The iliopsoas is a term used for three muscles in the lower back, hip, and pelvis, the iliacus, psoas minor, and the psoas major. These muscles cause and contribute to pain in the middle and lower back, hips, buttocks, and thighs. The iliopsoas muscles can also contribute to pain in the lower abdomen, pelvis, and groin.
You may have trouble rising from sitting if you have tightness and trigger points in the iliopsoas. You may feel a 'hitch' as you straighten to stand. Another sign is the tendency to walk with one or both feet turned out, which may give you the appearance of waddling like a duck.
Where Are The Iliopsoas Muscles?
The iliopsoas muscles are the iliacus, psoas minor, and psoas major.
The iliacus muscle lines the inside of the hip bone (ilium). The psoas major attaches to the low back (lumbar) vertebrae and descends with the iliacus to connect to the top of the thigh bone (femur).
The psoas minor attaches to the T12 and L1 vertebrae of the lower spine and travels down to connect to the pubis (pelvis bone) via the pectineal line.
For detailed anatomy information: Iliopsoas Muscles Anatomy Page.
The Movements and Functions of the Iliopsoas Muscles
- Picks up the thigh when you raise your thigh toward your stomach (flexion of the thigh at the hip)
- Assists in straightening (extension) of the spine.
Iliopsoas Muscles Pain Symptoms
The iliopsoas muscles can cause a wide range of symptoms, including low back pain, hip pain, groin pain, and pain in the lower abdomen. If abdominal and groin pain is persistent, please consult a physician to rule out medical conditions. If no medical condition is causing your pain, then it is time to consider the iliopsoas muscle group.
The symptoms:
- Low back pain
- Abdomen pain
- Groin pain
- Thigh pain
- Difficulty standing from a sitting position
- Inability or severe pain when doing sit-ups or crunches
- A tendency to walk with feet turned out
- Extreme dysfunction in the iliopsoas can cause pain under the shoulder blade extending down to the top of the hip.
Note: If the iliopsoas muscle is affected on one side, the pain travels vertically along the back, hip, and upper leg on the same side. If the iliopsoas muscles on both sides are affected, the pain spreads horizontally across the lower back, pelvis, and abdomen.
What Causes Iliopsoas Muscles Pain?
Sitting too much and a slumping posture can adversely affect the iliopsoas muscles. Sitting and habitually slumping can cause the muscles to remain in a shortened and tight state which tugs on the bones of the spine, hip, and thigh, causing pain and discomfort.
Frequently climbing or running stairs, running, and abdominal exercises can lead to overuse of the muscles and the development of trigger points. When muscle fatigue sets in, it is time to rest or stop.
Other causes:
- Sleeping on your side in the fetal position
- Shallow breathing, hyperventilating
- Strenuous running
- Sleeping on a lumpy or too soft mattress
- Abdominal surgical scars
Sports and activities that affect the quadratus lumborum:
- Running and power walking
- Cycling
- Soccer and football
- Martial arts
- Gymnastics
- Dance
A list of muscles including the iliopsoas muscles that may be involved in and influence these conditions:
ABDOMINAL PAIN | BUTTOCK PAIN | GROIN PAIN | HIP PAIN | LOW BACK PAIN | PELVIC PAIN | QUADRATUS LUMBORUM SYNDROME | SCIATICA | STENOSIS | TESTICLE PAIN | TROCHANTERIC BURSITIS | UPPER LEG PAIN
Iliopsoas Treatment Suggestions
- Many of us have a habit of slumping when we sit. A lumbar support cushion will remind you not to slouch and support your back, which will help with abdominal and lower back pain.
- Sleeping on your side can throw your spine, hips, and legs out of alignment, putting stress on the iliacus and psoas muscles, neck, back, and hip muscles. If it is the only position in which you sleep comfortably, a body pillow will help keep you in alignment and reduce daily pain and stiffness.
- If you have abdominal scars from surgery, massage is one of the best treatments to treat the restrictions in the area of the scar. The build-up of scar tissue affects the psoas muscle. Massage will reduce your pain and tightness and increase your mobility.
- Avoid activities that aggravate the muscles and cause pain. Give the muscles time to heal before reintroducing activities and movements that cause pain.
Trigger Points In The Iliopsoas Muscles
The iliopsoas muscles trigger points are tricky to self-treat. If you are unsure how to apply treatment, you can bruise or damage vital organs in the area. Find a massage therapist, physical therapist, sports therapist, or chiropractor trained in trigger point therapy to show you how to locate and treat the trigger points.
How To Avoid Development of Trigger Points In The Iliopsoas
- Maintain good posture. Stand up straight. Don't be stiff, stay relaxed, but keep the spine straight.
- Alternate sitting and standing throughout the day. Take time to get up and walk around periodically.
- We all have a habit of slumping when we sit. Sit squarely on the buttocks. Do not slide down so you are sitting at the top of your hips. Keep your back relaxed but straight. Don't slump at the shoulders or waist.
- If you are doing targeted abdominal exercises, stop when you begin to feel fatigued. More is not always better. Don't overdo it!
- If you are a side sleeper, try rolling onto your back and stretching out your hips and legs occasionally. Better yet, try and fall asleep on your back.
- Are you a shallow breather? Does your chest or abs expand to take in air when you inhale? It should be the abdominals. Practice inhaling deep into the stomach and exhaling slowly until deep breathing becomes a habit.
- If you have abdominal scars from surgery, massage is one of the best treatments for treating the restrictions that form in the area of the scar. The build-up of scar tissue affects the psoas muscle. Massage will reduce your pain and tightness and increase your mobility.
Interesting Facts:
- The iliopsoas is an important postural muscle and plays a significant role in a human’s upright stature and ability to walk on two legs.
- In approximately 50% of individuals, the psoas minor is absent
- The psoas major is the strongest hip flexor (brings your leg up toward your stomach).
- Due to their deep location within the body, diagnosing issues with the iliopsoas muscles can be challenging. Healthcare professionals often use a combination of physical examination, imaging studies, and diagnostic injections to assess and treat iliopsoas-related pain and dysfunction.
- In ancient Greek mythology, the iliopsoas muscles or groin region were believed to be the seat of emotions and desires. This area was considered vulnerable in combat and was sometimes targeted by warriors.
Muscle Groups
Abdominal, Low Back | Arm | Chest, Shoulder, Upper Back | Face, Head, Neck | Foot | Hand | Hip, Pelvis | Leg (Lower) | Leg (Upper) | Spine
Areas of Pain
Abdominal Pain | Ankle Pain | Arm (Low) Pain | Arm (Upper) Pain | Back (Low) Pain | Back (Upper) Pain | Chest Pain | Elbow Pain | Foot Pain | Groin Pain | Hand Pain | Head Pain | Hip Pain | Knee Pain | Leg (Low) Pain | Leg (Upper) Pain | Neck Pain | Pelvic Pain | Shoulder Pain | Wrist Pain
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References:
Clay, J. H., Allen, L., Pounds, D. (2015). Clay & Pounds' Basic Clinical Massage Therapy: Integrating Anatomy and Treatment (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins
Davies, C,. Davies, A., (2013). The Trigger Point Therapy Workbook: Your Self-Treatmend Guide For Pain Relief (3rd ed.). Oakland, CA: New Harbinger Publications
Finando, D., Finando, S. , (2005). Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch (1st ed.) Rochester, VT: Healing Arts Press.
Muscolino, J., (2016) Kinesiology: The Skeletal System and Muscle Function (3rd ed.). Maryland Heights, Missouri: Mosby.