Iliopsoas tendinopathy

What is Iliopsoas Tendinopathy?

Iliopsoas tendinopathy is a condition that occurs when the tendon or bursa of the iliopsoas muscle becomes inflamed or injured due to overload or overuse.

The iliopsoas muscle is composed of two distinct muscles, the psoas major and the iliacus. It is located in the front of the trunk and extends from the lower back to the femur in the groin. This muscle plays an important role in hip flexion and posture. The iliopsoas bursa is a small sac located between the iliopsoas muscle and the hip joint capsule. This bursa helps reduce friction and wear between these structures during movement. Inflammation of the iliopsoas bursa is known as iliopsoas bursitis and can also be a cause of hip and groin pain.

What are the causes of iliopsoas tendinopathy?

Causes of iliopsoas tendinopathy can include:

• Overuse and repetitive movements: This is the most common cause. Sports activities that involve constant hip flexion, such as running (especially on hills), cycling, dancing, soccer, or martial arts, can generate repetitive microtrauma to the tendon, leading to inflammation or degeneration.
• Direct trauma: Blows or falls to the hip or groin can directly injure the tendon.
• Muscle imbalances: Lack of strength or flexibility in the synergistic muscles (abdominals, glutes, adductors) can cause the iliopsoas to overwork to compensate, increasing the risk of injury.
• Poor body alignment and posture: Prolonged incorrect posture, such as lumbar hyperlordosis (excessive curvature of the lower back) or scoliosis, can alter the biomechanics of the hip and spine, placing more stress on the iliopsoas tendon.
• Overtraining and overexertion: Performing intense physical activity without proper conditioning or recovery can lead to muscle fatigue and tendon injury.
• Anatomical factors: In some cases, iliopsoas bursitis (inflammation of the bursa near the tendon) can be a cause, often due to the tendon rubbing against bony structures. Other conditions such as femoroacetabular impingement, hip dysplasia, or a labral tear can also predispose to this tendinopathy by altering joint mechanics.
• Aging: The natural wear and tear of tissues with age can make tendons more susceptible to degeneration.
• Improper footwear: Wearing shoes that don't provide adequate support or high heels can affect hip biomechanics.
• Inflammatory diseases: Some autoimmune diseases, such as arthritis, can increase the risk of tendon inflammation in general, including inflammation of the iliopsoas muscle.

It's important to note that iliopsoas tendinopathy can result from a combination of factors, so it's important to seek medical attention for an accurate diagnosis and appropriate treatment.

How is iliopsoas tendinopathy diagnosed?

The diagnosis of iliopsoas tendinopathy is made through a combination of history and physical examination. In addition, imaging tests, such as X-rays, ultrasound, or MRI, may be necessary to obtain a detailed view of the tendon and surrounding tissues.

How is iliopsoas tendinopathy treated?

Treatment for iliopsoas tendinopathy may include:

• Activity modification: Avoid activities that aggravate pain and get adequate rest.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce inflammation and pain.
• Physical therapy: Strengthening and stretching exercises for the hip, abdominal, and lower back muscles to relieve tension and pain.
• Ultrasound-guided injections of corticosteroids or other medications may be effective in relieving pain and inflammation or improving the condition of the tendon.
• Shockwave therapy: Can help improve blood circulation and accelerate tendon healing.
• Physical therapy and strengthening exercises: To prevent future injuries and improve the function of the affected joint.
• Surgery: In severe cases, surgery may be necessary.

Make an appointment with Dr. Jordi Jiménez. He will see you in the center of Palma and help you regain your quality of life.