Your #1 Guide to Iliacus Muscle Pain

The iliacus muscle is located deep on both sides of the hip and is shaped to fit the exact shape of the hip. Sometimes it is referred to as the Iliopsoas, alongside the psoas muscle of the hip. These two muscles combined are the strongest hip flexors within the body. Its function is to flex and externally rotate the femur bone. This is the action of bending your leg at the hip and rotating your leg so your knee is angled outwards. The iliacus muscle is vital in maintaining proper body posture.

Upper 2/3 of the ilium iliac fossa, iliac crest internal lip, lateral aspect of sacrum, ventral sacroiliac ligament and lower portion of the iliolumbar ligament.Lesser trochanter of the femur. 

Causes of iliacus muscle pain 

Overuse is common from sports or activities such as running or cycling.

Muscle shortening: The muscle shortens when you exercise without proper stretching beforehand, or if you sit for most of your day, for example at a desk job or if you drive a lot. This muscle shortening can cause trigger points (hypersensitive knots within the muscles) that can cause pain referrals. Shortened iliacus can cause anterior pelvic tilt, affecting your posture negatively and predisposing you to hip, back and knee pain. Due to being shortened, the iliacus will have reduced blood flow. Iliacus muscle pain can feel like stiffness, reduced range of movement in the leg, or tenderness in the area.

Pain referral patterns

Trigger points within the iliacus can refer pain to the front of the thigh and to your lower back, as shown on the diagram above.

Testing for tightness

Stand with your back against the wall, your feet shoulder-width apart and the back of your head and shoulders touching the wall. Attempt to tilt your pelvis so that the small of your back touches the wall. The movement should involve pushing your groin forward and curving the small of your back. If you can complete this movement with your knees and hips straight, you do not have any shortness. If you bend your knees and hips to achieve this movement, you most likely have shortening in this muscle. 


Here are two ways to stretch the iliacus: 

Stretch 1: 

  • Lie on your back, on a table/bed with your legs hanging off the edge (with both knees bent).
  • Bring your right leg up, bending it so that your right knee is resting on your chest. 
  • The left leg that is dangling should feel a stretch. 
  • Hold this position for a minimum of 30 seconds and swap sides. 

Stretch 2: 

  • Start by standing with both hands on your hips. 
  • Step forward with your left leg and bend your knee. Ensure that your shoulders, hip and foot are facing forward. 
  • Extend your right leg behind you, with the top of your foot resting on the floor with your sole facing up. 
  • Slightly lean into your front leg. 
  • You should feel a stretch in your right hip. Hold for 30 seconds and swap legs.

Soft tissue occupational therapy treatment

Soft tissue occupational therapy treatment focuses on treating musculoskeletal disorders of the body through diagnosis, treatment, and rehabilitation. A soft tissue occupational therapist will be able to provide iliacus muscle pain relief through hands-on massage treatments such as trigger point therapy.

If you would like iliacus muscle pain relief, book in to see a soft tissue occupational therapist at Urban Health HQ. You can make an appointment today or contact us by calling 0411 563 391 or email 

Published by Urban Health HQ

We are a health and fitness centre offering Occupational Therapy, Exercise Physiology, Personal Training and Group Fitness classes.

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