Ilio What?

Iliopsoas Syndrome.

What the heck is that?

Can I first just say how thankful I am to have dragged my butt into PT and not procrastinated as I usually do? Otherwise I would have never found the underlining issue and some new interesting facts about my running form that would have probably caused a more severe injury down the road.

As I mentioned in a few of my previous posts, I've had this nagging pain in my right hip since the 15k race two weeks ago and have not been able to run since. I tried some deep tissue massage last weekend but the pain was still there. What's a girl with 10 weeks left till IMBoise to do? PT it was...and am I happy to report that the culprit has been identified!

The below excerpt was taken from a blog entry by Dr John Michie on Iliospoas Syndrome. (the best piece of info I could find on the topic - click here for the whole article).

The ilispoas is made up of two muscles, the psoas and iliacus, as described above. Basically they work as the primary hip flexors and as such are susceptible to tightening/tearing etc. in folks that use repeatitve hip flexion movements. (i.e. triathletes, cyclists, runners - see a pattern?)  Iliopsoas Syndrome is referred to by some as the " Hidden Prankster" in that it's buried so far underneath the abdominal wall muscles that its difficult to access and can also be confused with other more common running injuries.

What causes this issue? Repetitive hip flexion movements (built up training) and also in my case, a 3 mile hill decline during the Shamrock Run. (I swear that race is trying to kill me!). I have never experienced an issue with this muscle group before but have also never trained on hills with such a long decent.

During my visit, the LPT checked for flexibility and strength in all my lower muscle groups. In determining that this wasn't the issue (hooray - this gal is "SUPER STRONG"!) she had me do some simple squats. BINGO! We have a cause....apparently my darn right knee pulls inward during my run. This is usually due to weak glutes but in my case just a weird matter of fact. Kind of annoyed that my local running shop never pointed this out during the gait analysis I had last year (I mean they recorded my run for crying out loud) but am so happy to have pinpointed the issue now.

Anyway, the knee bending issue + 3 miles of downhill running caused my iliospoas to pull all wonky and basically scream out in anger. I was flying down that hill too, feeling freakin' awesome! Had I only known I was doing more harm than good.......

So how do we treat it and what is the plan going forward:

1. PT once a week for the next 3 weeks.
2. Astym massage - which hurts like a mother!!! See those tools on the right.....they suck and I hate them.
3. Stretch & foam roll
4. Ice 
5. Daily work on opening up my right knee on the run

I will also begin a run/walk routine to replace my scheduled training runs but these will max out at 30 mins. Frustrated that I won't be able to get in the proper amount of miles I should be but am thankfully that this is a fixable issue and with the proper care should have me back up to 100% very soon!

So there you have it! Probably much more than you ever wanted to know about my hip pain but figured perhaps someone else could benefit from learning a bit more about "The Hidden Prankster".....


....and be forewarned about that damn Astym massage!!