Iliopsoas Syndrome - The Hidden Root of Pain

Iliopsoas Syndrome: The Hidden Root of Pain
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Iliopsoas Syndrome
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Feb 07, 16 08:31 PM

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The Hidden Root of Pain
for Unexplained
by Stephen ODwyer, CNMT
Back, Hip & Leg

Pain
The Hidden Prankster

The iliopsoas muscle is one of the most complex muscles in the body.
Read More
When it becomes dysfunctional (either excessively short and tight, or

overstretched and strained) it can be the source of a bewildering variety
Healing the Hidden

Root of Pain:
Self-Treatment for
Iliopsoas Syndrome
Jan 17, 16 09:01 AM
of mysterious and hard-to-diagnose pain.

Among the most common problems caused by dysfunction of this muscle
is lower back and hip pain. But many other regions of the body can also
experience pain.
Healing the
In Myofascial Pain and Dysfunction: The Trigger Point Manual, by
Hidden Root of
Janet Travell M.D. (personal physician to President John F. Kennedy) and
Pain:
David Simons, M.D., this muscle is referred to as "the hidden prankster.

Self-Treatment for
Iliopsoas Syndrome, the
not well-understood
dysfunction of the primary
hip flexors, can be healed
using the 4-phase system
developed by Stephen
O'Dwyer, CNMT.
These two eminent and long-time pain researchers could hardly have
Iliopsoas Syndrome
come up with a more fitting label for this muscle.

(Instant Streaming or
In my clinical experience I have found that dysfunction of the iliopsoas
2-Disc DVD set)
commonly referred to as Iliopsoas Syndrome is responsible for more
Learn more...
unexplained back, hip and leg pain than any other single cause.
Read More
Nerve Compression
and Nerve Entrapment
| Two Distinct Causes
of Pain
Oct 31, 15 07:02 AM
Nerve compression and
nerve entrapment are one
of the five primary causes
of lower back pain.
Read More
Anatomy: Two Muscles in One

The iliopsoas is actually comprised of two muscles: the psoas muscle and
the iliacus muscle.
Your website is
phenomenal! Thanks for
helping anyone who might
be confused when offered
surgery as the only option!
Carmen from Los
Angeles, CA
I tried all of your lower
back stretches. They're
wonderful!
Lee from Milwaukee,
WI
Sometimes you stumble
on something like this and
you say "EUREKA!"
Laverne from Pearl
City, Hawaii
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The psoas major muscle attaches along the lumbar spine and
intervertebral discs then descends obliquely to attach at the upper inner
thigh bone (lesser trochanter of the femur).
The iliacus muscle attaches to the upper two-thirds of the iliac fossa then
descends to join the psoas major tendon, with some of its fibers attaching
directly to the femur near the lesser trochanter.
The primary function of both the psoas and iliacus is hip flexion,
also known as flexion of the thigh. In other words, these muscles lift the
knee to take a step in walking.
But due to its attachment along the spine, the psoas plays a major role
in maintaining upright posture. It can assist in extending the lumbar
spine and, when excessively short, can contribute to excessive lumbar
lordosis.
Cause of Iliopsoas Syndrome

