Iliopsoas Injuries in Dogs

You’re playing fetch with your dog, they’re participating in dock diving or agility, or they slip on wet grass and suddenly pull up lame on three legs … what’s your first thought? For many dog owners their first thought is that their dog has partially, or fully, ruptured their cranial cruciate ligament (or the anterior cruciate ligament in humans). However, CCL tears tend to be more chronic in nature and there’s another injury that is relatively common, but often under diagnosed in dogs, and that is an injury of the Iliopsoas muscle. So, what and where is the Iliopsoas muscle, what does it do and how does it get injured? 

The Ilipsoas muscle is essentially two muscles that come together to attach the spine to the hind limb. It is a muscle that originates in the lower back and attaches to the upper thigh. 

While humans have five lumbar (lower back) vertebrae, a dog has seven. The Psoas part of the muscle comes off the side of the second and third vertebrae, and the middle of the third to seventh. The Iliac comes off the inside of the pelvis. These two muscles then join together to form a thick band that attaches to the upper leg (or more technically, to the lesser trochanter of the femur). Therefore, the Ilipsoas works on two areas. It helps straighten (or extend) the lower back and bend (flex) the thigh bone (femur). It also works to turn the hip out and stabilise the lumbar spine and pelvis. 

A dog will most commonly injure the Ilipsoas muscle when their hind leg is extended behind them and it slips further into a straightened position.  It is also not unusual for the hip to be in a turned in position at the same time. In order to recover from this, the dog has to make a sudden movement from having their leg behind them to pulling it forward. If you think about how a dog moves during the weave in agility, it is the same motion. 

There are two ways the Ilipsoas can be injured … acutely or chronically. Acutely is when an injury suddenly occurs, such as jumping too early in dock diving, and tends to be less common. A chronic injury occurs over time when the muscle is continuously damaged and isn’t given enough time to heal. This tends to occur due to overuse, repetitive activity, lack of core control and congenital abnormalities such as hip dysplasia. With chronic problems lameness often tends to be intermittent (comes and goes), rather than persistent. 

So, what symptoms might you notice in a dog with an Ilipsoas problem? Common objective findings include: 

• A short and shuffling gait.

• A hesitancy to go upstairs or jump.

• Mild to severe lameness (that often worsens with exercise).

• Tenderness on palpation through the Iliopsoas muscle.

• Pain on hip extension, with abduction or internal rotation.

How is an Iliopsoas injury diagnosed? 

It is important to remember that, due to his being a muscular injury, it is unlikely that anything will show up on an x-ray (unless it is very chronic in nature and there are mineralised densities that may show up). An ultrasound, CT or MRI may be helpful but overall this type of injury is diagnosed on clinical findings found during a physical (objective) examination. History from the owner (subjective examination) is also very important, so if you can provide your veterinarian or rehabilitation specialist with as much information as possible in regard to signs and symptoms you notice that is incredibly helpful. 

How long does this injury take to heal? 

This is always a hard question to answer. And not just with this injury but most. As both a human and canine physiotherapist I find that time to heal depends on so many factors, including age, prior fitness, activity level and compliance of the patient/dog (and their owner!). If managed well acute injuries should heal within 6-12 weeks. If chronic, it often depends on how long the dog has had the problem. Again, with both dogs and humans, my go-to response is ‘as long as the injury has been there, it’s likely to take that length of time to heal’. Patience is always the key! 

So, what treatment is recommended? 

In the majority of circumstances treatment will be conservative. That means that surgery isn’t needed. Instead treatment will consist of rehabilitation practices such as range of movement exercises, stretches, strengthening, core stability work and a progressive return to function/sport program. 

If you suspect your dog has an Ilipsoas injury my best advice is to reach out to your local or rehabilitation veterinarian, or canine rehabilitation specialist in your area, who will be able to help diagnose this injury and set you on a path to success with your dog. 

And, as always, if you have any questions or would like me to source an appropriate professional in your area to talk to, please feel to touch base. 

I would also love to hear if you have had a dog with this injury and what you found most helpful in their rehabilitation process, so please leave a comment below. 

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