Tapering of the M. iliopsoas

A tape bandage is used in sports medicine, orthopedics and accident surgery both for prevention and therapy.It is a functional bandage that does not completely immobilize injured or endangered ligaments, joints and muscles, but merely prevents undesired movements. The effect is based, among other things, on the fact that any forces that occur are transferred to the plaster, thus relieving the strain on joints, for example. This is called augmentation.

In addition, a tape bandage can improve the perception of bodily functions (proprioception), reduce swelling (compression), and ultimately have a splinting effect. Tape bandages are usually used on the joints and muscles of the extremities (arms and legs). In principle, however, they can also be applied to the trunk of the body, for example the spine.

Whether it makes sense to tape the muscle iliopsoas is questionable. It is a muscle located in the depths of the body, which is very difficult to palpate (feel) even in physiotherapy. However, tape bandages or so-called kinesio-tapes of the muscle Iliopsoas are regularly found. They run diagonally from the inner side of the thigh to the outer part of the hip.

Bursitis of the iliopsoas

In the area of the tendon of the Musculus Ilipspoas there is a large bursa, the Bursa Iliopectinea. This bursa also borders the hip bone (Eminentia iliopectinea). An inflammation of the bursa is called bursitis.

Strictly speaking, one cannot speak of bursitis of the iliopsoas, as it is not an inflammation of the muscle. Bursae serve to redistribute pressure at joints and reduce friction. An inflammation of this bursa leads to pain in the hip area, which increases when the iliopsoas is stressed.

Since the bursa is located near the tendon of the muscle, the inflamed bursa is always irritated when the muscle is stretched. Bursitis is initially treated conservatively. Exertion and sport should be avoided in the first period.

Cooling compresses (e.g. with alcohol) have proven effective and alleviate the symptoms. In addition, anti-inflammatory non-steroidal anti-rheumatic drugs such as ibuprofen or diclofenac are also used in this case. The hip should nevertheless be moved and stretched carefully.

No movement at all only leads to joint stiffening and that would be highly counterproductive. If the cause of the bursitis is bacterial in nature, antibiotics such as ciprofloxacin and gyrase inhibitors are prescribed. If the conservative measures do not show any success, the bursa is treated surgically.

As a muscle of the pelvis, the M. iliopsoas is assigned to the group of inner hip muscles. Anatomically, the M. iliopsoas is located in the so-called retroperitoneal space, a fatty connective tissue space between the posterior abdominal wall and the peritoneum. Basically, the iliopsoas muscle is not just a single muscle.

The muscle known as M. iliopsoas is rather composed of the large muscle psoas major, the muscle iliacus and the small muscle psoas minor. In addition, the large psoas major muscle is further subdivided into a superficial and a deep-lying layer. The individual components of the M. iliopsoas differ mainly in their origin.

The superficial parts of the musculus psoas major originate in the area of the twelfth thoracic vertebra and the first four lumbar vertebrae. The deep layer of this part of the iliopsoas muscle, however, originates from the transverse processes of the upper lumbar vertebrae. The iliac muscle originates primarily from the so-called iliac fossa (iliac bone pit) of the pelvis.

Starting from their origin, both parts of the iliopsoas muscle pass through the laterally located Lacuna musculorum and insert into the small trochanter of the thigh bone (trochanter minor). The nervous innervation of the iliopsoas muscle takes place via various branches of a nerve plexus in the lumbar spine (plexus lumbalis). The so-called “iliopsoas syndrome” (synonym: psoas syndrome) is one of the most frequent diseases in the area of this muscle.

Pain at the front of the hip caused by excessive stretching is one of the typical symptoms of iliopsoas syndrome. In addition, affected patients often complain of pain in the lumbar region, the lower abdomen and the thighs. The large M. iliopsoas generally acts as an antagonist to the abdominal and gluteal muscles.

The main function of the iliopsoas muscle in this context is the flexion of the hip joint. It also performs an important function in straightening the upper body from a supine position. The movement performed by the iliopsoas muscle can be compared to throwing a ball into a soccer.Another important function of the M. iliopsoas becomes clear when looking at the walking process.

Both when running and walking, as well as when jumping, the iliopsoas M. serves to move the leg forward, up and out. A possible disease-related failure of the iliopsoas muscle can be compensated at least partially by targeted training of other muscle groups. Its function as the flexor muscle of the hip joint can be taken over by, for example, the thigh-band tensioner (Musculus tensor fasciae latae), the straight thigh muscle (Musculus quadrizeps femoris) and the tailor muscle (M. sartorius).

In the course of aging, the muscle fibers of the iliopsoas muscle shorten enormously in many people. This structural change results in an age-related limitation of its function. For this reason, many older people suffer from problems when walking.

Furthermore, the increasing shortening of the iliopsoas muscle often causes problems when climbing stairs. If severe movement restrictions in the hip area occur in younger patients, this can be a first indication of the presence of the so-called iliopsoas syndrome. The affected patients usually suffer from severe pain, which is mainly located at the front of the hip, the lumbar spine and the thighs.

Furthermore, this pathological overloading of the iliopsoas muscle is often manifested by an acute limitation of the muscle’s function. Patients suffering from iliopsoas syndrome have difficulty walking, running and jumping. In addition, the ability of the hip joint to bend is often enormously restricted.

In most cases, the cause of this disease is due to overloading or incorrect movement sequences. For this reason, the function of the M. iliopsoas can be maintained for a long time through targeted warm-up training with intensive stretching. In addition, periods of stress on the iliopsoas muscle should be regularly replaced by rest and relaxation phases.