From the Research
Injuries to the gluteus medius and psoas muscles require a comprehensive treatment approach combining rest, medication, and rehabilitation, with a focus on managing the load on the tendons through exercise and education on the underlying pathomechanics, as suggested by the most recent evidence 1.
Initial Management
Initially, reduce activity that causes pain and apply ice for 15-20 minutes several times daily for the first 48-72 hours to reduce inflammation.
- Take non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-600mg every 6-8 hours with food) or naproxen (220-440mg twice daily) for pain and inflammation for 7-10 days, as supported by 2.
- After the acute phase, begin a progressive rehabilitation program focusing on gentle stretching and strengthening exercises.
Rehabilitation Program
For the gluteus medius, include:
- Side-lying leg raises
- Clamshells
- Bridges For the psoas, try:
- Gentle hip flexor stretches
- Core stabilization exercises Start with 2 sets of 10 repetitions daily, gradually increasing as tolerated, as recommended by 3. Physical therapy is highly recommended to ensure proper technique and progression. Heat therapy before exercise can improve blood flow and tissue elasticity.
Importance of Rehabilitation
These muscle injuries typically require 4-8 weeks for recovery depending on severity. Proper rehabilitation is crucial as these muscles play key roles in hip stability and movement—the gluteus medius stabilizes the pelvis during walking and standing, while the psoas is essential for hip flexion and core stability. If pain persists beyond 2-3 weeks despite these measures, consult a healthcare provider for further evaluation, considering the possibility of underlying conditions such as iliopsoas bursitis, tendonitis, impingement, or snapping, as discussed in 4. A comprehensive approach, including rest, medication, and rehabilitation, prioritizing the management of tendon load and pathomechanics, is essential for the effective treatment of gluteus medius and psoas injuries, aiming to minimize morbidity, mortality, and improve quality of life 5, 1.