That Deep Hip Pain Could Be Coming From a Muscle You’ve Never Heard Of

September 4, 2026

Pain in the front of your hip or groin can sometimes come from a muscle you rarely think about or even heard off: the psoas muscle. This deep muscle connects your lower spine to your thigh and plays an important role in walking, climbing stairs, lifting your leg and maintaining stability around the hip and lower back.

When the psoas and surrounding iliopsoas tissues become irritated or overloaded, they can cause pain that is often mistaken for a hip, back or groin problem. This is commonly referred to as psoas syndrome.

The good news is that most cases can be managed without surgery, particularly when the underlying cause is identified and addressed through appropriate movement, strengthening and activity modification.

What is psoas syndrome?

Psoas syndrome describes pain or dysfunction involving the psoas or iliopsoas muscle-tendon complex.

The iliopsoas is made up primarily of the psoas major and iliacus muscles, which come together and attach near the upper part of the thigh bone. It is the body’s primary hip-flexor muscle and also contributes to stability of the hip, pelvis and lower spine.

Because the iliopsoas is involved whenever you lift your leg or move from one position to another, it is repeatedly used throughout the day.

Psoas-related problems can occur in athletes who repeatedly flex their hips, but they can also affect people who spend long hours sitting or suddenly increase their physical activity.

Where is the psoas muscle?

The psoas is a deep muscle located behind the abdominal organs and alongside the lumbar spine.

The psoas major originates from the lower thoracic and lumbar region of the spine. It travels down through the pelvis and joins the iliacus before attaching to the lesser trochanter of the femur.

Together, these muscles form the iliopsoas, which is particularly important for hip flexion.

Think about movements such as:

Walking
Climbing stairs
Running
Cycling
Getting into or out of a car
Standing up from a chair
Lifting your knee
Getting dressed

Your iliopsoas is involved in many of these movements.

What does psoas syndrome feel like?

Psoas-related pain can be difficult to pinpoint because the muscle is located deep within the body.

Common symptoms include:

A deep ache in the front of the hip
Pain in the groin
Discomfort in the lower back
Pain when lifting the knee
Pain when getting up after sitting
Stiffness after prolonged sitting
Discomfort when walking, climbing stairs or running
Difficulty standing completely upright
A clicking or snapping sensation in the front of the hip
Pain that may extend into the front of the thigh

Symptoms can vary considerably between people. Some individuals primarily experience hip or groin pain, while others notice symptoms around the lower back or pelvis.

Because several hip and lower-back conditions can cause similar symptoms, the location of pain alone cannot confirm that the psoas is responsible.

What causes psoas syndrome?

Psoas problems usually develop when the muscle or tendon is subjected to more load than it is prepared to handle.

1. Prolonged sitting

Sitting keeps the hip in a flexed position for an extended period. If you spend several hours at a desk, driving or working from a sofa, the hip flexors remain in a shortened position for much of the day.

However, it is important not to assume that sitting automatically “shortens” or damages the psoas. The bigger issue is often reduced movement combined with insufficient strength and conditioning.

Regularly changing position and moving throughout the day can help maintain comfortable hip movement.

2. Repetitive hip movement

Activities that repeatedly require powerful hip flexion can place considerable demand on the iliopsoas.

Examples include:

Running
Cycling
Football
Dancing
Martial arts
Certain gym exercises
Repeated kicking or jumping

Problems can arise when training volume or intensity increases faster than the tissues can adapt.

3. Increasing exercise too quickly

Starting a new exercise programme, suddenly increasing running mileage or returning to sport after a long break can overload muscles that are not adequately conditioned.

A gradual increase in activity gives the muscles and tendons time to adapt.

4. Weakness around the hip and pelvis

The psoas does not work in isolation.

The gluteal muscles, abdominal muscles and other muscles around the hip and pelvis contribute to controlling movement and maintaining stability. If these muscles are not functioning effectively, the iliopsoas may be exposed to additional demands.

This is why treatment often focuses on the whole hip and pelvic region rather than simply stretching the psoas.

5. Previous injury or hip surgery

An injury or surgery involving the hip or lower back can change movement patterns. In some cases, this can place additional stress on the iliopsoas.

Iliopsoas irritation can also occur after hip replacement, although this is a distinct clinical situation that requires physician's assessment.

Is psoas syndrome the same as a tight psoas?

Not necessarily.

The terms “tight psoas” and “tight hip flexors” are commonly used online, but feeling tight does not automatically mean that the muscle is physically shortened.

A muscle may feel tight because it is fatigued, sensitive, overloaded or poorly conditioned. In some cases, weakness can contribute to the sensation of tightness.

This is one reason why repeatedly stretching the psoas is not always the answer.

A more comprehensive approach may include mobility work, progressive strengthening and addressing the activities that are contributing to symptoms.

How is psoas syndrome diagnosed?

There is no single symptom or test that can definitively diagnose psoas syndrome in every person.

A healthcare professional will typically consider:

Where the pain occurs
Which movements reproduce the symptoms
Your activity and exercise history
Previous hip or back injuries
Hip range of motion
Muscle strength
Tenderness around the iliopsoas
Other possible causes of hip, groin or lower-back pain

Clinical examination can include resisted hip-flexion movements and other manoeuvres designed to determine whether the iliopsoas is contributing to symptoms.

Imaging is not always necessary. However, ultrasound, MRI or other investigations may sometimes be appropriate, particularly when symptoms are persistent, severe or atypical. Musculoskeletal ultrasound can also provide dynamic assessment of the iliopsoas tendon and surrounding structures.