A very common problem for the iliacus and psoas is that they both can
shorten over time, especially in those individuals who sit for long periods
of time.
Prolonged sitting in which muscles are in a shortened state for extended
periods can lead to the muscles adapting to this position.
Once in an adapted state, muscles have trouble returning to their
normal resting length. This is a basic characteristic of muscle function.
The Cross-Bridge Theory, which attempts to explain the contractile action
of muscle tissue, asserts that, once contracted, a muscle cannot lengthen
on its own.
The contractile units of the muscle (sarcomeres) must be stretched back
to their original resting length by an outside force (such as an opposing
muscle group) before the muscle is able to actively contract and relax
again.
You might ask, Cant you just stretch the muscle out then?
2/14/2016 10:46 AM
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In some cases, yes, if the proper type of stretching is done. For example,
I have found the technique of Active Isolated Stretching to be vastly
superior to static stretching, especially in cases where muscles are
stubbornly tight and short.
But in some cases even this type of stretching must be preceded by
manual therapy in order to enable the muscle to fully lengthen. The
reason for this is that the fibers of a muscle can become adhered or stuck
together.
Sometimes this "adhering" is within the muscle itself, and sometimes one
muscle can become adhered to another muscle.
In both cases the attempt of the muscle to fully lengthen or fully contract
is impeded. This results in a dysfunctional muscle which can be painful in
and of itself, but also can result in compensatory muscle patterns
throughout the body.
This is one reason a dysfunctional iliopsoas muscle on the right side of the
body, for example, could result in pain on the left side of the body. The left
side might be getting severly overworked.
But there are many reasons for the variety and complexity of pain from
this "syndrome."
Consequences of Chronic Muscular Contraction

If a muscle cannot return to its normal resting length, it then resides in a
state of chronic contraction and numerous undesirable consequences can
result:
1. Ischemia
A chronically contracted muscle can become
ischemic (low blood flow). Imagine the white
knuckles of a clenched fist. No blood flow there. An
ischemic muscle is often a painful muscle.
2. Trigger Points
A chronically contracted muscle can develop trigger
points which refer pain (or numerous other possible
sensations thermal, tingling, numbness, aching)
either radiating out from the muscle or felt in other
parts of the body.
3. Distorted Movement Patterns

A chronically contracted muscle can distort the
movement of the joint it crosses. For example, a
chronically tight iliacus could reduce movement at
the front of the hip.
4. Muscular Compensation
A chronically contracted muscle can cause other
compensations or distortions in the body. If a
chronically tight iliacus, for example, reduces
2/14/2016 10:46 AM
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movement in one hip, then the other hip or the

spine or other parts of the body will be called upon
to compensate or to change their normal pattern of
movement.
5. Nerve Entrapment
A chronically contracted muscle may be responsible
for entrapment of nerves, another cause of pain. In
the case of the iliopsoas, entrapment of the
following nerves is possible: the femoral nerve, the
lateral femoral cutaneous nerve, the femoral
branch of the genitofemoral nerves, the
iliohypogastric nerve and the ilioinguinal nerve.
Potential Regions of Pain

During my 25 years of treating iliopsoas dysfunction, clients have
presented with pain in following areas...
Lower abdomen
Groin
Buttocks
Down the leg
Hip
Lower back
Sacroiliac joint
Across the top of the hip bone (iliac
crest), sometimes wrapping around
the lower back or buttocks
The problem an individual may face when being examined by a

physician not trained in muscular problems is that examination of
any of the above areas of pain may reveal exactly nothing.
Many standardized allopathic tests, including neurological tests, will come
back normal because they are not tests designed to evaluate muscular
problems. Such problems can only be properly assessed with skilled
palpation and knowledge of musculoskeletal dysfunction.
Of particular difficulty in the case of the iliacus is the fact of its hidden
location. This muscle is not easy to palpate if you dont have any practice
at it. The psoas is more accessible but no less intimidating to palpate,
much less treat, if youre unsure of what to do.
What to Do
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Due the outpouring of inquiries I've received about Iliopsoas Syndrome

I've spent the last 6 months developing a self-treatment system for home
use.
This system mirrors the treatment progression I follow when treating
clients at my office over the course of a number of weeks.
This system is now available as a 2-Disc DVD set which I've titled,
Healing the Hidden Root of Pain: Self-Treatment for Iliopsoas
Syndrome.
Click on the image or link below to go to the description page for this
product...
NOW AVAILABLE
Healing the Hidden

