Sep 1, 2026
Psoas Syndrome: Why Your Hip Flexor May Be the Source of Your Pain
Welcome to "Movement Matters," Your Guide to Wellness!
Written by Dr. Rachael MacGregor DPT, DMT, FAAOMPT
The psoas is a deep muscle connecting the lower spine to your hip and plays an important role in walking, climbing stairs, standing upright, and lifting your leg. When the psoas becomes irritated or overloaded, it can contribute to a condition commonly called psoas syndrome or iliopsoas syndrome.
What Causes Psoas Syndrome?
Common contributors include
Running or repetitive exercise
Suddenly increasing your workout intensity
Prolonged sitting, especially with the hips held in a flexed position
Repetitive sports or recreational activities
Muscle weakness or poor movement mechanics
Changes following hip surgery, including hip replacement
Repetitive hip flexion, such as climbing stairs or repeatedly lifting the legs
Limited hip mobility or flexibility
Athletes involved in running, dance, hockey, track and field, and other activities requiring repetitive hip movement may be particularly susceptible.
What Does Psoas Pain Feel Like?
Deep hip or groin pain
Pain may feel like it is located deep in the front of the hip or groin.
Low back discomfort
Because the psoas attaches to the lumbar spine, irritation can sometimes contribute to low back pain or stiffness.
Pain when lifting your leg
Getting into a car, climbing stairs, walking uphill, or lifting your leg into bed may aggravate symptoms.
Pain when standing upright
Some people notice increased discomfort when transitioning from sitting to standing or when trying to fully straighten the hip.
Hip tightness or stiffness
You may feel as though one hip simply doesn't move as freely as the other.
A clicking or snapping sensation
Some people experience a snapping sensation in the front of the hip when moving the leg.
How Can You Find Relief?
1. Don't simply stretch harder
One of the biggest mistakes people make is assuming that a painful or “tight” muscle needs aggressive stretching.
If the psoas is irritated, repeatedly forcing it into a stretch may actually aggravate your symptoms.
Instead, the goal is to determine why the muscle is being overloaded in the first place.
2. Temporarily modify aggravating activities
You don't necessarily have to stop moving completely.
Consider temporarily reducing activities that consistently reproduce your pain, such as:
Steep hills or inclines
High-volume stair climbing
Deep lunges
Repetitive leg lifting
High-intensity workouts
Long periods of uninterrupted sitting
Gradually returning to these activities as symptoms improve is generally more helpful than pushing through significant pain.
How Can You Find Relief?
3. Keep moving throughout the day
If you spend hours sitting, try getting up and walking around periodically.
Changing positions throughout the day can reduce the amount of time your hips remain in a flexed position and may help reduce stiffness.
Set a reminder to stand up and move for a few minutes every 30–60 minutes.
4. Strengthen—not just stretch
The psoas is a muscle, and like other muscles, it needs to be able to tolerate the demands placed on it.
A physical therapist may incorporate exercises targeting:
Core stability
Glute strength
Hip strength
Hip mobility
Pelvic control
Functional movement patterns
The goal isn't simply to make the psoas “looser.” It's to improve how your hip, pelvis, and trunk work together. Physical therapy is one of the commonly recommended treatments for psoas syndrome.
Simple Reminder: Pain ≠ Always a Tight Muscle
Hip and groin pain can come from many different structures, including muscles, tendons, joints, nerves, and the lumbar spine.
Psoas syndrome can also be confused with other conditions that cause similar symptoms, which is why a thorough physical examination is important.
If your pain persists, worsens, causes you to limp, or interferes with your normal activities, it's worth having it evaluated rather than continuing to self-treat.
When Should You See a Physical Therapist?
Consider an evaluation if:
Your hip or groin pain has lasted more than a week
Pain is interfering with walking, exercise, sleep, or daily activities
You have difficulty getting up from a chair or getting in/out of a car
You experience recurring hip or groin pain with exercise
You have tried stretching and rest without improvement
You recently had hip surgery and are experiencing new or persistent symptoms