Psoas Syndrome Causes Hip Pain and Tightness – Here's How
/By Dr. Greg Freitag — Last Updated: August 12, 2024
Ah, the end of summer! The days are shorter, the air is crisper, and the busy routine of the school year is near.
Hopefully, you’ve had a chance to be outdoors-active this summer – walking, bicycling, and/or playing pickleball – before our Minnesota winter arrives. Perhaps you’ve taken the opportunity to travel. Or maybe you’ve had to spend the summer grinding away behind a computer.
Whatever your choice of activity or lack thereof, if you have been “over-doing-it” and now notice severe front-of-hip tension, tightness, and pain, you may be experiencing a condition called Psoas Syndrome.
What Is Psoas Syndrome?
The Cleveland Clinic defines it as “a painful irritation or injury in one or both of your psoas muscles.” (1)
Your psoas muscles are a pair of long, thin muscles that run from your lower back vertebrae to the top of your thigh bone. Along the way, they cross over the front of your hip. Because of their location and action (they are responsible for lifting your knee and flexing your hip), these muscles are often called “hip flexors.” Your psoas muscles work with other core muscles to stabilize your body during every movement.
If you perform regular cardiovascular exercise such as walking, jogging, running, or cycling and you don’t spend adequate time performing hip-flexor stretches or hip-opening yoga poses, the muscles and surrounding fascia can tigthen. This tightening or tension often leads to soft-tissue soreness and pain, which, if severe enough, can be classified as Psoas Syndrome. Psoas Syndrome is frequently caused by chronic overuse of your psoas muscles.
If you bicycle, your psoas muscles are at an even greater risk for tension and associated pain for two reasons. First, the femur or upper leg bone is internally rotated while sitting in a bike saddle. This position limits the active range of motion by preventing full extension at the hip joint. Second, if you wear clip-in shoes or have a pedal strap, you automatically engage your hip flexors while pulling up on each pedal stroke, causing additional stress to your working muscles.
In addition to chronic overuse during exercise, spending much of the day seated can result in tight hip-flexor muscles. If this risk factor is likely the cause of your psoas tension, you may notice that the fronts of your hips are tight, especially when getting up from a seated position.
The length of your psoas muscles changes greatly with different body positions. When standing or performing Mountain pose, your psoas muscles are at resting length. When performing a hip extension, as in an Upward-Facing Dog pose, your psoas muscles are elongated. When in a yogi squat pose or seated in a chair, your psoas muscles are shortened. However, the yogi squat position does not lead to psoas tension because you only perform that pose for minutes at most. We get into trouble when we spend much of the day sitting, especially when we sit for days on end behind a desk or when traveling in a plane or car with limited opportunity for movement. When this occurs, our hip flexors get used to being in a shortened state. When we stand up, they pull on our lower back vertebra, which can lead to low-back pain.
Psoas Syndrome can present as anterior hip pain and can be a significant contributor to groin or butt pain or general hip and pelvic muscular tenderness. In fact, the word “psoas” originates from the ancient Greek word for “muscle of the loin,” and its muscular equivalent in a cow is the tenderloin.
So, if you have a “tender” loin or notice some of the symptoms above, you may have Psoas Syndrome. While this can be painful, you’re still in luck. It’s not permanent, and there are positional modifications and exercises you can implement to minimize your symptoms and get your hips, lower back, and nearby areas feeling much better.
First modification: If you sit for long periods, do your best to get up from your desk or chair, walk around, and perform some of the hip stretches listed below. Drink lots of water: Not only does staying hydrated lubricate your fascia, but also you’ll need to get up and use the restroom more often!
Second modification: You can convert your workstation to a sit-stand desk. This limits how long you spend with your psoas muscles in a contracted state.
Third modification: Perform hip-opening yoga poses. These include Warrior I and II, Upward-facing Dog, Low Lunge or Runner’s Lunge, and Pigeon poses.
As with any new yoga or stretching exercise, start slowly, especially if you are experiencing a tender loin area.
Warm up your muscles prior to stretching them. Go for a short walk or bike ride before doing the stretches or go through a warmup yoga series to get your spine and core muscles warm before stretching your psoas muscles directly.
Move into the pose or stretch gently. Only go to what you believe is about 50 percent of your maximal stretch limits. Take five or more deep breaths as tolerated. Gently move out of the stretch and perform on the other side of the body. Perform other hip opener stretches in a similar fashion.
Repeat two to three times per week. Slowly increase your percentage of maximal stretch limit weekly or biweekly to 60, then 70, then 80 percent as tolerated.
To greatly speed your recovery from tight hip flexors or psoas syndrome, I recommend a combination of complementary and integrative care strategies, including massage, physical therapy, acupuncture, and chiropractic care.
With a team of healers on your side, your tender loin may soon be a thing of the past.
Reference:
1. https://my.clevelandclinic.org/health/diseases/15721-psoas-syndrome
If you have any questions about psoas tightness or any other musculoskeletal condition, contact Dr. Greg Freitag via email at drgreg@freitagfamilychiropractic.com, or schedule an appointment at the Green Lotus Lakeville center at 952-373-0055 or Mendota Heights at 651-319-9525.
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