Treatment of Illiopsoas Bursitis and Tendonitis

Treatment usually is based on conservative treatments. Often these conditions can last for months or years depending on how long you have had the symptoms (especially if you don't take time to heal your body when they first happen).

The most important factor in healing an iliopsoas injury is getting rest. During your recovery you will probably have to modify or avoid the activities that stress your iliopsoas muscles and create muscle spasms, until your pain and inflammation settle. Scar tissue can often develop with iliopsoas tendinitis and/or bursitis. As your damaged groin tissues heal this dead, fibrotic tissue will be produced instead of forming brand new healthy tissue. This tissue adheres to your muscle fibers, tendons, ligaments, fascia, nerves, and joints causing pain and preventing them from moving properly (this limits your range of motion, flexibility and strength). However, the more diligent you are with your treatment and rehabilitation, the faster you will see successful results.

Surgery is rarely used with iliopsoas tendonitis or bursitis or iliopsoas syndrome.

Return to your normal activities is okay, once you are pain-free and you demonstrate adequate flexibility and strength of your hip flexors and opposing muscle groups (abdominals, gluteus muscles, back muscles, hip adductors). Pain-free participation in activities should be demonstrated before you start up your normal routines.

A good rule of thumb is not increase your activity by more than 10% per week until you are back to reasonable exercise levels (this is especially with older populations, who may need to stop or severely modify their running/jumping activities). It is often helpful to investigate new activities like cycling or swimming that will complement your previous activities and not aggravate your iliopsoas.

Conservative Treatments for Iliopsoas Tendonitis or Bursitis

The R.I.C.E. Treatment Philosophy

This treatment philosophy is used to decrease inflammation and relieve pain for a chronic or acute iliopsoas tendinitis or bursitis within the first 48 hours of a flare-up.

• Rest and limit your activity. Use crutches or walking supports to help alleviate pressure if required and prevent strain from a limp.

• Ice your groin and abdominal area 2-3 times/day for approximately 15 - 20 minutes at a time to help reduce blood flow and fluid build up. Gel packs are a better option than frozen peas if possible, as they mold to your body shape and are reusable (do not apply ice/gel packs directly on your skin, instead wrap cold compress in a wrap or cloth). Utilizing 2 gel packs with a wrap will allow you to cover your entire groin, pelvic and thigh area at one time.
• Compress the area if possible by adding light pressure to minimize swelling (make sure the compress is snug, but not too tight as it could cause numbness, tingling or more pain). Neoprene groin strain braces that wrap around your groin, hip flexor and adductor muscles are very useful.
• Elevate your leg above chest level to relieve the pressure from swelling and allow fluid to drain from your injured area. Gentle massage around the groin and pelvis area will also help to prevent stiffness.

Ultrasound Therapy

Ultrasound is a great therapeutic option to decrease inflammation, pain and soft tissue (muscle, tendon, ligament, nerve and connective tissue) damage experienced with inner thigh (adductor) and hip flexor pain that may be associated with iliopsoas tendonitis and/or bursitis. Treatment can be placed on the inner thigh using a portable, home ultrasound device (self-administered) or by seeing a physiotherapist. Ultrasound therapy is easy, painless, safe, and generally requires between 5 - 10 minutes, 3 times a day. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and raise the temperature of your soft tissue. The waves are delivered through a hand held transducer and medicinal conductive gel that are used together in a slow, circular motion on your skin over the injured area. You may experience a slight tingling or warm sensation during the process partly due to phonophoresis - a secondary enhancing, therapeutic effect of ultrasound. Do not use ultrasound over the abdomen, pelvis or genital areas and please seek the approval of your physician before using ultrasound!

Ultrasound therapy increases collagen and tissue elasticity, which in turn promotes blood flow (circulation) and brings oxygen and nutrients to your injured area. This cleans your tissue by getting rid of cell waste products and helps your injury to heal. If not treated properly injured tissue can heal with a weakened state, which can lead to scar tissue or calcification. If used on an ongoing basis, ultrasound will help to increase your range of motion by breaking down any scar tissue that may form in your upper thigh muscles and hip flexors. Ultrasound waves penetrate deep into your tissues, repair and relax your muscles and other tissues, decrease chronic inflammation and pain, and accelerate your recovery rate, so you can return to your daily activities as soon as possible.

Blood Flow Stimulation Therapy™

An Inferno Wrap™ is one of the most helpful tools for a bursa injury. With Blood Flow Stimulation Therapy™ tissues are safely and gently heated - increasing blood flow within the treated area. Your body’s natural response to this increased temperature is to try to maintain a condition of homeostasis — a balanced environment or state of equilibrium throughout the body. To do this, your body responds with a rapid increase in blood flow to the area (this is known as vasodilation), increasing the supply of nutrients to injured cells and flushing out toxins (including lactic acid, commonly found in trigger points) to promote healing. Our Inferno Wrap™'s provide effective, non-invasive, non-addictive pain relief with no side effects.