Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Iliopsoas Related Groin Pain

SYMPTOMS

Gradual onset of diffuse or localised exercise-induced groin pain and occasionally lower back pain. A runner often complains that he cannot produce enough force in the stride forwards and a footballer cannot strike a ball properly. This condition can also present as low back pain.

AETIOLOGY

This is secondary pain in the groin caused by a tight or cramping iliopsoas muscle, which blocks normal movements of the hip joint. The pain can be severe and radiate to the posterior thigh or medial femur. This condition typically occurs as a result of sudden changes in training habits, such as an increase in intensity or amount of impact in preseason training, or as secondary to low back injuries.

CLINICAL FINDINGS

There is tenderness on palpation over many structures around the groin area. Flexibility around the hip joint is decreased in all directions, in particular in extension. Iliopsoas flexibility is decreased and stretching of the iliopsoas may relieve or decrease the symptoms dramatically.

INVESTIGATIONS

X-ray, MRI and other investigations are normal.

TREATMENT

This problem responds to conservative treatment including modification of training and stretching exercises. Occasionally the player walks into the clinic in agony and leaves free of pain. However, if the symptoms are chronic the core stability has been affected and a long re-training period will be required. Furthermore, any underlying disc prolapse or instability must be addressed.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon and physiotherapist for functional rehabilitation.

EXERCISE PRESCRIPTION

Stretching and strengthening exercises and core stability training are required. Otherwise full training can be resumed as soon as the symptoms subside.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs. Similar flexibility in hip joint movement should be achieved on both legs.

DIFFERENTIAL DIAGNOSES

It is important to be aware that different conditions can cause these symptoms.

PROGNOSIS

Excellent.

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