Root of Pain
Self-Treatment for Iliopsoas
Syndrome
2-Disc DVD Set
or
Instant Streaming
Lasting Relief for Unexplained
Back, Hip and Leg Pain
In the meantime be sure to check out my stretching videos, especially

those for the hip flexors (your iliacus and psoas muscles are your primary
hip flexors).
Also, if you currently work with a skilled manual therapist (massage
therapist, bodyworker, physical therapist), I have created instructions for
therapists which provide a good starting point.
And please join the Iliopsoas Syndrome Forum below. Share your story
and learn from others.
Return to Top of Iliopsoas Syndrome

Go to Lower Back Pain Answers Home Page
Do You Think You Might be Suering from

Iliopsoas Syndrome?
If so, please share your story here. You might be able to help others who
are also suffering from this pernicious problem.
I try to respond in this forum to stories that seem to be representative of
2/14/2016 10:46 AM
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this issue. So please be as specific as possible about your history,

symptoms, and the course of treatments you've tried.
Enter Your Title
Click here to see the rest of the form and complete your submission.
What Other Visitors Have Said

Click below to see contributions from other visitors to this page...
Groin and Hip Flexor Pain
Hi I had bilateral hip arthoscopies last year. My right hip was done in May
2014 and then the left in July 2014. My hip pain actually began in
November
24/7 Chronic Pain
Following more than a decade of sport related pain (so I thought), I was
diagnosed with Spondylolithesis S1/L5 and had a spinal fusion in 1998.
Since
Injured Police Officer
I have spent much of my adult with some low back pain, but never so
much that it was more than a troubling annoyance. Chiropractors told me
I had tight
Pain Came Back with a Vengeance
I am a 34 year female, I was pretty active prior to my injury. I was
involved in a motor vehicle accident almost 14 months ago. I was at a
complete
Pelvic Pain of Unknown Origin
I am a 30 year old female. Former runner and soccer player and what you
would describe as the 'jock' type: always active, strong, and in shape. Ive
never
Trochanteric Bursitis and Iliopsoas Syndrome
The pain started early in January 2012, but being a stalwart runner, I
thought a couple of weeks off and it would go away. Wrong. While I
waited for
3 Years of Recurring Hip Pain
I never knew what happened to make my hip begin to hurt. I am a
runner. I was running 4-5 miles per day with longer runs on the weekend.
My hip started
From Fit and Happy to Disabled and Depressed
My story is very similar to the others here. I was in terrific shape,
teaching 2 fitness classes a day. I had energy to be active in all areas of
my
Is the Psoas Muscle Causing My Husband to Bend Forward?
My husband is 67 and has had every test imaginable (11 different Doctors
and Chiropractors) and nothing has manifested. He walks bent over
sometimes almost
Seven years of pain - is it the psoas?
My daughter has suffered right lower quadrant pain for 7 years. It started
when she was ten. She has had every test you can think of. Doctors
2/14/2016 10:46 AM
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thought
Desk Stretches Helped
My problem started after high kicks. Most probably it happened because I
started on a cold body and straight away began kicking with high
intensity.
Dull Pain in My Groin
I'm a sheriff's deputy and sit in a patrol car for sometimes hours at a
time. I began experiencing dull pain in my groin, a pulling/aching
sensation behind
Pain in My Lower Back
I am not sure if this is what I have but it sounds a bit like it, in that as
time has gone on, it has developed from one set of nerve pain to involve
different
So I'm not crazy?
I am a 28 year old female with no history of injury. I was a competitive
cheerleader for four years but only suffered occasional leg pain during
