Table of ContentsView AllTable of ContentsAnatomy of the Iliopsoas MuscleFunctionAssociated ConditionsRehabilitation ConsiderationsSummary
Table of ContentsView All
View All
Table of Contents
Anatomy of the Iliopsoas Muscle
Function
Associated Conditions
Rehabilitation Considerations
Summary
The iliopsoas muscle is the major flexor of your hip joint. It’s made up of two muscles: theiliacus, thepsoasmajor. These muscles work together to flex your hip, as well as stabilize your hip andlower backduring activities like walking, running, and rising from a chair.
Your body has two iliopsoas muscles: one at the left hip, and one at the right hip. Injury to the iliopsoas may causehip pain and limited mobility.
The iliopsoas consists of two distinct muscles. They are usually grouped together due to their common attachment point on your femur (thigh bone).
The iliacus and psoas major muscles arise from the pelvis andlumbar spine, respectively, and blend to insert on the lesser trochanter of the femur. The psoas minor, a separate muscle, arises from the lumbar spine and inserts onto the pectineal line and iliopubic eminence, contributing to pelvic stability.
There is a fluid-filledbursathat lies near the iliopsoas muscle that helps it glide and slide over the front of your hip during movement.
The iliopsoas muscle gets blood supply from the iliolumbar artery that arises from the internal iliac artery.
Treating Tight or Weak Psoas Muscle Pain
Anatomical Variations
The psoas minor has been shown to be absent in 40% of the population.
Other variations include muscles originating from different points, or variations in nerve placement within the lumbar plexus (the network of nerves stemming from the lumbar region) or the psoas major muscle, which can lead to symptoms of nerve entrapment, otherwise known as apinched nerve.
Function of the Iliopsoas Muscle
Since the iliopsoas muscle arises from different places in your pelvic area and lumbar spine, it functions in different ways. The main action of the iliopsoas is to flex your hip. This means that it bends your hip toward your body, as in the action of marching. It’s considered the major flexor of your hip.
If your iliopsoas muscle contracts on only one side of your body, it works to assist in lateral flexion, or side-bending, of your lower spine. When you have one foot on the ground and the other in the air, as occurs with walking, the iliopsoas contracts to help stabilize your pelvis, hip, and lumbar spine.
The psoas major primarily flexes the hip and can assist in flexing the lumbar spine when the trunk is stabilized. This occurs when you are lying on your back and go to sit up. The psoas major contracts and pulls your lumbar spine into flexion to help you rise.
The psoas muscles also assist with bending your spine backward into extension. This is in direct opposition toflexion, so the question arises of how the psoas can both extend and flex your spine. This is often referred to as the “psoas paradox.”
Your psoas muscle acts as a lumbar spine flexor when your body is in certain positions, and it can assist other muscles to pull your low back into extension when your body is in other positions. The contribution of the psoas during extension has been shown to be minor, but the psoas paradox remains an interesting caveat of the function of the muscle.
Why Does My Iliopsoas Muscle Hurt?
The hip flexor pain usually starts around the front of the hips and can radiate down the thighs to the knees. Some individuals may experience stiffness or tightness in the hip region, particularly after prolonged inactivity or upon waking up.
Many different problems may involve your iliopsoas. These conditions may cause pain, weakness, and difficulty with basic tasks such as walking, running, and rising up from a lying position.
While these problems are prevalent in athletes, they can affect anyone. Conditions that may affect your iliopsoas may include:
While many of the conditions that affect the iliopsoas may cause pain and limited mobility, other conditions that cause hip pain may be at play.
Ahip labrum tearcan cause pain in the front of your hip, and a condition calledfemoroacetabular impingementcan make flexing and extending your hip painful.Hip arthritiscan cause limited mobility with your hip joint. These conditions may or may not affect the iliopsoas directly.
If you are experiencing hip pain or difficulty walking, you should visit your physician right away. They can help diagnose your condition and guide you to the correct treatment.
