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 feel a 'hitch' as you rise sitting if you have tightness and trigger points in the iliopsoas. The stiffness and pain make it difficult to stand.
Another sign of iliopsoas dysfunction is the tendency to walk with one or both feet turned out, which may give you the appearance of waddling like a duck.
Table of Contents
Where Are The Iliopsoas Muscles?
The three muscles of the iliopsoas group are the iliacus, psoas minor, and psoas major.
The iliacus muscle lines the inside of the hip bone (ilium) and attaches to the crest of the pelvis. The psoas major attaches to the lower back lumbar vertebrae (T12-L5) and descends with the iliacus to connect to the top of the thigh bone (lesser trochanter of the 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.
Note: Recent information does not include the psoas minor as part of the iliopsoas muscle complex.
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)
- Twists the hip and leg outward (Rotation of the hip)
- Assists in bending (flexion) of the spine.
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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. A tight psoas major muscle mimics sciatica pain.
The pain is often a deep ache in the lower back, pelvis, and the front of the hip that increases with long periods of standing or sitting. This pain pattern is often mistaken for dysfunction in the hip or a hernia. Pain may radiate into the front of the thigh and knee.
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
- Hip pain and stiffness affecting your ability to straighten up at the hip
- Hip instability
- Groin pain
- Abdomen pain
- Thigh pain
- Difficulty standing from a sitting position
- Inability or severe pain when doing sit-ups or crunches
- A tendency to walk with one or both 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:
- Weak abdominal muscles are responsible for much of the pain caused by the iliopsoas muscles.
- Sleeping on your side in the fetal position - Keeps the iliopsoas in a shortened state
- Shallow breathing, hyperventilating
- Strenuous running
- Climbing stairs - the repetitive motion of bending at the hip to lift the leg can overwork the muscles
- Wearing high heels affects the alignment of the pelvis causing the iliopsoas muscles to tighten and shorten.
- Carrying heavy bags on one side - muscle imbalance
- Carrying a child using your hip to help balance the child.
- Sleeping on a lumpy or soft mattress
- Abdominal surgical scars
Sports and activities that affect the quadratus lumborum:
- Running, power walking, and cycling - the repetitive up and down motion of the leg at the hip can lead to muscle soreness in the hips.
- Running stairs - overworks the muscles with the repetitive lifting of the leg and the added speed of running
- Soccer and football - require quick speed and sudden turns that stress the muscles. Kicking requires extreme power and bending at the hip joint affecting the iliopsoas.
- Basketball - requires high jumps, sprinting, and quick pivots all of which can cause ilopsoas stress and injury.
- Martial arts - high kicks and knee lifts can overwork iliopsoas muscles.
- Gymnastics and dance - the extreme bending and straightening of the hip and spinal vertebrae requires strength and flexibility of the iliopsoas which can lead to muscle overload.
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 scar area. The build-up of scar tissue affects the psoas muscle. Massage will reduce your pain and tightness and increase your mobility.
- Weak abdominal muscles are a primary cause of low back pain. Start doing exercises that target the abs and low back muscles to build muscles and strength
- 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 the soft tissues and 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 Iliopsoas Pain
- 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!
- On the other hand, if your abdominal and low back muscles are weak and out of shape, begin exercises that target the core muscles. Start slowly and build up reps within your tolerance.
- 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 develop 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.
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 | TROCHANTERIC BURSITIS | UPPER LEG PAIN
Interesting Facts About The Iliopsoas Muscles:
- They connect the upper body to the lower body and are important postural muscles. The muscles play a significant role in a human’s upright stature and ability to walk on two legs.
- The psoas major is the strongest hip flexor (lifts your leg up toward your stomach).
- The iliopsoas is responsible for explosive movements, required in many sports
- The muscles are important for maintaining balance and preventing falls in older adults.
- In approximately 50% of individuals, the psoas minor is absent
- 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.
Muscles With Similar Pain Patterns
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
Muscle Groups
Abdominal, Low Back | Arm | Chest, Shoulder, Upper Back | Face, Head, Neck | Foot | Hand | Hip, Pelvis | Leg (Lower) | Leg (Upper) | Spine
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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.