Iliopsoas bursitis is inflammation of the bursae located in front of the hip. The underlying cause can be an injury, overuse, or inflammatory arthritis. Physical therapy can aid in your recovery if you experience acute issues with iliopsoas bursitis, or may be used as part of a pain management program for inflammatory arthritis. 

Stretching Tight Muscles

Hip extension exercises can be used to stretch tight muscles. Depending on your mobility, there are several variations of hip extensions that can be used. If you are more limited in your physical activity, you can stand in front of a wall or behind a chair for support. Move one leg backwards to help stretch the front of your hip. After you have sufficiently stretched one hip, return to the starting position and stretch the other hip. People with more mobility and access to exercise equipment via their physical therapist or a gym can use a hip extension machine. One of the benefits of using a machine is you are simultaneously strengthening your low back muscles. Although it is recommended to continue stretching exercises until the pain resolves, you should continue these stretches since they may reduce recurrence of bursitis.

Strengthen Your Hips

The muscles responsible for internal and external rotation of the hip not only need to be strengthened, but there needs to be balance so one set does not dominate the other. Clam shell exercises are the easiest to strengthen the muscles responsible for external rotation. While lying on your side with your knees slightly bent, raise the top leg. When you raise the top leg, the knee should remain bent and your feet should continue to touch. You are opening and closing your legs like a clam shell. A more advanced version consists of adding a band around your thighs for resistance. You can work on the muscles responsible for hip internal rotation in a similar way. While lying on your side, rotate the top leg inward so your knee is pointing inward, while your foot is pointing outward. Think of this exercise as the opposite movement of clam shells. You can place an exercise band around your ankles for more resistance.

Gait Retraining

In some instances, a physical therapist might also recommend gait retraining. The goal is to engage more of your glute muscles during walking, which increases hip stability. Some common exercises that can be used to improve glute strength are squats, lunges, and pelvic thrusts. As these exercises become easier, you can switch to weighted variations by incorporating a kettle bell, resistance bands, or a barbell. Depending on your current gait, you may also need help correcting postural issues or pelvic tilt. In the beginning, your physical therapist will give you cues when to contract your glutes at specific times in your gait. With sufficient practice this will become automatic.

Iliopsoas bursitis can become a chronic issue if it is not addressed promptly. Regardless of the underlying cause, physical therapy can reduce pain and help you return to normal physical activities.

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