Acta Ortopédica Mexicana

Magaña-Reyes J, Domínguez-Gasca LG, García-Luna A, Domínguez-Carrillo LG
Iliacus muscle injury caused by inadequate exercise
Acta Ortop Mex 2016; 30 (3)

Language: Español
References: 11
Page: 154-157
PDF: 236.87 Kb.

[Fulltext - PDF]


Background: Traumatic iliacus muscle injury is rare; it is usually caused by trauma or intense exercise involving the pelvic girdle; it can produce a hematoma with femoral nerve neuropathy. Spontaneous muscle hematomas occur in patients with coagulation disorders. Clinical case: A 45-year-old male with 18 days of evolution, with an intense pain in the right buttock, groin and iliac fossa, with an inability for hip flexion and ambulation caused by inadequate exercise (supine double leg lifts). On the physical examination: intense pain with bending and/or internal rotation of the right hip, positive Thomas maneuver, quadriceps rated 3/5; area of paresthesia in the right femoral nerve territory. Pelvic magnetic resonance imaging showed: right iliacus muscle tear with blood between its fibers. Initial treatment was rest and analgesics for eight days and gradual extension of the hip, axillary crutches with partial weight bearing and diathermy on the right abdominal lower quadrant, active hip exercises, bicycle and right quadriceps strengthening. The evolution was satisfactory, with full recovery in six weeks.

Key words: Iliacus muscle strain, hematoma, femoral palsy, exercise.


  1. Tamai K, Kuramochi T, Sakai H, Iwami N, Saotome K: Complete paralysis of the quadriceps muscle caused by traumatic iliacus hematoma: a case report. J Orthop Sci. 2002; 7(6): 713-6.

  2. Ashrani AA, Osip J, Christie B, Key NS: Iliopsoas haemorrhage in patients with bleeding disorders--experience from one centre. Haemophilia. 2003; 9(6): 721-6.

  3. Silvermetz MA: Pathokinesiology of supine double leg lifts as an abdominal strengthener and suggested alternative exercises. Athletic Training. 1990; 25: 18-22.

  4. Volpi P, Melegati G, Tornese D, Bandi M: Muscle strains in soccer: a five-year survey of an Italian major league team. Knee Surg Sports Traumatol Arthrosc. 2004; 12(5): 482-5.

  5. Werner J, Hägglund M, Waldén M, Ekstrand J: UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med. 2009; 43(13): 1036-40.

  6. Falvey EC, King E, Kinsella E, Franklyn-Miller E: Athletic groin pain (part 1): a prospective anatomical diagnosis of 382 patients—clinical findings, MRI findings and patient-reported outcome measures at baseline. Br J Sports Med. 2016; 50: 423-30 doi: 10.1136/bjsports-2015-094912

  7. Thorborg K, Branci S, Stensbirk F, Jensen J, Hölmich P: Copenhagen hip and groin outcome score (HAGOS) in male soccer: reference values for hip and groin injury-free players. Br J Sports Med. 2014; 48(7): 557-9.

  8. Bui KL, Ilaslan H, Recht M, Sundaram M: Iliopsoas injury: an MRI study of patterns and prevalence correlated with clinical findings. Skeletal Radiol. 2008; 37(3): 245-9.

  9. Choa GP, Lim CS: Iliopsoas haematoma: an uncommon differential diagnosis for groin pain. Hong Kong J Emerg Med. 2011; 18: 173-6.

  10. Tyler TF, Fukunaga T, Gellert J: Rehabilitation of soft tissue injuries of the hip and pelvis. Int J Sports Phys Ther. 2014; 9(6): 785-97.

  11. Giuliani G, Poppi M, Acciarri N, Forti A: CT scan and surgical treatment of traumatic iliacus hematoma with femoral neuropathy: case report. J Trauma. 1990; 30(2): 229-31.