolfing, pfrimmer massage or any other therapeutic massage should be able to give you the treatment you need.

If you're interested in self-treatment, here is some simple advice for you.

To bring down the swelling in the tendon ice it. The sooner you start icing your iliopsoas tendonitis the faster it will heal. You may have heard of the term R.I.C.E.

• Rest
• Ice
• Compression
• Elevation

For all you self-massagers out there, this isn't an injury that I'd recommend massaging yourself. Simply because of the amount of other things in your abdomen that you could damage.

You can do some simple stretches to help release the muscles and heal the tendon. Try laying on your bed with the leg that's bothering you dangling off the edge of the bed. This will give your psoas and illacus a nice stretch.

You can do another stretch by getting on the floor in a lunge position. That means you're down on the knee of the side that's bothering you. Your other foot is on the floor in front of you with your knee at a 90 degree angle. Push your hips forward as you lean back slightly stretch the muscles.

Doing these stretches three times daily will help release the muscles.

Once your iliopsoas tendonitis has healed, work on strengthening your core muscles. If you have a strong core you'll be less likely to have a re-occurrence.

Remember to warm-up and stretch thoroughly before working out.

Here's a video that demonstrates some stretches you can do for your iliopsoas.

Books that May Interest You

Dance anatomy and kinesiology

Massage and Manual Therapy for Orthopedic Conditions (LWW Massage Therapy and Bodywork Educational Series)

Sports Medicine Bible : Prevent, Detect, and Treat Your Sports Injuries Through the Latest Medical Techniques