How is psoas syndrome treated?

Most psoas-related problems are initially treated conservatively.

The objective is not simply to eliminate pain temporarily. The longer-term goal is to restore comfortable movement and gradually improve the capacity of the hip and surrounding muscles.

1. Reduce aggravating activities

If a particular activity consistently triggers pain, temporarily reducing its intensity or volume can allow the irritated tissues to recover.

This does not necessarily mean complete rest.

For example, someone experiencing pain while running may be able to continue walking or perform other low-impact activities comfortably.

2. Keep moving

Complete inactivity can sometimes make stiffness worse.

Gentle activities such as walking, when comfortable, can help maintain mobility and general physical conditioning.

The right amount of activity varies from person to person. A useful principle is to gradually increase activity rather than repeatedly pushing through significant pain.

3. Work on hip mobility

Gentle hip-flexor and hip-mobility exercises may help restore comfortable movement.

However, stretching should be controlled and comfortable. Aggressive stretching of an already irritated tendon or muscle can sometimes make symptoms worse.

4. Strengthen the hip and core

Strengthening is an important part of rehabilitation.

Depending on the individual, exercises may target:

Gluteal muscles
Hip stabilisers
Abdominal and core muscles
Hip flexors
Muscles controlling the pelvis

Exercises such as bridges, controlled hip extensions and progressive hip-flexion exercises may be incorporated into a rehabilitation programme.

The appropriate exercises depend on the cause and severity of symptoms, so a physiotherapist can help determine which movements are suitable.

5. Use heat or cold for symptom relief

Heat may feel helpful when the area feels stiff or muscularly tight, while cold may provide temporary relief after an aggravating activity.

Neither treats the underlying cause by itself, but either may be useful as part of a broader recovery strategy.

6. Consider physiotherapy

Persistent or recurring symptoms may benefit from assessment by a physiotherapist.

A physiotherapist can identify contributing movement patterns, assess strength and mobility, and develop a progressive rehabilitation programme.

Evidence and clinical reviews generally support conservative management and active rehabilitation for iliopsoas-related problems, although treatment should be tailored to the underlying cause.

Can sitting cause psoas pain?

Long periods of sitting may contribute to hip and lower-back discomfort, particularly when combined with low activity levels and poor conditioning.

But sitting itself is not necessarily harmful.

Instead of trying to maintain a “perfect” sitting posture all day, focus on changing positions regularly.

If you work at a desk:

Stand up periodically
Take short walking breaks
Change your sitting position
Avoid remaining in one position for several hours
Include regular hip and whole-body movement throughout the day

Small, frequent periods of movement can be easier to maintain than relying on one long stretching session at the end of the day.

When should you see a doctor?

Not every case of hip or groin pain is caused by the psoas.

Seek medical evaluation if:

Pain is severe or progressively worsening
Symptoms started after a significant fall or injury
You have persistent weakness, numbness or tingling
You have fever or unexplained weight loss
Pain is interfering substantially with walking or everyday activities
Symptoms are not improving despite appropriate activity modification
You have a history of significant hip or spinal disease

How long does psoas syndrome take to improve?

There is no fixed recovery timeline.

Mild irritation caused by an increase in activity may improve relatively quickly once the aggravating activity is modified. More persistent tendon or muscle problems can take considerably longer.

Recovery generally depends on:

The underlying cause
How long symptoms have been present
Activity levels
Muscle strength
Previous injuries
How gradually rehabilitation is progressed

The goal should be steady improvement in movement, strength and tolerance, rather than expecting pain to disappear immediately.

The bottom line

Psoas syndrome is a relatively under-recognised cause of pain around the front of the hip, groin and sometimes lower back.

The iliopsoas is an important muscle group involved in hip flexion and stability, so it is exposed to repeated loads during everyday activities as well as exercise.

While prolonged sitting, repetitive hip movements, sudden increases in training and previous injuries may contribute, psoas-related pain can have several different causes. Because symptoms overlap with other hip and back conditions, self-diagnosis is not always reliable.

For most uncomplicated cases, treatment focuses on staying appropriately active, improving mobility, progressively strengthening the hip and core, and addressing the activities that may be contributing to the problem.

If your pain is persistent, severe or accompanied by other concerning symptoms, consult a qualified healthcare professional for an appropriate assessment.

Frequently Asked Questions

1. Is psoas syndrome serious?
Most psoas-related muscle and tendon problems are not serious and respond to conservative treatment. However, persistent or unusual pain should be evaluated because other conditions can produce similar symptoms.

2. Can walking help psoas syndrome?
Gentle walking can help maintain movement and conditioning if it does not significantly aggravate your symptoms. Start with a comfortable duration and gradually increase activity.

3. Should I stretch my psoas every day?
Not necessarily. Stretching can improve mobility, but rehabilitation often needs a combination of mobility and strengthening rather than stretching alone.

4. Can sitting all day cause psoas syndrome?
Prolonged sitting may contribute to hip stiffness and discomfort, but it is not necessarily the sole cause of psoas syndrome. Regular movement and appropriate strengthening may be more useful than focusing solely on posture.

5. Can psoas syndrome cause groin pain?
Yes. Groin pain is a common presentation of iliopsoas-related problems. However, groin pain has many possible causes and should not automatically be attributed to the psoas.

6. Can psoas syndrome go away on its own?
Some mild cases improve with activity modification and gradual return to movement. Persistent, recurrent or worsening symptoms should be assessed by a healthcare professional.

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Medical Review: This article is written and medically reviewed by Dr Nishtha Mittal (Senior Health Content Editor at Zanskar Health). This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.