Rehabilitation of the Iliopsoas Muscle
After visiting with your physician to determine the cause of hip pain and limited mobility, you may benefit from working with a physical therapist (PT) to help you treat your iliopsoas condition. Your PT may recommend various treatments for your iliopsoas. These may include some of the following.
Rest
If you’re experiencing iliopsoas irritation due to overuse, resting it for a few days may be recommended. Stop any activity that’s causing hip pain. Rest is usually recommended, and then resume gentle stretches and strengthening exercises.
Stretching
If your iliopsoas muscle is tight, stretches may be prescribed.To stretch your iliopsoas:
You can also stretch your hip iliopsoas while lying on your back on a bed or massage table:
fizkes / Getty Images
Strengthening
If your iliopsoas muscle is weak, strengthening exercises may be done.Simple straight leg raiseson your back or resisted seated marching may be recommended. Resistance can be added with cuff weights or with a resistance band.
You can also strengthen your iliopsoas while standing. Simply use a resistance loop that is tied to a stable object. Place the loop around your ankle, maintain an upright posture, and flex your straight leg forward. Hold the flexed position for three seconds, and then slowly release.
Strengthening exercises can be done for 15 to 20 repetitions. Two or three sets can be done once a day. Stop if you feel any increasing pain while doing the exercise.
Low Back Exercise
If a pinched nerve is causing iliopsoas weakness, getting pressure off your nerve may be recommended. Targeted lumbar exercises, such as prone press-ups or other prescribed stretches, may help alleviate nerve-related symptoms depending on the underlying condition.
Sometimes,lumbar side-glidingis helpful. Check with your PT to determine the correct exercise for your specific lumbar condition.
Heat or Ice
Be careful: Heat or ice may cause skin irritation or burns, so use a covering over any hot pack or ice bag. Your PT can help determine if you should use heat or ice and can be sure it is applied safely.
Psoas Massage
There’s some debate in the physical therapy community as to whether psoas massage is effective or necessary. The procedure, often called a psoas release, is difficult to do, and it may be painful.
Many physical therapists debate that it’s impossible to be sure that the hands of the therapist performing the massage are actually touching the psoas. Plus, psoas massage is painful for the patient and may not provide any superior outcomes when compared to stretching or strengthening.
Before starting any treatment for your iliopsoas injury, visit with your physician and PT to ensure you are doing the correct things for your specific condition.
The iliopsoas muscle is a major hip flexor that also helps to move your spine. The two muscles of the group—the iliacus and the psoas major—arise from different areas of your pelvis and lumbar spine to form a common attachment in your hip. Knowing the anatomy of this muscle can help you make good choices in caring for an iliopsoas injury.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bordoni B, Varacallo M.Anatomy, bony pelvis and lower limb, iliopsoas muscle. StatPearls.Anloague PA, Huijbregts P.Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications.J Man Manip Ther. 2009;17(4):e107–e114. doi:10.1179/106698109791352201National Library of Medicine StatPearls.Psoas syndrome.University of Colorado Anschutz Medical Campus.Iliopsoas tendonitis.Tyler TF, Fukunaga T, Gellert J.Rehabilitation of soft tissue injuries of the hip and pelvis.Int J Sports Phys Ther. 2014;9(6):785-797.Wagner SC, Sebastian AS, Mckenzie JC, et al.Severe lumbar disability is associated with decreased psoas cross-sectional area in degenerative spondylolisthesis.Global Spine J. 2018;8(7):716-721. doi:10.1177/2192568218765399Pidgeon T, Ramirez J, Schiller J.Orthopaedic management of spasticity.R I Med J.2015;(Dec):26–31.Rauseo C.The rehabilitation of a runner with iliopsoas tendinopathy using an eccentric-biased exercise-a case report.Int J Sports Phys Ther. 2017;12(7):1150-1162. doi:10.26603/ijspt20171150Foran, J.Hip bursitis. American Academy of Orthopaedic Surgeons.