Iliopsoas Injuries in Sport Horses

Iliopsoas Injuries in Sport Horses

It’s among the most common muscular skeletal injuries seen in sport dogs and human athletes. Iliopsoas is also the number one reason people have back pain. Yet there’s very little research about it in sport horses.

In this episode, Dr. Audrey DeClue discusses her research on the iliopsoas muscle, which is responsible for the clinical signs of shivers and stringhalt in the hind limbs of horses.

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Mid Hoppenrath
Mid Hoppenrath
3 years ago

I just listened to your podcast about iliopsoas injuries in horses. It was actually your third podcast I heard. My dressage trainer recommended the one on straightness because we are working on getting my 23-year-old arab gelding to have smoother transitions and he is somewhat blocked by crookedness. He needs help not just for his sake, but also because I need him to be my therapy horse right now because I injured my iliopsoas and cannot even get my hips around my very wide dressage pony! I was amazed at the similarities in both symptoms of horses who suffer from iliopsoas injuries and also at the lack of understanding of this injury from the orthopedic specialists!

I was 67 when I presented to my orthopedic surgeon with ultrasound-proven right-side iliopsoas bursitis. There was no history of any injury. A week earlier I was riding two horses 5 times a week, and running up my stairs two steps at a time (I live on a hill, 42 stairs I take 4 times a day). Strangely enough, I could still walk down the stairs completely normally. I could not raise my right leg from the prone position, had to grab my pants leg just above the knee to climb stairs or get my foot on the gas or brake pedal in the car! I had a weird sensation when sitting, kind of dropping the last few inches to the chair. When I would squat, my butt would skew oddly to the right. I could not stand on one foot for a very long, and while I was attempting this, my whole torso would tremble, I could see my blouse buttons shaking! And my right butt cheek was smaller and undeveloped compared to my left butt cheek! When I stood and pulled my right leg straight back in an arc, it would swing oddly off to the right. I could not swing my leg up onto the saddle, not from either side!

I bet you are smiling knowingly right now, but guess what the doctor told me? That I needed a total hip replacement. I was stunned! My x-rays showed mild hip arthritis (I was 67 afterall) and no joint space narrowing. Who gets a total hip replacement for mild arthritis? I told him I had no problem or pain bearing weight, I could stand fine and got down the stairs no problems. And I was fine two weeks earlier. Nope, he said I needed a total hip replacement and I would not get better without one.

I got an MRI and that showed there was a communication from my iliopsoas bursa to my hip joint capsule (occurs normally in about 15% of the population) and that I had right side joint effusion and femoral head bone marrow edema. Interestingly, the radiologist reading the MRI did not find even mild arthritis!

I saw a total of 5 specialists for second opinions, including an orthopedic rheumatologist because my friends were telling me to stop seeing surgeons because they always recommend surgery. The rheumatologist was the most adamant that only a hip replacement would fix my issues, and told me any further PT would only hurt me.

I continued PT until the pandemic stopped that! I am much better, but still working on fixing snapping and joint alignment issues due to shortened ligaments and tendons. I can drive and climb stairs, but any prolonged activity will cause a flare up of symptoms from the bursa! I think I must be very patient because I am literally changing the alignment of my leg and hip.

The folks at PT had told me I had overworked my iliopsoas because the muscles normally supporting the iliopsoas were not being used and had weakened (sometimes called dead butt syndrome). This had happened because I had a mal-alignment in my right leg causing an uneven and unnatural distribution of forces. For example, my knees turned inward due to mal-alignment of my hip. They said I needed to rest my iliopsoas and strengthen the other muscles, like my glutes and hamstrings. And I needed to correct my alignment so the provoking issue would not return.

Still working on all these issues, but I can now (1.5 years later) get onto the saddle and ride my kind, forgiving older horse (I have had him since he was 3 years old). I think I will eventually make a complete recovery and be able to ride my wide dressage pony. I also hope to also have a better alignment of my body and to avoid or at least significantly delay any need for a hip replacement!

Thanks for these great podcasts. The one on straightness was the first podcast I ever heard. I think it is helping us help my older horse, who seems to be quite happy in his new role as therapy horse. I look forward to listening to many more of your podcasts.

Thank you!

Alison Roth
Alison Roth
2 years ago

Awesome podcast. I will be reaching out. This makes so much sense. I have seen so many 3year olds that are short behind and don’t block out. Worse under saddle.

1 year ago

What about toe dragging in front? Could this still be iliopsoas or would that be a different group of muscles?