How To Treat Iliopsoas (Psoas) - Trigger Point Release
Iliopsoas tendinopathy refers to irritation, degeneration, or overload of the iliopsoas tendon as it crosses the anterior hip. Because of its deep location and complex function, this condition is often misunderstood or misdiagnosed. The iliopsoas is not just a hip flexor — it is a key stabiliser of the lumbar spine, a guide for hip mechanics, and an important contributor to gait, stair climbing, athletic acceleration, and postural control. When the tendon becomes overloaded or irritated, patients may experience deep anterior hip or groin pain that can mimic hip joint pathology, sports hernia, or even abdominal conditions.
The tendon passes through a tight anatomical corridor, gliding over the iliopectineal eminence and attaching to the lesser trochanter of the femur. With repetitive loading — especially activities involving hip flexion, sprinting, uphill running, kicking, dance movements, or prolonged sitting — the tendon can become irritated. In some individuals, the iliopsoas bursa becomes inflamed alongside the tendon, adding a component of compressive irritation.
Unlike acute strains, iliopsoas tendinopathy typically develops gradually. Patients often describe a dull ache at the front of the hip that worsens with lifting the knee, transitioning from sitting to standing, walking uphill, or performing dynamic movements like lunges or kicks. Runners and athletes may feel their stride become “tight” or “restricted,” with reduced hip extension contributing to altered mechanics.
Central to understanding iliopsoas tendinopathy is recognising that it rarely reflects a single insult. Instead, it emerges from cumulative loading, impaired lumbopelvic control, reduced hip extension mobility, or compensatory movement patterns. Successful rehabilitation therefore requires more than simply treating the tendon — it involves restoring healthy hip extension, improving core–pelvic stability, addressing gait mechanics, and gradually reintroducing load in a structured, patient-specific manner.
Contrary to some common misconceptions, trigger points in the psoas muscles can sometimes be treated safely and effectively released with manual therapy.
Trigger points in the psoas muscles are too frequently overlooked and are often the source of lower back complaints.
Whilst the psoas muscles are buried deep, they are often not as difficult to treat for trigger points as many might assume.
Whilst special care must be taken when treating the iliopsoas group (iliacus and the psoas), they can generally be treated effectively by a trained therapist.
00:00 - Introduction to Iliopsoas Muscle
00:11 - Anatomy Overview
01:20 - Iliacus Muscle Anatomy
02:00 - Psoas Muscle Anatomy
03:30 - Functions of Iliopsoas Muscle
05:00 - Trigger Points in Iliopsoas
05:40 - Identifying Trigger Points
07:30 - Treatment Techniques: Psoas
09:20 - Treatment Techniques: Iliacus
11:00 - Treatment Techniques: Groin
12:30 - Summary and Conclusion
About the Psoas Muscles
The psoas major and iliacus are considered part of the posterior abdominal wall because of their position and cushioning role for the abdominal viscera.
However, based on their action of flexing the hip joint, it would also be relevant to place them with the hip muscles.
Note that some upper fibers of the psoas major may insert by a long tendon into the iliopubic eminence to form the psoas minor, which has little function and is absent in about 40% of people.
Bilateral contracture of this muscle will increase lumbar lordosis.
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