Muscles
Iliopsoas Trigger Points
Symptom Area: Lower Torso
Iliopsoas Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Primary hip flexor; psoas major also influences lumbar lordosis.
Where you feel it
When the Iliopsoas holds active trigger points, you usually notice it as anterior thigh pain, appendicitis-like pains, groin pain, low back pain and si joint pain (base of the spine). Where the pain spreads: Anterior hip and groin, with vertical 'low back' pain along the lumbar spine. What often sets it off: Prolonged sitting, sit-up overload, hip flexor dominance in running.
Overview
Primary hip flexor; psoas major also influences lumbar lordosis. Trigger points here are common in everyday and athletic populations and frequently contribute to the referred pain patterns described below.
Trigger point locations
Iliacus inside the iliac fossa; psoas major along the lumbar spine.
Referred pain pattern
Anterior hip and groin, with vertical 'low back' pain along the lumbar spine.
Palpation & testing
Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.
Common causes
Prolonged sitting, sit-up overload, hip flexor dominance in running.
Self-care & clinical treatment
Hip flexor stretches, hip extension strengthening. Clinically: careful manual release; needling by trained clinicians.
Treatment protocol
For Iliopsoas, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate the muscle belly along its accessible course.
Regional precaution for clinicians: In the flank and abdominal wall the kidney (behind the twelfth rib and the quadratus lumborum), the abdominal viscera and the lower lung fields are the structures at risk.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Groin pain that isn't a hernia: the adductor, pectineus and iliopsoas trigger points behind it
- The piriformis: the muscle that imitates sciatica from deep in the buttock
- Do stretching and exercise actually change a trigger point? What the trials show
- Low back pain that flares when you stand: a step-by-step quadratus lumborum treatment plan
- SI joint pain (base of the spine): which trigger points cause it and how to treat them
- Low Back Pain: which trigger points cause it and how to treat them
References
- • Travell & Simons — Myofascial Pain and Dysfunction
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2017;47(3):133-49
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points — J Bodyw Mov Ther 2019;23(3):539-46
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response — Am J Phys Med Rehabil 1994;73(4):256-63
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