that time.
Finally an Answer!!
I'm in my mid 50s, female, very small & fit, active, quite strong. 25 years
ago a chiropractor pulled on my right leg. I not only FELT it like a bullet,
FRUSTRATED WITH MY DOCTORS...WONDERING IF I'M CRAZY
I have been suffering from low back pain on the right side for about 10
years now. I thought at first that it was just due to bad posture. I have
always
Multiple Diagnoses & Pain Before and After Hip Arthroscopy
In January of 2011, while at work, I experienced a shooting pain in my
left buttock (which I did not understand at the time was really part of my
hip).
Terrible Time Walking
My present age is 57 and I am female and slim. About 7 yrs. ago, I was
beginning to learn the banjo. I sat a lot holding this 17 lb. instrument
while practicing
My Doctor Thinks I'm Crazy
I have suffered from both low back pain and pain between my shoulder
blades for years. It all started when I was pregnant with my daughter
about 4 years
Diagnosed with Psoas Syndrome
Back in September 2010 I jumped down from the back of a truck and
injured my thigh. I did not realize it was serious until I could not stretch
or do exercises
Hidden Prankster Sufferer
I think that I have this "hidden prankster" syndrome. I have suffered
back pain for many many years. I have tried Pilates but some of the
exercises
Cramping in Upper Thighs
I have been riding a stationary bike for over a year for a minimum of 45
minutes a day followed by sit-ups. I started to have extreme cramping in
my
My Iliopsoas Dysfunction Discovery and Yoga
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I'm a 56 year old female. I have had chronic back pain for over a decade.
I have been to many doctors and every time they found nothing. I had
the usual
Pain After Cycling
4 years ago I returned from a 10 day sea kayaking trip and went straight
on a cycle tour in mountainous terrain. I bent over to pick up a friend's
punctured
Click here to write your own.
Finally the Answer to My Dilemma
Ten months ago I suffered a lower back injury while bending repetitively.
After approximately ten sessions of physiotherapy and rest and gentle
regular
Disabled and suffering
I am a student and also suffer from a seizure disorder and fainting spells
which prevent me from exercising and stretching on a regular basis. From
everything
Bike Accident
Fell off my bike in summer 2009 right onto my greater trochanter. I was
traveling at speed and hip took full force because my shoes were clipped
in. I
Injured International Hockey Player
I was an extremely fit international hockey player and one day I finished
a game and was very stiff. My back had seized up and I could hardly walk.
I got
20 Months of Pain Getting Worse
I think it may have started at the gym when I overdid an exercise on a
hip-flexing machine. I had a pain in my groin and down the inside of my
right leg
Injured Professional Surfer
I am a professional surfer from France and I have been injured for a total
of 29 months since I pulled something during a surfing session. Since that
day
10 Year History of Pelvic, Groin, and Low Back Pain
I m a 40 year old female and have had chronic left sided groin, low back,
hip, and pelvic pain for about the past 10 years. I have tried many
different
A Crash to the Ground Not rated yet
Hello. I fell from a height of 2 ft. smack down on cement with my legs
stretched out on Nov. 2. I was babysitting my 2 1/2 year old
granddaughter and
Standing too long! Not rated yet
I had been wearing my beloved toe shoes for three years and standing on
concrete floors too many hours. I developed a deep pain in the fold
between leg
Labral Tear with Iliopsoas Syndrome Not rated yet
I suffered an anterior labral tear to my hip three years ago. I cannot take
anti-inflammatory meds but swim and bike as much as I can. Recently, my
Congenital Hip Malformation Not rated yet

