The Psoas Major and Groin Pain: The Inguinal Ligament

inguinal ligamentGroin pain can be directly related to the psoas major through the inguinalinguinal ligament ligament. Clients come to me with all manners of pain. Back pain, hip pain, knee pain, shoulder pain, groin. To be hyperbolic, which is my favorite way to be, I always say- It’s your psoas. I am only half joking. An unhappy psoas major prevents the rest of the body from being content.

There is plenty of knee pain that is directly related to the knee as well as back pain limited to a disc in the spine but there are certain common pains that I find to be associated with the psoas major though the pain radiates from a different part of the anatomy.

The inguinal ligament connects from the anterior superior iliac spine (ASIS) of the ilium to the pubic tubercle of the pubic bone. It passes right above the psoas major essentially strapping it into place. Interestingly, the function of a ligament is to connect one bone to another bone. As you see in the pictures above, the inguinal ligament is connecting to the same bone. To digress a bit, when you are born the ilium and the pubis, along with the ischium are separate bones that fuse over time. So, technically, the argument can be made that the ligament is connecting two separate bones that have simply fused into one.

Back to the psoas major and groin pain. As I said, the inguinal ligament basically runs over the psoas strapping it across the rim of the pelvis. One of the common pains that I mentioned earlier was a wrapping pain that tends to run from the pubic bone up and around the groin to the hip and the lower back. Over time I have come to think that this wrapping pain is a tight psoas major pushing on the inguinal ligament causing the discomfort.

To Heel Strike or Not to Heel Strike
Brain strain in Midtown Manhattan (at the dentist)
  1. “As I said, the iliofemoral ligament basically runs over the psoas strapping it across the rim of the pelvis.”

    You mean the inguinal ligament.

    BTW, great blog! And Sharon’s artwork on anatomical parts is a creative addition…influenced by Leonardo De Vinci’s work? Also, I enjoyed your concise book, Psoas Release Party, which makes for a good complement to Liz Koch’s The Psoas Book. (Yours is better written.)

    The Fitzgordon Method seems to be a composite of ideas from Jean Couch’s Balanced Yoga, Pilates, Feldenkreis, Aston-Patterning, Pose Method, and Rolfing…. Of course, you’d disagree with Jean Couch in that the feet should be slightly splayed when standing for proper alignment (so do I).

    Alfredo Balaban
    author of The Financial Athlete

    • Corrected! Thanks so much. You are right about Jean Couch and splayed feet. Though she is not alone and I really appreciate her work.Two other influences to throw in are Body Mind Centering (Bonnie Bainbridge Cohen) and Anti-Gymnastique (Therese Bertherat) I look forward to checking out your book as well.

  2. Are you familiar with the following?

    1) Michaelle Edwards’ YogAlign? I apply some of her ideas in my personal practice for yoga. Her website is I think you’ll find the links for YogAlign Articles and YogAlign injury prevention interesting. She also has some video material on youtube.

    2) For the psychological traits underlying postures, read The Body Reveals, What Your Body Says About You by Ron Kurtz and Hector Prestera. Copyright 1976, 1984.

    3) The Eric Franklin Method. His book, Inner Focus Outer Strength, is a good start.

    4) Florence Kendall’s book, Muscles Testing and Function, 4th Edition with Posture and Pain, Copyright 1993

    5) Ruthy Alon’s Bones for Life. (My Feldenkreis/Bones for LIfe teacher has given me a whole new meaning for “earth touch,” with the whole palm on a yoga block.)

    6) Juliu Horvath’s Gyrokinesis and Gyrotonic.

  3. I used to be suggested this website by way of my cousin. I am now not certain whether or not this post is written through him as no one else recognise such certain approximately my difficulty. You’re incredible! Thanks!

  4. I’ve been to half a dozen osteopaths and physiotherapists who keep misdiagnosing my pain. I’d have to say this is the first accurate description of my symptoms and experience.

    Many thanks!

    • Hi Frank, I dont know why, but many doctors and health care professionals have a serious-seeing the forest from the trees- issue when it comes to the pelvis and the psoas. Check out the video for constructive rest and try to take your thighs back a little making some room for the groin area when you are standing and walking.

  5. There is some great information contained here. I am a international athlete and have been experiencing some discomfort in my hip and back area it sometimes radiates through the entire region. It is not constant and comes on after standing for long periods or sitting awkwardly – the irony is that I have never investigated the inguinal ligament and chose tonight to look for it – as I happened across your page Holby City (a hospital drama) was on my TV in the background and the guy they were examining had a inguinal hernia! What a coincidence.

    Anyways – I am now a telemark skier, I used to be a bobsledder before that but had to stop because of PSOAS problems – I think the two are related and I am going to get the whole area checked out by my physio now – so thanks! Happy blogging.

  6. Hi Johnathan,
    I had 2 inguinal hernia repairs, along with the doctor removing a cyst almost a year ago & am experiencing a confusing amount of pain, acute in some movements & aching in others.
    I am working in a sedentary job which I am sure is not helping. I have adapted my work station to stand so that I can stretch & have been trying to do physio & some aquafit.
    But I have pain through my groin, hip, psoas, and am experiencing knee pain & a frozen shoulder / rotator cuff issues on the same side.
    I don’t know if the surgeon sewed my inguinal ligament to my psoas or something or if it is just so tight it is trapping my psoas & all the over correcting I am doing is causing havoc?
    I used to enjoy great health & flexibility & now am afraid to even do yoga if I could stand the pain.
    Please help – I would appreciate any suggestions – I feel like I am at the end of my rope!!!

    • Hello,

      I believe that with difficult cases it sometimes is a trial and error to find the origin of the pain experienced. Inguinal pain can be caused by so many sources. I am a PT of 33 years and the key to me is to evaluate all of the movements and thus movement impairments down in this area. Ensuring that the myofascia between tissues is fluid is important. The psoas is pertinent as is the iliac us and then all other anterior core muscles. there is a fascial envelope if you will that can be too tight. The proper core muscles need to fire properly from one side to the other as well.

      Looking at the fascia, bones and joints, flexibility in the muscles and ligaments and biomechanics in the joints can help to unlock this puzzle. There may even be a visceral component to this as well.

      Never stop looking for your answer.

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