Hip & Thigh

What It Is

Iliopsoas bursitis is inflammation of the iliopsoas bursa, which lies between the iliopsoas muscle and the front of the hip joint capsule. The bursa helps to reduce friction and rubbing between the soft tissues and the bones at the hip joint (Corvino et al., 2020). It is often mistaken for hip joint arthritis, iliopsoas tendinitis or a hip flexor muscle strain. It can become inflamed from trauma or overuse (Corvino et al., 2020), and muscle imbalance or tightness may play a part.

So what exactly is a bursa? It is a small, jelly-like sac containing a little fluid, which acts as a cushion between bones and soft tissues (AAOS, n.d.). Bursitis is simply an inflamed bursa. With iliopsoas bursitis, the pain is felt in the groin area (AAOS, n.d.).

The condition can be caused by a few distinct factors, such as (Corvino et al., 2020)

Sports and activities that involve repeated hip bending, such as soccer, martial arts, jumping hurdles and ballet (overuse)
Osteoarthritis or rheumatoid arthritis
Infection of the bursa
Injury (trauma)

Iliopsoas bursitis is not particularly common, and it can be hard to diagnose from symptoms alone. A scan (usually ultrasound, or sometimes CT or MRI) is often needed to confirm it and to tell it apart from other causes of a lump in the groin, such as a hernia, swollen lymph glands or, rarely, a tumour (Corvino et al., 2020).

Iliopsoas Bursitis Anatomy

The hip flexors are a strong group of muscles at the front of the hip. They include the iliopsoas, a deep muscle at the front of the hip, and the sartorius and rectus femoris, which lie over it along the upper front of the thigh.

The hip flexors lift the thigh towards the body, or bend the body towards the thigh, for example when you sit up from lying down. They also help to control the hip when you walk or run.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Iliopsoas Bursitis

A physical therapist can teach you exercises to stretch and strengthen your hip muscles, including the hip flexors, and improve hip flexibility (AAOS, n.d.). I can teach you these too, and help settle the pain with hands-on work around the hip. See the My Approach tab for how I work.

1. Ice

Ice may help to ease pain. Wrap an ice pack (or a bag of frozen vegetables) in a tea towel and apply it for up to 20 minutes every 2 to 3 hours (NHS, 2024). Never put ice directly onto the skin, or you could end up with an ice burn.

2. Modified Activities

If certain activities make the problem worse, take some time to rest. Avoiding activities that worsen your symptoms is one of the first things to try (AAOS, n.d.).

3. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons lists non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, as a simple treatment that may relieve pain and inflammation in hip bursitis. It advises using them cautiously, for limited periods, and talking to your doctor about them, as they can cause side effects in people with some medical conditions or who take certain medicines (AAOS, n.d.). (This medicine information comes from the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Corticosteroid injection: an injection of a steroid medicine into the bursa, which may help to relieve symptoms (AAOS, n.d.).
Surgery: rarely, if the bursa stays inflamed and painful after all other treatments, an operation to remove it may be considered (AAOS, n.d.).

How I can help (see the My Approach tab)

Hands-on work for the muscles around the hip, keeping pressure off the bursa
Stretching and strengthening for your hip muscles
Advice on which activities to cut back and how to build them up again

Tips

Exercise regularly to help maintain flexibility and strength in your hip muscles (AAOS, n.d.).
Avoid activities that inflame the bursa.
Avoid repetitive activities that put a lot of stress on the hips (AAOS, n.d.).
Hip bursitis in general is more common in women and in middle-aged or older people (AAOS, n.d.).
Iliopsoas bursitis is not common (Corvino et al., 2020) and can be overlooked as a cause of groin and hip pain.

Treatment

My Approach

An irritated bursa doesn't like being squashed or rubbed, and it tends to flare with activities that bend the hip over and over. My aim is to settle it down without pressing on it, ease the muscles around the front of the hip, and then build strength and flexibility so the problem is less likely to come back.

I start by assessing how your hip and low back move, the strength and flexibility of your hip muscles, and what brings the pain on. Groin pain has several possible causes, so if you have a lump in your groin, or the area is hot, red and swollen, especially with a fever, I'll ask you to see your family doctor or nurse practitioner first.

When It's Sore

No pressure on the bursa itself, and no dragging the tissue over it
Positioning with pillows so nothing presses on the front of the hip
Work on the low back, buttock and thigh muscles from a distance, to ease tension around the hip
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Cutting back the activities that flare it, such as repeated hip bending, rather than stopping everything

As It Settles

Myofascial work and contract-relax stretching for the hip flexors and other muscles around the hip
Gentle stretches for the front of the hip that don't press on the sore area
Strengthening for the hip and core, starting with gentle holds and building to bridges, step-ups and lunges, and gym-based work if you lift
A home programme between visits
A gradual return to sport or dance, building the load back up step by step

Work on the buttock, hip or groin area is only with your informed consent and a written consent form, and you can say no at any time.

If the pain isn't settling with simple measures, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more on your own. Pain usually starts to ease within a few weeks of changing the activities that irritate it, and most people are back to their usual activities in around 6 to 12 weeks.

What I Focus On

Assessment

No Pressure on the Bursa

Hip Muscle Release

Hip & Core Strength

Gradual Return to Activity

Please read

When to See a Doctor First

When to see your family doctor or nurse practitioner

You notice a lump or swelling in your groin. This needs checking, because other conditions, such as a hernia or swollen lymph glands, can look similar (Corvino et al., 2020).
Your pain is not settling with simple measures.

Sources

References

American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Hip bursitis. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/hip-bursitis/ (Accessed: 7 October 2026).
Corvino, A., Venetucci, P., Caruso, M. et al. (2020) 'Iliopsoas bursitis: the role of diagnostic imaging in detection, differential diagnosis and treatment', Radiology Case Reports, 15(11), pp. 2149–2152. doi: 10.1016/j.radcr.2020.08.036. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7484528/ (Accessed: 7 October 2026).
NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooIliopsoas Bursitis

What It Is

Iliopsoas Bursitis Anatomy

Self-Care & Treatment

How to Treat Iliopsoas Bursitis

1. Ice

2. Modified Activities

3. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to see your family doctor or nurse practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooIliopsoas Bursitis

What It Is

Iliopsoas Bursitis Anatomy

Self-Care & Treatment

How to Treat Iliopsoas Bursitis

1. Ice

2. Modified Activities

3. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to see your family doctor or nurse practitioner

References

Related Conditions

Adductor Tear

Adductor Tendinopathy

Biceps Femoris Tendinopathy

Femoroacetabular Impingement (FAI)

Book a session