Unbeknowst to me, I was born with a congenital hip malformation. One
side of my hip had no hip socket. The femoral ball attached itself to the
2/14/2016 10:46 AM
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hip
Longtime Runner Trying to Self-Diagnose Not rated yet
I have been running for close to 20 years, and my body is finally starting
to break down from it's dysfunction and lack of strength and mobility in
my
Sudden Pain Out of Nowhere Not rated yet
I had just walked into my home when out of nowhere a very sharp pain
hit me in my hip. I was not sure what had just happened. All I knew is
that I had
My Self-Diagnosis of Iliopsoas Symptoms Not rated yet
I sit for 4-6 hours daily. I get my exercise by walking, gardening,
housework and outdoors activities (swimming, sailing, kayaking and
hiking). I believe
Pilates Trainer with Chronic Hip Pain Not rated yet
Hello. I'm 42, female and had fusion surgery 11 years ago in my lumbar
region. I had a quick recovery, got into fitness training a year after my
surgery,
Father of Triplets Can't Stand Up Not rated yet
I first noticed this pain in my mid-twenties while playing in a flag football
league, but it was not as debilitating as it is now. Now Im 36 and one
Runner with Hip and Lower Back Ache Not rated yet
I've been struggling with an aching pain in my hip for some time while
training for a marathon. The pain doesn't inhibit my ability to run but
certainly
Belly Dancer with Back Pain Told to Strengthen Abs Not rated yet
My first memory of back pain was when I was in my mid- teens. I was in a
play and one scene was rehearsed again and again forcing me to stand for
a couple
My Sister Injured While Skiiing Not rated yet
My sister fell while skiing in early December. She believed she injured her
knee and the emergency room physician placed her in a universal splint
and
Camel Pose and Table Pose Relieve Pain Not rated yet
From time to time I get the sensation of a slightly pulled muscle. This
develops by the next day into a very severe pain which shoots from my
lower left
Suffered for 5 Years Not rated yet
My name is Jan and I've suffered for at least 5 years with psoas pain. It
started when I had knee pain and went to an orthopedic surgeon. The
MRI didnt
I Thought it Was Sciatic Pain Not rated yet
The sharp pain in my sacral area started a few years ago. I get tingly feet
and my legs feel fatigued as if Ive just run a marathon. When I stretch
Lower Back, Lower Abdomen, Aching Legs Not rated yet
I have had several bouts of lower back pain in my life. I'm now 48. I work
a physical job so think nothing of it. Yes, it's my back. But I had a
hysterectomy
Pain at Top Corner of Pelvis, Hip Flexors, and Lower Back Not rated
yet
Pain in my hip area began about 8 weeks ago. I'm a runner, so I stopped
running, as the pain was getting progressively worse. I took it to be a
2/14/2016 10:46 AM
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standard
Back Pain During Pregnancy Not rated yet
I've suffered with lower back pain for the past five years. After MRIs, CT
scans, X-rays, Neurologists etc, I was diagnosed with fibromyalgia and
sciatica.
Extreme Lower Back Pain Not rated yet
After spending a month in the hospital and two months resting at home
after having abdominal surgery, my lower back felt as if I had been hit by
a4x
Work injury Not rated yet
In April of this year I was injured in an explosion at my job. A piece of
metal punctured my abdomen at high velocity like a gun shot. The
projectile lodged
This page has "me" written all over it! Not rated yet
I'm going to try to be as brief as possible! I'm an 18-year-old female
that's has chronic, severe tendonitis in my iliopsoas tendon for over 4
years.
Groin Pain Not rated yet
I have suffered with groin pain for about 3 years. I had cortisone shots in
my hip and groin area 2 years ago. When it didn't work they gave me
another
Running Out of Non-Surgical Options Not rated yet
I am a low back (L5-S1) patient that has had everything done over the
past four years without any success (only local 3-4 level pain when
walking that
Terrible Hip pain! Not rated yet
During my 22 years in the Army I always had some back problem but
nothing I could not stretch out and continue exercising and have normal
movement.
Condition arose during pregnancy! Not rated yet
I'm 7 months into my first pregnancy and I am in absolutely excellent
health. I have not gained much weight and am just starting to show a
belly. For
TIGHT ILIACUS Not rated yet
My physiotherapist diagnosed a tight iliacus and psoas last January. After
only one massage treatment the psoas loosened up but it's been 4
months and
Feeling Much Better Not rated yet
Dear Stephen O'Dwyer, I can not find words to tell you how grateful I am!
You literally saved my life from every day and every night pain. It all
Dangerous Condition? Not rated yet
Sounds like me, I have the symptoms almost to the core of what you say
can present. Dr. hasn't figured it out yet. Haven't had MRI yet but hoping
for
Distance Runner Hip Pain Not rated yet
I am a collegiate distance runner who has been out for 4.5 months. From
December 20th to March 7th I was recovering from bilateral femoral
stress fractures.
Hip and groin pain Not rated yet
2/14/2016 10:46 AM
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I am a 55 year old woman. About 10 years ago I began having pain deep
on my hip in the middle of the night. Sometimes it was my left hip, other
times my
Long Distance Driving Causing Pain Not rated yet
I am a 54 mother of three teenage children. I am 5'2" tall and weigh
about 8 stone (128 lbs I think). Until the children started at secondary
school
Pain and Weakness in My Right Leg Not rated yet
I'm not exactly sure how it happened, either by dead-lifting or by doing
yoga. It started out as a little bit of tightness in my hips and general
Lower Back Pain for 4 Years Not rated yet
I got pregnant with my daughter 4 years ago and about 8 weeks later my
lower back pain started. I was in pain my entire pregnancy, unable to
enjoy any
Goodluck to Me & My Iliopsoas Syndrome Not rated yet
I just read about this iliopsoas on your site and I think this is what I have.
I've been suffering for 10 years now from this hip pain and every time
I've
"Hip Pain" Not rated yet
I'm an athlete who has been having this aching pain in my "hip" for
almost a year now. Luckily it has not yet affected my performance
because I don't usually
Nerve Pain Might Be Iliopsoas Syndrome Not rated yet
I am an accountant so I sit for most of the day. I am very active but I
have been limited over the last few years due to my hip problems. I had
sciatica
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6 Comments
Sort by Newest
Gustavo Bessone
Co-Founder and CEO at Taggify
Hi, I have a similar pain for almost 2 years now (5th november
2010 it started), done dozens of studies and seen dozens of
doctors and nobody has a clue of what I got for now.
Wonder if this might be related to it.
It started one night in a bar where I had too much beer, really
needed to pee and the line to the mens room was much longer
than usual. Had to hold it until my bladder was about to explode.
When I finally got to the urinal it just didn't come out. I tried to
force it (i believe I might have injured something at this point).
Later that night pee started coming out drop by drop until
... See More
Like Reply Sep 24, 2012 12:33am
Laverne Ishihara Higashionna

