Psoas Impingement

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An Overview on Psoas Impingement

As a ball and socket joint, the hip is formed by the femoral head (ball) and a portion of the pelvis known as the acetabulum (socket). If the ball and socket are not properly shaped, it leads to a hip condition known as femoroacetabular impingement (FAI). Patients in the Santa Barbara, Goleta, Santa Maria and Ventura, California area affected by FAI, or those involved in activities that require repetitive hip flexion, may experience tightening and inflammation of the iliopsoas (hip flexor) tendon. When the tendon becomes tight and inflamed leading to painful symptoms, it is commonly referred to as psoas tendinitis or impingement. Dr. Jervis Yau, orthopedic hip specialist, is highly experienced at treating psoas impingement, as well as an associated condition known as iliopsoas bursitis.

Psoas impingement, otherwise known as internal snapping hip syndrome, is caused by the psoas tendon becoming tight and inflamed from repetitive hip flexion movements such as in gymnastics, dance and certain track and field events. The repetitive flexion may cause the psoas tendon to snap across either the femoral head or acetabulum leading to an audible and palpable pop. In certain patients, the tendon may even compress the labrum and cause injury or tear.

An associated hip condition, iliopsoas bursitis causes patients to experience similar symptoms as psoas impingement, and is also caused by repetitive hip flexion during athletic activities. Iliopsoas bursitis is characterized by inflammation of the psoas bursa located between the psoas muscle and the front of the hip joint.

Psoas Impingement Symptoms

The most common symptoms of psoas impingement include pain, inflammation and soreness in the front of the hip/groin area. The pain is often intensified during and after activities that require hip flexion. Patients with psoas impingement may also experience a snapping sensation in the front portion of the hip when the hip is gradually extended from a flexed position.

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Psoas Impingement Diagnosis

Dr. Yau will perform a complete physical examination to diagnose psoas impingement and to rule out other hip injuries, such as iliopsoas bursitis. In many cases he will use x-rays and MRI to evaluate the soft tissues structures within the hip joint in detail in order to confirm the diagnosis.

Psoas Impingement Treatment

Non-Surgical

Psoas impingement is commonly treated with non-operative measures prescribed by Dr. Yau. Patients are instructed to rest, apply ice, take anti-inflammatory medications and engage in a detailed physical therapy program. A corticosteroid injection may be injected into the inflamed soft structures to help alleviate pain and inflammation and to allow ease while returning to normal activities.

Surgical

If surgery is required to treat psoas impingement, Dr. Yau will typically repair it arthroscopically, or hip arthroscopy. For a tight iliopsoas tendon, he may perform a fractional lengthening of the tendon to make it longer, thereby relieving the symptoms associated with the tightness while preserving hip flexion. Any other hip pathology, such as iliopsoas bursitis, that is discovered through the diagnostic tests will be treated during the same operation.

For additional resources on psoas impingement, or for more information on iliopsoas bursitis, please contact the orthopedic office of hip specialist Dr. Jervis Yau, located in the Santa Barbara, Goleta, Santa Maria and Ventura, California communities.

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