You’re halfway up the trail above Lithia Park when it catches again. A deep, hard-to-point-at ache in the front of your hip, right in the crease where your leg meets your body. Every time you lift your knee for the next step, it’s there.
It started small. A twinge getting out of the car after the drive back from Medford. A click when you swung your leg into bed. Now it’s the first thing you notice when you stand up from your desk, and you’ve started skipping the runs, the dance class and the yoga flow that used to be the best part of your week.
The worst part is how hard it is to describe. It’s not quite your back and not quite your groin. You’ve stretched your hip flexors until you’re sick of it, and the ache keeps coming back. Part of you wonders if something is seriously wrong inside the joint. Part of you is just tired of wondering.
You shouldn’t have to piece this together from internet videos. Deep front-of-hip pain has a short list of real causes, and one of the most common in active people is psoas tendinopathy. Once it’s examined properly, it’s very treatable.
What’s Actually Going On in the Front of Your Hip
The psoas is one of the deepest muscles in your body. It starts on the sides of your lower spine, runs down through your pelvis, joins the iliacus muscle and crosses the front of your hip joint before attaching to the inside of your upper thigh bone. Together they’re called the iliopsoas, and they’re the main muscles that lift your knee toward your chest.
Tendinopathy means the tendon has been asked to handle more load than it could adapt to. Uphill running, sprinting, kicking, dance, lots of sit-ups or leg raises, and a sudden jump in training are the usual triggers. So is the combination of long days sitting followed by a hard weekend hike on Mt. Ashland. The tendon gets irritated and sensitive, and it hurts most when you lift your leg against resistance or stretch it far behind you.
Some people also feel or hear a click in the front of the hip as the tendon slides over the bone underneath. That’s called internal snapping hip. A painless snap is common and harmless. When the snap comes with pain, it tells me the tendon and the muscles around it need attention.
This isn’t your fault, and it’s why stretching alone stalls. An irritated tendon doesn’t want to be pulled on harder, so aggressive hip flexor stretching often keeps it sore. The psoas also rarely works alone. Weak glutes, a stiff lower back or pelvis, or a core that doesn’t share the load all push more work onto that one tendon. Until those pieces change, the hip keeps getting irritated.
Meet Your Guide
I’m Dr. Noah Volz, a chiropractic physician in Ashland. In Oregon, chiropractors are licensed as chiropractic physicians, and hip and groin pain sits squarely in what I examine, diagnose and treat. You don’t need a referral. You can come see me directly.
I see this pattern in runners, hikers, cyclists, dancers and people who sit all day. My approach is gentle and precise: less force, more precision. Your body has learned to guard that hip. My job is to find out why and help it feel safe enough to move well again.
What I Do When You Come In
Front-of-hip pain can come from the tendon, the hip joint itself, the lower back, a hernia or other structures. So the exam comes first.
- A detailed history: when it started, what you were doing, what makes it worse and what you’ve already tried.
- A hands-on exam: hip range of motion, resisted hip flexion, tendon palpation, hip joint tests for impingement and labral irritation, a lower back screen, and strength testing of your glutes and core.
- Imaging when the exam calls for it: if anything points to the joint itself, a stress fracture or something beyond the tendon, I order X-rays or an MRI and coordinate with the right specialist.
- A clear diagnosis: you’ll leave knowing what’s irritated, why, and what we’re going to do about it.
Then we treat it. I use gentle chiropractic care and mobilization for the lower back, pelvis and hip so the joints around the tendon move freely, soft-tissue work for the guarding muscles, and a progressive loading program for the tendon and the glutes and core that support it. Tendons get stronger when they’re loaded the right amount, so your plan calms the tendon first and then builds it back. I’ll also show you how to keep training without flaring it. You can read more about how I work on my gentle chiropractic care page.
If your tendon has been stuck for months despite good rehab, focused shockwave is one more option, and you can learn about it at Ashland Shockwave.
Your Plan in 3 Steps
- Contact Dr. Volz. Send a short note through my contact page and tell me where your hip hurts and how long it’s been going on.
- Get examined. A thorough exam, imaging if you need it, and a clear answer about what’s causing your pain.
- Follow a plan that fits. Gentle hands-on care plus a loading program built around your sport, your job and your schedule.
If you want a chiropractor in Ashland who will actually examine your hip instead of guessing, contact Dr. Volz. I help people from Ashland, Talent, Phoenix, Medford and across the Rogue Valley get back to moving.
Three Months From Now
Picture lifting your knee for the next stair without bracing for it. Getting out of the car after the drive from Medford in one smooth motion. Back on the trail, back in class, trusting your hip again.
Now picture the other path. You keep stretching, resting and hoping. The ache settles into your routine, you quietly drop the activities you love, and your back and your other hip start picking up the slack. Tendons that stay irritated for months get harder to calm down, not easier.
Common Questions
Is psoas tendinopathy the same as a hip flexor strain?
No. A strain is a sudden tear in the muscle, usually with a clear moment of injury. Tendinopathy builds over weeks from load the tendon couldn’t keep up with. The exam tells them apart, and the treatment is different.
Should I keep stretching my hip flexors?
Not hard. Aggressive stretching often keeps an irritated tendon sore. I’ll show you which movements to keep, which to pause and how to load the tendon so it gets stronger.
Can I keep running or dancing?
In most cases, yes, with changes. I’ll tell you exactly which activities to modify, for how long, and how to build back up without a flare.
When I’ll Send You Somewhere Else First
I screen every new patient for these. If you have one, I’ll tell you right away and help you get to the right doctor.
- You can’t put weight on your leg after a fall, or the exam suggests a fracture
- Fever, chills or unexplained weight loss along with hip, groin or back pain
- New bladder or bowel control problems, or numbness in the groin or inner thighs
- Tendon pain that started soon after taking a fluoroquinolone antibiotic such as ciprofloxacin or levofloxacin (tell your prescriber right away)
Keep Reading
See how I treat low back pain, learn more about gentle chiropractic in Ashland, or browse everything I treat on my Conditions page.