Psoas Strain

By: Chad Evans, MPT

What is The Psoas?

What is a psoas strain? Better yet, what is a psoas? A psoas is a large muscle group that originates on either side of the lower spine and travels through the pelvis. It combines with the iliacus muscle before traveling down and inserting unto the upper part of the femur (thigh bone). Together these muscles are known as the iliopsoas and they play a key role in helping you walk as well as maintaining your lumbar spine posture. 

Anatomical image of the hip flexors with labels and arrows to show Psoas major, psoas minor, and Iliacus

What is a Psoas Strain?

A Psoas strain is when fibers of the muscle or tendon of the Psoas are damaged. This can range anywhere from a few fibers or minor strain, to a complete tear. 

These muscles are commonly injured or strained from overuse. This is more likely seen in individuals that perform frequent running or jumping activities. (Think dancers, gymnast, basketball players, soccer players and track and field athletes.)

Causes of Psoas Strain

An overuse strain to the psoas muscle is often referred to as psoas syndrome. This condition can be related to chronic hip and lower back pain and is also associated with those who have poor core strength and flexibility deficits. It can also be related to ramping up too quickly with sports training or activities. Due to the muscle group’s anatomical location, it is common to have symptoms along the area in which this muscle travels. 

Typically people with this condition will complain of pain in the lower back, glutes, pelvis, hip or groin region. Sometimes there is lower back pain with walking or when changing positions. This is frequently seen when going from a sitting to standing position. It is also common for pain to increase with activity and improve with rest. If persistent, in some cases the pain results in a limp.

Diagnosis of Psoas Strain

To correctly diagnose a psoas strain or psoas syndrome, one would need to see a physician to have an assessment of the hip and lower back. A thorough history of symptoms and physical exam would be required.

 X-rays are often performed to rule out other problems that may present with similar symptoms. An MRI can be beneficial to get a better understanding of the psoas condition. In rare cases, lidocaine injections can be used to try to identify the origin of the pain.

How Do You Fix A Psoas Strain?

In most cases a psoas strain or psoas syndrome will respond well to physical therapy. Patients will improve when starting an appropriate stretching and strengthening regimen targeting specific areas. A licensed physical therapist will be able to identify which muscles or joints are stiff, tight or weak and design a program to address these deficits.Female physical therapist stretching the left psoas or hip flexor of a male patient who is lying on his right sidePhysical Therapy for Psoas Strain
If the condition is chronic and there are other health issues involved, recovery make take a little longer. Manual techniques such as joint mobilization and massage are often beneficial. In some cases the use of modalities such e-stim, heat, or ice can be helpful to reduce reactivity and pain in the underlying muscles. If you think you have a Psoas Strain or Hip Flexor Strain, the Jacksonville Orthopaedic Institute can help.

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