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Iliopsoas Muscles: Abdominal, Groin, Low Back Pain

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?

Image of 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.

What Do The Iliopsoas Muscles Do?

  • 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.

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).
Image of woman demonstrating hip flexion
Image of woman demonstrating spine extension

Iliopsoas Muscles Pain Symptoms

Tightness, dysfunction, and trigger points in the iliopsoas muscles can cause a wide range of symptoms, including pain in the lower abdomen and genitals which are similar to various medical conditions. If there is no medical condition causing your pain, you should check iliopsoas for tightness and trigger points.

Image showing the iliopsoas muscles pain pattern.

The symptoms:

  • Low back pain
  • Abdomen pain
  • Groin pain
  • Thigh pain
  • Pelvic 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 that extends down to the top of the hip.

Note: If the iliopsoas is affected on one side, the pain runs verticle, up and down the back, hip, and upper leg on the affected side. If both iliopsoas muscles are affected, the pain runs 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

Other muscles, including the iliopsoas group, contribute to these conditions

Muscles With Similar Pain Patterns

Satellite trigger points associated with the iliopsoas muscles:

Trigger points in the iliopsoas muscles will cause TrPs to develop in other muscles. These are known as satellite trigger points. You will need to check these muscles for additional TrPs.

Text image defining trigger points
Illustration of a trigger point.

Iliopsoas Trigger Point Treatment

Image showing the locations of iliopsoas muscles trigger points.

The iliopsoas muscles are tricky to treat, and 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.

TWD also recommends getting a copy of The Trigger Point Therapy WorkbookThe book explains trigger points and provides symptoms and treatment techniques for muscles throughout the body.

How Long Before I Feel A Reduction In Pain?

Once you learn how to self-treat psoas trigger points and they are deactivated, your pain and stiffness will be reduced and possibly eliminated.

New trigger points usually deactivate quickly after a few days of consistent treatment. If they have affected the muscle for months or even years, it may take several weeks to deactivate entirely. The good news is that you notice a reduction in pain and stiffness after each treatment.

How To Avoid Development of Trigger Points In The Iliopsoas

  • Pay attention when doing targeted abdominal exercises. When you feel fatigued, stop. More is not always better. Don't overdo it!
  • Alternate sitting and standing throughout the day. Consider a standing desk if you sit at a desk for hours a day. Take time to get up and walk around periodically.
  • We all 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 low back pain.
  • Sleeping on your side can throw your spine, hips, and legs out of alignment, which puts stress on the iliacus and psoas muscles and other 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.
  • 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 to treat 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, tightness, and increase your mobility.

Products We Use and Recommend For Iliopsoas Muscle Pain

There are cheaper braces, but none better.

If you have low back pain or need abdominal support, the Professional's Choice Back Brace will help reduce your pain and stiffness. The waist wrap and 2 side straps are easily adjusted and provide support compression to the low back and abdomen. It is the only low back brace TWD recommends. It works!

Doctors and physical therapists often recommend TENS to relax muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator is an excellent choice for treating back and hip pain.

Image of an adjustable standing desk.

Sitting at a desk for long hours is not good for the body or the mind. A standing desk allows you to alternate standing and sitting.

Image of a lumbar support pillow

Lumbar support pillows support the lower back while sitting, helping to relieve low back pain caused by the iliopsoas muscles and other lower back and abdominal muscles.

Image of body pillows

People who sleep on their side often experience low back and hip pain and stiffness. Body pillows help keep your back, hips, and legs aligned. Wouldn't it be nice to wake up pain-free?


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.

Image Credit: Depositphotos