yogabook / pathologie / psoas-syndrome

psoas-Syndrome (part of the picture of a „groin strain“)

Definition of

Insertional tendinopathy of the tendon of the iliopsoas at its insertion on the lesser trochanter of the thigh. Depending on the duration and severity, acute, subacute or chronic irritation of the tendon of the most important hip flexor, which usually occurs as overuse syndrome due to frequently repeated hip flexion with or without load, more rarely also traumatic. The insertional tendinopathy of the tendon is often accompanied by iliopectinealbursitis of the underlying large bursa. The symptoms of the syndrome usually build up over weeks or months, beginning with pain on exertion, which can later develop into pain on movement or pain at rest.

Cause

1. Overuse

Predisposing

1. Unusual or unusually intensive training, especially of cyclical hip flexion sports or movement elements
2. W > M
3. Younger adults with sporting activity
4. Soccer players, dancers, gymnasts, rowers and runners

Symptoms

1. Cause Overuse: usually creeping pain on movementand exertion, improvement after the end of exertion. If more pronounced, sometimes also pain at rest.
2. Possible snapping in the hip
3. Possible knee pain

Complications

1. Partial rupture of the tendon, very rarely also total rupture

Therapy

1. Cooling against the inflammatory component
2. NSAIDs against inflammation
3. Setting down the load
4. Progressive stretching of the hip flexors
5. regenerative strength training
6. Strict avoidance of triggering movements and stresses
7. Only in rare cases is non-conservative intervention indicated, in which case the success is uncertain
8. Stretching and strength training and adapting training to prevent recurrence

Asana practice and movement therapy

The iliopsoas is one of the particularly strong muscles in the human body. Nevertheless, its insertion tendon (common insertion of the psoas major and iliacus) cannot always withstand the required load in the long term and can eventually develop insertional tendinopathy. The triggers for the disorder are usually sport-related and of a repetitive, impulsive nature; depending on the type of sport, the training sessions are too close together for the tendons, with their turn over of 1 – 1.5 years in relation to the demand, not to be able to regenerate. This is the first pillar of therapy: medium-term protection before overloading the tendon, i.e. refraining from repetitive, impulsive use of the high muscular capacity of the iliopsoas. As with other insertional tendinopathies, a sustained strengthening of the muscle-tendon system, also at least in the medium term, with a longer holding time and stretching training must also be recommended. After all, the strain on the tendon is even greater in the case of a shortened muscle.