Iliopsoas tendinopathy
Understanding this condition
The iliopsoas is a deep muscle that connects the lumbar spine to the femur, passing in front of the hip. It is the main hip flexor: it lifts the thigh when climbing a step or raising the leg in a seated position.
Iliopsoas tendinopathy is a painful condition of this muscle's tendon, generally at its passage in front of the hip. It can occur in athletes (runners, dancers, footballers), after a hip replacement (conflict with the implant), or in isolation.
Symptoms
Deep pain in the groin crease, sometimes associated with an audible snapping sensation ("snapping hip") during certain movements. It is typically triggered by the sit-to-stand movement, climbing stairs, or abdominal exercises.
Normal walking is rarely affected, but sporting activities involving hip flexion (running, cycling, dancing) become painful.
How can it progress?
The natural course is generally favourable with time and activity modification. However, a chronic tendinopathy can become persistent and limit sporting activity.
In the specific case of conflict with a hip prosthesis, discomfort may persist until the mechanical conflict is resolved.
Treatment options
Relative rest, gentle stretching, targeted physiotherapy, and anti-inflammatory drugs are the first-line treatment. The vast majority of cases resolve within a few weeks.
When discomfort persists for several months despite well-conducted treatment, or in the case of confirmed conflict with a prosthetic implant, endoscopic iliopsoas tenotomy may be proposed. A consultation establishes the indication.