Massage therapy · Kitchener–WaterlooPsoas Syndrome

Psoas syndrome often happens without a known cause (Cleveland Clinic, 2024). Psoas injuries are rare because the muscle lies deep inside the body, but athletes whose sports put a lot of force on their core or hips are more likely to injure it (Cleveland Clinic, 2024). Dancers, for example, can develop iliopsoas syndrome from repeated hip movements (Laible et al., 2013).

Many of the symptoms can also be found in other conditions, some of which are serious. The psoas runs over or near many organs in the abdomen, and health conditions affecting these organs can also irritate it (Cleveland Clinic, 2024).

If you have any of the symptoms listed above, it's best to consult with a healthcare professional, especially if they do not get better in about a week (Cleveland Clinic, 2024). They can work out which condition is likely to be the cause, make sure you get a proper diagnosis, and recommend an appropriate treatment plan.

Typically, your doctor will begin with a physical examination of your back and hips, and I'll also assess your back and hips before treating you. Imaging tests may also be used to look at the psoas muscles and the area around them (Cleveland Clinic, 2024).

Rest and Exercise: If you have a minor muscle strain, you might only need to rest or avoid intense physical activity for a few weeks (Cleveland Clinic, 2024). In most cases, exercise is the best treatment for psoas syndrome, and non-surgical treatment works for most athletes (Vandeputte et al., 2026). Usually, your physician or a physical therapist will give you specific stretches and strengthening exercises that can be done during visits and at home (Cleveland Clinic, 2024). They'll also let you know how often to do the routine and how many repetitions of each move you need. I can set up and coach you through these exercises too.

Options outside my scope

• Injection: very occasionally, a specialist may give an injection guided by imaging if other treatments have not helped (Vandeputte et al., 2026; Laible et al., 2013).
• Surgery: an operation is only considered in rare cases where other treatments have failed (Laible et al., 2013).

How I can help (see the My Approach tab)

• A stretching and strengthening programme for the hip, core and lower back
• Hands-on work for the hip, thigh and lower back
• Advice on sitting, activity and a gradual return to sport

With the proper care and time, most people with psoas syndrome recover with non-surgical treatment and return to their normal routine (Vandeputte et al., 2026).

To help prevent muscle injuries, warm up and stretch before exercise, work on your core strength and stability, and increase your activity level gradually rather than suddenly (Cleveland Clinic, 2024). Avoid sitting or standing in one position for a long time (Cleveland Clinic, 2024).

Working with a running coach or football coach, and wearing suitable footwear, can also help to prevent a re-occurrence.

Work near the groin, front of the hip or buttock is only done when it's clinically relevant, with your informed consent and a written consent form.

Because problems with organs in the abdomen can also irritate the psoas, see your family doctor or nurse practitioner if your symptoms don't get better in about a week.