Psoas pain


Nurse Director
Jun 8, 2007
The North
United Kingdom United Kingdom
People often get confused about psoas pain as it seems to be so spread out. But the psoas is a huge muscle so if you get inflammation/pain, it can occur almost anywhere. You can see the spread of it here

psoas pain.JPG

The psoas is a unique muscle. It connects the lower spine to inside of the hip and then (through its associated muscle, iliacus) to the top of the thigh bone. When it contracts, it brings the thigh toward the torso. It’s also instrumental in helping us sit up from a lying down position. In this diagram, the uppermost X shows the common location of the (right side) upper psoas trigger point. If present, it usually occurs about an inch or two to each side of the navel and sometimes slightly below it. The trigger point at the lower black X is found just inside the most prominent aspect of the hip bone. The yellow X shows an iliacus trigger point which occurs on the inside upper thigh, just below the groin. Tension at any of these three points can produce pain or numbness in the upper thigh (and also in the groin, genitals, and lower back).

You can access this muscle most easily if you lie on your back with your knees bent and resting together on one side.

feeling for psoas.jpg

This allows you to feel the psoas on the side opposite from where your knees are lying. Use all your fingertips together to press deeply at the uppermost X first (you may want to trim your fingernails for this). Start an inch or two to the outside of your navel, and search a few inches in all directions. If you raise your head, this will contract the more superficial rectus abdominis muscles. Keep in mind that you need to feel outside and underneath these muscles to get to the psoas.

If the psoas is overly rigid, it will feel like a firm vertical band, roughly like a banana, and it will be tender. If this is the case, do some self massage here (you will likely need to repeatedly work on it to encourage the muscle to really let go). If you are feeling the psoas on the left and notice a strong pulsation in our abdomen, this is probably your descending aorta (a major artery) and you should move just slightly outward (toward your side) to find the psoas.

Next, you can follow the psoas downward and outward to its lower attachment inside the pelvis. From where the pelvic bone sticks up the most (the anterior superior iliac spine or ASIS), you’ll be feeling just slightly closer to the midline. Feel a few inches up and down. If you encounter a very tender point that produces the pain you have been experiencing in your groin or pelvis, do some gentle massage.

It is less likely that you will need to address the iliacus trigger point (indicated by the yellow X in the diagram above) if you work on these upper points. However, if the pain remains, especially in the thigh, you can search for this trigger point by lying flat with your legs extended and pressing deeply against the front/inside surface of the thigh bone about an inch below your groin. If you find a significantly tender point that produces the pain you have been experiencing, you can do some massage here.

The text for this article was obtained from this site Thigh Pain by Dr Peter Borten
I had a double hip resurfacing two years ago and always had a catching sensation which became painful from early on. I tried cortisone, prp, prolatherapy incase it was scar tissue. Nothing worked.
Anyway I had a psoas release done four weeks ago, I wish I’d done it sooner! Was a super easy operation, crutches for two weeks. The surgeon confirmed my cup was overhanging. He released at the central compartment so I don’t loose too much stability.
I know lots of people have this complication and wonder about the operation. Please feel free to ask questions!

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