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bordoni B, Varacallo M.Anatomy, bony pelvis and lower limb, iliopsoas muscle. StatPearls.Anloague PA, Huijbregts P.Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications.J Man Manip Ther. 2009;17(4):e107–e114. doi:10.1179/106698109791352201National Library of Medicine StatPearls.Psoas syndrome.University of Colorado Anschutz Medical Campus.Iliopsoas tendonitis.Tyler TF, Fukunaga T, Gellert J.Rehabilitation of soft tissue injuries of the hip and pelvis.Int J Sports Phys Ther. 2014;9(6):785-797.Wagner SC, Sebastian AS, Mckenzie JC, et al.Severe lumbar disability is associated with decreased psoas cross-sectional area in degenerative spondylolisthesis.Global Spine J. 2018;8(7):716-721. doi:10.1177/2192568218765399Pidgeon T, Ramirez J, Schiller J.Orthopaedic management of spasticity.R I Med J.2015;(Dec):26–31.Rauseo C.The rehabilitation of a runner with iliopsoas tendinopathy using an eccentric-biased exercise-a case report.Int J Sports Phys Ther. 2017;12(7):1150-1162. doi:10.26603/ijspt20171150Foran, J.Hip bursitis. American Academy of Orthopaedic Surgeons.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bordoni B, Varacallo M.Anatomy, bony pelvis and lower limb, iliopsoas muscle. StatPearls.Anloague PA, Huijbregts P.Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications.J Man Manip Ther. 2009;17(4):e107–e114. doi:10.1179/106698109791352201National Library of Medicine StatPearls.Psoas syndrome.University of Colorado Anschutz Medical Campus.Iliopsoas tendonitis.Tyler TF, Fukunaga T, Gellert J.Rehabilitation of soft tissue injuries of the hip and pelvis.Int J Sports Phys Ther. 2014;9(6):785-797.Wagner SC, Sebastian AS, Mckenzie JC, et al.Severe lumbar disability is associated with decreased psoas cross-sectional area in degenerative spondylolisthesis.Global Spine J. 2018;8(7):716-721. doi:10.1177/2192568218765399Pidgeon T, Ramirez J, Schiller J.Orthopaedic management of spasticity.R I Med J.2015;(Dec):26–31.Rauseo C.The rehabilitation of a runner with iliopsoas tendinopathy using an eccentric-biased exercise-a case report.Int J Sports Phys Ther. 2017;12(7):1150-1162. doi:10.26603/ijspt20171150Foran, J.Hip bursitis. American Academy of Orthopaedic Surgeons.
Bordoni B, Varacallo M.Anatomy, bony pelvis and lower limb, iliopsoas muscle. StatPearls.
Anloague PA, Huijbregts P.Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications.J Man Manip Ther. 2009;17(4):e107–e114. doi:10.1179/106698109791352201
National Library of Medicine StatPearls.Psoas syndrome.
University of Colorado Anschutz Medical Campus.Iliopsoas tendonitis.
Tyler TF, Fukunaga T, Gellert J.Rehabilitation of soft tissue injuries of the hip and pelvis.Int J Sports Phys Ther. 2014;9(6):785-797.
Wagner SC, Sebastian AS, Mckenzie JC, et al.Severe lumbar disability is associated with decreased psoas cross-sectional area in degenerative spondylolisthesis.Global Spine J. 2018;8(7):716-721. doi:10.1177/2192568218765399
Pidgeon T, Ramirez J, Schiller J.Orthopaedic management of spasticity.R I Med J.2015;(Dec):26–31.
Rauseo C.The rehabilitation of a runner with iliopsoas tendinopathy using an eccentric-biased exercise-a case report.Int J Sports Phys Ther. 2017;12(7):1150-1162. doi:10.26603/ijspt20171150
Foran, J.Hip bursitis. American Academy of Orthopaedic Surgeons.
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