Iliopsoas bursitis is a cause of pain at the front of the hip and deep in the groin, arising around the iliopsoas — the powerful muscle that flexes the hip. It is less familiar than outer-hip problems, and its deep, front-of-hip pain can be puzzling, but it is a mechanical, soft-tissue issue that usually responds well to the right care. At Back in Action in Penwortham, we care for people across Preston and Lancashire with front-of-hip and groin pain of this kind.
Understanding iliopsoas bursitis
The iliopsoas is the main hip-flexor muscle, and in fact comprises two muscles working together, running from the lower spine and pelvis to the top of the thigh bone and allowing you to lift your knee towards your body. Where its tendon passes across the front of the hip, a bursa — a small, fluid-filled sac — reduces friction between the tendon and the structures beneath it. When this area is irritated, often through overuse of the hip flexor, the result is pain felt deep in the front of the hip and groin, known as iliopsoas bursitis.
It frequently goes hand in hand with tightness or overload of the iliopsoas tendon itself, and sometimes with a sensation of snapping or clicking at the front of the hip as the tendon moves. It is a mechanical problem rather than a sign of anything serious, but because deep groin pain can have several causes, a careful assessment is important to be sure of what is involved.
Modern life arguably encourages this kind of problem. Long hours sitting keep the hip flexors in a shortened position, so that when they are then asked to work hard — in running, cycling or sport — they are tight and more easily overloaded. This combination of prolonged sitting and bursts of demanding activity is a common background to front-of-hip pain.
What it can feel like
Symptoms centre on the front of the hip and groin, and may include:
- Pain felt deep in the front of the hip or groin, often worse with activity
- Discomfort when lifting the knee, climbing stairs or getting up out of a low chair or car
- A snapping, clicking or catching sensation at the front of the hip with certain movements
- Pain that builds with repeated knee-lifting and eases when the hip is rested
- Pain that eases with rest and builds with hip-flexing activity
- Tightness or a feeling of restriction at the front of the hip
- Discomfort that is often worse after long periods of sitting
The link between the pain and movements that work the hip flexor — particularly lifting the knee — is a useful clue that the iliopsoas is involved.
Common causes and risk factors
Iliopsoas bursitis usually develops from overuse or overload rather than a single dramatic injury, and it is often the result of a gradual build-up. Common contributors include:
- Repetitive hip-flexing activities such as running, cycling, rowing or kicking sports
- Sudden hill running or stair climbing after a period of less activity
- A sudden increase in training or activity
- Tightness or weakness in the hip flexors and surrounding muscles
- Prolonged sitting, which keeps the hip flexors in a shortened position
- Sometimes occurring alongside other hip, pelvic or lower back problems
Part of our assessment is confirming that the iliopsoas is the source, and understanding what has overloaded it, so that care addresses the cause as well as the symptom.
When to seek help
Front-of-hip and groin pain is worth having assessed, particularly when it is persistent or limiting. Please seek prompt medical attention if the pain follows a significant injury, if you cannot bear weight, or if the area is hot, swollen and red with a fever. In men, a persistent lump or bulge in the groin should be checked by a doctor, as it may indicate a hernia rather than a muscle or bursa problem.
How chiropractic care can help
Chiropractors care for many people with front-of-hip and groin pain. The aim of our care is to settle the irritation, release what is tight, and rebuild a better balance of flexibility and strength around the hip so the problem is less likely to return. Following a thorough assessment, our hands-on, drug-free care may include soft-tissue work to release the tight hip flexors and ease tension around the front of the hip, mobilisation of the hip, pelvis and lower back where movement is restricted, and a graded rehabilitation programme to restore balance, flexibility and strength around the hip. Because we are a multi-practitioner clinic, we can also draw on physiotherapy. We will be honest about what care can realistically offer and refer you on where appropriate.
What to expect at Back in Action
Your first visit is mostly about understanding your hip and groin pain. We will take a careful history — including any recent change in your activity — and carry out a physical examination of the hip, pelvis and lower back, including tests of the hip flexors and movement. We will explain what we have found in plain language and discuss whether chiropractic care is appropriate. Because deep groin pain can occasionally relate to the hip joint itself rather than the surrounding soft tissues, part of this assessment is satisfying ourselves about which is involved, so that care is directed correctly.
You can read more on our new patients page, with current charges on the fees page. Because this kind of problem often relates to overload and tightness, we will set out a realistic plan that combines easing the irritation with addressing what caused it, and review your progress as we go.
Helping yourself: self-care and recovery
There is plenty you can do to help iliopsoas-related pain:
- Reduce, rather than completely stop, the hip-flexing activities that aggravate it
- Set up your seating and workstation so the hips are not held in a deeply flexed position all day
- Break up long periods of sitting, which keep the hip flexors shortened
- Introduce gentle stretching and, in time, strengthening of the hip flexors and surrounding muscles
- Increase running, cycling or training loads gradually rather than in sudden jumps
- Be patient and consistent, as overload problems reward steady effort over time rather than a quick fix
If you would like guidance tailored to you, we can build a safe, progressive exercise and self-care plan around your particular problem. Combining a reduction in what is overloading the hip flexor with steady work on its flexibility and strength tends to give the most reliable, lasting results.
Related conditions and treatments
Iliopsoas bursitis is closely linked to hip, groin and pelvis pain, hip pain, hip tendonitis and groin and thigh pain. The care we provide draws on approaches such as exercise and rehabilitation and chiropractic manipulation, and may form part of a wider plan alongside our chiropractic, physiotherapy and sports therapy services.
Take the first step
If front-of-hip or groin pain is getting in the way of your life, you do not have to simply put up with it. We are happy to talk it through and help you understand your options. You can get in touch to book an appointment, or to ask any questions before your first visit.