Registered Nurse at Kuakini Medical
Sometimes researching your own symptoms of pain u can

stumble upon something like this and possibly say
"EUREKA!".....glad to know I amnot alone in having low right
sided pain near the SI joint AND hip/groin pain at he
sametime...my ortho didn't see how having both were even
related...go figure .
Like Reply
2 Sep 12, 2012 1:05pm
Sharen Clozza Malone

Love this website. I've only recently started having back pain
and terrible spasms. Everything I've read points to a contracted
iliopsoas, so I'm hoping to fix this before it becomes
debilitating. Thanks for this.
Like Reply May 24, 2012 5:08am
Norma Lundquist
Anoka-Ramsey Community College
I am reading this article because because I have been having

pain that started between my spine and my hip on the L side.So
far NOYHING helps it.I am a nurse and have had 2 back
surgeries.
Like Reply Jan 25, 2012 4:44am
Teresita U. Tiu
that's very helpfull.
Like Reply Jan 8, 2012 12:26am
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Iliopsoas Syndrome - The Hidden Root of Pain

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Iliopsoas Syndrome: The Hidden Root of Pain

Feb 07, 16 08:31 PM

The Hidden Root of Pain

by Stephen ODwyer, CNMT

Back, Hip & Leg

The Hidden Prankster

When it becomes dysfunctional (either excessively short and tight, or

Healing the Hidden

of mysterious and hard-to-diagnose pain.

In Myofascial Pain and Dysfunction: The Trigger Point Manual, by

Janet Travell M.D. (personal physician to President John F. Kennedy) and

David Simons, M.D., this muscle is referred to as "the hidden prankster.

come up with a more fitting label for this muscle.

In my clinical experience I have found that dysfunction of the iliopsoas

2-Disc DVD set)

commonly referred to as Iliopsoas Syndrome is responsible for more

Anatomy: Two Muscles in One