Deep Hip or Groin Pain That Feels Like a Possible Injury? It Could be a Tight Psoas

I’ve been working with a patient who came in thinking she had a groin injury. The pain felt deep, far back, and significant enough that she assumed something was actually injured. She works out often and takes good care of herself, so a tight psoas was not something she suspected. But after evaluating her movement, alignment, and muscle tension, it became clear that the psoas was playing a major role. That tightness had already begun affecting her back, pelvic alignment, and the way one leg appeared shorter than the other. The pain was also changing the way she walked, which is what ultimately brought her in.

I see this kind of pattern more often than many people realize.

Patients will often describe deep hip pain, groin pain, low back tightness, or discomfort in the front of the hip when walking. Sometimes they assume they have a strain. Sometimes they fear a more serious injury. And often, they are surprised to learn that one deep muscle may be contributing to much of what they are feeling: the psoas.

What Is the Psoas?

The psoas (pronounced so-as) is a deep muscle that connects the lower spine to the hip and upper leg. It plays an important role in posture, walking, stability, and the relationship between the spine, pelvis, and lower body.

It is one of the body’s great connectors, and when it becomes tight or irritated, its effects can travel farther than people expect. A restricted psoas can influence the low back, the pelvis, the hips, and even the way someone walks through the world.

Why This Pain Can Be So Confusing

One of the reasons psoas dysfunction is often misunderstood is because it does not always feel the way people expect muscle tightness to feel.

For some, it presents as a deep, hard-to-place ache. For others, it feels sharp, reactive, or serious enough to suggest injury. It may show up in the groin, the front of the hip, deep within the pelvis, or through the low back. It may even begin to affect your stride.

When pain is difficult to locate, it can be unsettling. It can also make people feel uncertain about what their body is trying to communicate.

How Sitting and Daily Life Contribute

I frequently see this in people who spend long hours sitting, especially at a desk.

When the body remains seated for much of the day, the hips stay flexed and the psoas remains in a shortened position. Over time, that shortened state can begin to feel normal to the body. The muscle may stop lengthening as easily, even once you stand.

As this tension builds, it can start pulling on the lower spine and influencing the position of the pelvis. What begins as tightness in one area can gradually create compensation in many others.

Even active people can develop a tight psoas. Exercise is important, but it does not always undo the effects of prolonged sitting, repetitive patterns, or subtle imbalance.

Common Signs a Tight Psoas May Be Involved

A tight psoas can present in a number of ways, including:

• deep groin or hip pain
• hip flexor pain
• pain in the front of the hip when walking
• low back tightness or aching
• discomfort after sitting for long periods
• a sense that one side of the body feels more restricted than the other
• pelvic imbalance
• a change in stride or walking pattern
• Some patients also feel as though one leg is shorter than the other.

Often, this is what we call a functional leg length discrepancy, meaning the difference is not structural, but related to muscle tension and pelvic alignment. In these cases, one psoas may be more restricted than the other, and that imbalance can create a chain reaction throughout the surrounding structures.

The Relationship Between the Psoas, Pelvis, and Low Back

Because the psoas attaches directly to the lumbar spine, it can create tension through the lower back when it becomes tight.

It also commonly contributes to an anterior pelvic tilt, where the pelvis tips forward. In some cases, one side of the pelvis rotates differently than the other, creating what we call pelvic obliquity. One side may be more anteriorly rotated, while the other sits more posteriorly rotated.

When that happens, people often begin to feel that something is off, even if they cannot fully explain it. Their posture changes. Their walk changes. Their discomfort begins to spread.

This is one reason proper evaluation matters. The body is wonderfully interconnected, and when one structure is restricted, many others begin adapting around it.

Why Walking May Start to Hurt

Because the psoas helps lift the leg and support efficient movement, a restricted psoas can make walking feel strained or uncomfortable.

Some people notice pain in the front of the hip or what they describe as hip flexor pain when walking. Others feel a deep ache that alters their stride. If the pelvis and low back are no longer moving well together, each step may begin to feel less fluid and more guarded.

That change in gait is often one of the clearest signs that the body is compensating.

Treatment Should Address More Than the Symptom

If the psoas is contributing to the issue, treating only the area where the pain is felt may provide temporary relief without fully resolving the cause.

This is why I place so much importance on thoughtful evaluation and individualized care. When we take the time to understand how someone is moving, how their body is compensating, and where the restriction is truly coming from, treatment becomes much more effective.

At Physio Whitefish, treatment may include hands-on work to release the psoas and surrounding tissues, along with exercises that support mobility, core stability, pelvic alignment, and more balanced movement patterns.

The goal is not simply to calm the pain. It is to help the body return to a place where movement feels more supported, more natural, and less guarded.

Using Two Balls in a Sock Along the Spine

For some patients, I may recommend a simple release technique using two firm balls in a sock to help relax the muscles alongside the spine.

This can be helpful, but it needs to be done with care.

How to position the balls

Place two tennis balls or similarly sized therapy balls inside a sock and tie the end so they stay together. When you lie down, position the balls so they straddle the spine, allowing the spinous processes to rest in the space between them. The pressure should be directed into the muscles on either side of the spine, not onto the spine itself.

A few important precautions

Allow your body to rest with gentle, sustained pressure instead
This is not intended to be aggressive. The goal is to invite the muscles to release, not to force them.
Make sure you don’t place the balls directly on the spine
Do not roll on them

If you feel numbness or tingling, stop right away. Those sensations can suggest that pressure is being applied to an irritated nerve or a sensitive area.

It’s also important to be mindful of the floating ribs. If the balls are too low or too wide, they can create irritation rather than relief.

If you are unsure about placement, your physical therapist can help guide you.

Healing Requires Support Between Visits

Hands-on treatment can be powerful, but the body also needs consistency outside the clinic.

Home exercises are an important part of the healing process because they help reinforce the changes made during treatment. They encourage the psoas to lengthen, improve core support, restore balance through the pelvis, and reduce the compensation patterns that have built up over time.

This is where so much of the long-term progress happens.

I’m already seeing tremendous results with this patient. Since committing to her home program consistently, her body is responding beautifully. Her improvement is a reminder that once the true source of the problem is identified, healing can begin in a much more meaningful way.

You May Be Feeling the Effects of a Tight Psoas Without Knowing It

Many people have never heard of the psoas, even though it plays such a central role in connecting the lower back, pelvis, and hip.

If you are dealing with deep hip pain, groin pain, hip flexor pain, pelvic imbalance, low back tightness, or discomfort when walking, the psoas may be part of the picture.

The encouraging news is that these patterns can improve. With the right evaluation, treatment, and follow-through at home, the body often begins to shift in ways that feel both relieving and hopeful.

If you think your psoas may be tight or contributing to your pain, schedule an appointment with one of our highly seasoned team members. Our caring, experienced physical therapists are here to help you better understand what your body is telling you and support you in moving toward greater comfort, balance, and ease.

If you learned from this article, you may also enjoy reading our article on Back Pain, or this one on Knee and Hip Pain.