Lifestyle

Physio: Inflamed hip and groin result of repetitive use strain

It is a pain felt in the front of the hip and groin region.

It can occur during activities involving hip flexion like running, dancing, kicking, or something as simple as putting on your socks.

Iliopsoas (illio-so-ass) bursitis and iliopsoas tendonitis are inflammatory conditions that involve the tendons and busra in the front of the hip/groin region.

They are often the result of repetitive hip flexion in activities such as running, dancing, kicking and gymnastics.

People report having pain in the front of the hip and groin region that often radiates down the front or inner thigh all the way to the knee.

Rising from a seated position (with the hips flexed for a prolong period of time) often creates a sharp pain to the front of the hip and a feeling of reluctancy to initially bear weight through that leg.

Occasionally, a snapping or clicking is heard that may or may not be painful.

The pain is worsened by extending the hip back, crossing the leg in front of the body, and twisting the leg inwards.

Bringing the knee up to the chest can often produce a pinching sensation in the hip or groin.

Inflammation of the iliopsoas bursa results when the overlying hip flexor tendon produces excessive pressure or friction on the bursa during movement.

A bursa is a fluid-filled sac that lies between a tendon and bony prominence. It is designed to reduce the friction and provide cushioning for the tendon as it glides over the bony prominence.

This increase in friction is often a result of tight hip flexors combined with repeated hip flexion, poor body mechanics, or even direct trauma.

Inflammation of the bursa and tendon often exist together because of their close proximity and associated mechanical stresses.

The amount of repeated hip flexion during running, dancing, kicking, and gymnastics makes this a familiar condition for these athletes, but it is also common among the recreational athlete.

Clinically, what I tend to see with people who present with iliopsoas bursitis—typically someone who has a seated job (desk job, driver, etc.)—is they spend the majority of their day in a seated position, which can cause hip flexor tightness (not to mention hamstring and calf tightness).

Then, with their tight hip flexors, they go for a jog, hike or participate in an activity with repetitive hip flexion.

The whole time the tight hip flexor is gliding over the underlying iliopsoas bursa, creating excessive friction and inflammation.

The end result is pain, decreased hip motion, decreased activity tolerance, and often tenderness to touch.

Treatment for iliopsoas bursitis and iliopsoas tendonitis include stopping the irritating activity, decreasing the inflammation with ice, and seeing your physiotherapist for assessment and treatment.

Your physiotherapist can help to determine the cause of the irritation, rule out other possible diagnosis, provide treatment to reduce the pain and inflammation, and prescribe exercises to help promote healing and a quick return to your regular activities and sports.

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