Iliopsoas related (hip flexor assessment)

Question 1

S&S:

Answer 1

Deep ache on anterior medial groin
– Acute or chronic
– often unilateral (esp initially)
– well localised
     ■ no crossover sign - sign of progression
– ache - progressing to pain
– loss of acceleration/deceleration
– reduced sprint speed
– pain on kicking

Question 2

Causes

Answer 2

-Repetitive kicking
– Overstretch injury
– Poor posture
– LSP hypomobity

Question 3

How Common

Answer 3

Less common than adductor-related problem
• Generally due to neuromuscular tightness rather than
tendinopathy

Runners

Question 4

Palpate

Answer 4

Psoas (supra-inguinal)
Iliopsoas (infra-inguinal)
Proximal rec fem
Proximal sartorius
*Tenderness of muscle in lower abdomen or below
inguinal ligament, lateral to femoral artery, medial
to sartorius

Question 5

Stretch

Answer 5

-Passive hip extension in modified Thomas Test
-Passive hip extension and knee flexion in modified Thomas Test
-*positive Thomas test
– ? neural component

Question 6

Resist

Answer 6

• Hip flexion in 0 degrees hip flexion
• Hip flexion in 90 degrees hip and knee flexion
• Hip flexion in the modified Thomas Test
• Knee extension in the modified Thomas Test

– * Resisted hip flexion in thomas test position
increases symptoms

Question 7

Rec Fem causing groin pain

Answer 7

Rec fem (causing groin pain)
● 94% - proximal tendon
● 63% tendinous
● primarily during kicking and
sprinting

Question 8

Iliopsoas causing groin pain

Answer 8

Iliopsoas
● mainly at MT junction
● change of direction
mechanism of injury