Iliopsoas shortenings can be classified according to cause and severity:

1. Functional shortening:
   • Temporary muscle shortening due to poor posture or overuse.
2. Structural shortening:
   • Permanent muscle shortening due to anatomical changes or scarring.
3. Unilateral shortening:
   • Affects only one side of the body and often leads to asymmetries.
4. Bilateral shortening:
   • Can cause a general restriction of hip mobility.

The causes of iliopsoas shortening are varied and include:

• Prolonged sitting:
  • Continuous sitting in offices or vehicles leads to a permanent shortening of the iliopsoas muscle.
• Poor posture:
  • A forward-tilted pelvic posture or a hollow back promotes shortening.
• Sport-related overuse:
  • Intensive training, especially in sports like sprinting or cycling, can lead to overuse of the muscle.
• Injuries:
  • After accidents or surgeries, protective postures can lead to shortening.
• Age-related changes:
  • With increasing age, the muscle loses elasticity and is more prone to shortening.

The symptoms of an iliopsoas shortening are often nonspecific and vary depending on the severity:

• Pain:
  • Back pain, especially in the lower back area, and hip pain during movement.
• Movement restrictions:
  • Problems with extending the hip joint or straightening the body.
• Hollow back:
  • An increased lordosis of the lumbar spine due to muscle shortening.
• Pulling sensations:
  • An unpleasant pulling in the groin or thigh during stretching movements.
• Gait changes:
  • A shortened gait or a limping gait pattern to avoid pain.

The diagnosis is made through medical history, physical examination, and possibly imaging techniques:

• Medical history:
  • The doctor inquires about typical symptoms, movement patterns, and possible triggers.
• Physical examination:
  • Tests such as the Thomas test, which checks the mobility of the hip joint.
• Imaging techniques:
  • Ultrasound: To assess the condition of the muscles.
  • MRI: Visualization of accompanying symptoms such as inflammation or scar formation.

Conservative Therapy

In most cases, an iliopsoas shortening can be remedied through non-surgical measures:

• Stretching exercises:
  • Regular stretching of the iliopsoas muscle to improve mobility.
• Physiotherapy:
  • Targeted exercises to strengthen and stretch the muscle complex.
• Manual therapy:
  • Treatment by physiotherapists to relieve tension.
• Ergonomic adjustments:
  • Optimization of seating furniture and workplace design to reduce poor posture.
• Medication therapy:
  • Painkillers and muscle-relaxing medications to alleviate acute symptoms.

Surgical Therapy

In rare cases, when conservative measures are not sufficient, a surgical procedure may be necessary:

• Fascia release:
  • Surgical loosening of the surrounding tissue structures to improve mobility.
• Lengthening of the iliopsoas muscle:
  • In extreme cases to correct a structural shortening.

To prevent iliopsoas shortening, the following measures are helpful:

1. Regular exercise: Promoting mobility through sports such as yoga or swimming.
2. Ergonomic posture: Avoiding poor posture through optimal workplace design.
3. Stretching exercises: Regular stretching of the hip flexor to maintain flexibility.
4. Change of body position: Frequent standing up and moving around during sedentary activities.
5. Strengthening the core muscles: Strengthening the abdominal and back muscles to support hip mobility.