Iliopsoas strain: the hind limb lameness you may not know about.

20120120 High flying Steve

Athletic dog is athletic.

Steve has always been a hard-hitting, heavy-duty athletic kind of dog. When he came up lame a few years ago, my heart dropped into my stomach. I had been through two knee surgeries with Luce already, and I knew how little fun that was. Looking at Steve, I was pretty sure it wasn’t a knee problem, but in we went to the vet. He agreed it was not Steve’s knee, it was higher in the leg. I immediately panicked that he had hip dysplasia, but on xray, his hips looked lovely (and indeed, OFA rated them as “good”). He was diagnosed with a generic “soft tissue injury” and prescribed rest and Rimadyl. I rested him as best I could (good luck with that) and then tried allowing him to start being active again. He wasn’t any better. I made him an appointment with a specialist.

It took her about two seconds to diagnose him with an iliopsoas muscle strain. I had never heard of this! My regular vet had never heard of this either. But there was no question at all for someone who was familiar with the injury and looking for it. She gently pressed on his muscle; he whipped his head around and gave her the stink eye. When she extended his hind leg and rotated it inward, he squirmed and fought her. That was where he hurt. There was no question.

The iliopsoas, or hip flexor, is the major muscle that allows the dog to move his leg up toward his abdomen. In a dog with a strain, you will often see a shortened stride on that side, especially at the trot, as the dog cannot comfortably move his leg as far forward as he normally would. He also may not want to completely extend his legs behind him, because stretching like that hurts. Often, affected dogs will not bear weight equally behind while standing, putting the lion’s share of weight on the uninjured side. In some performance dogs, the first symptoms are vague- popping out of weave poles or dropping bars behind, even if the dog looks sound on the flat.

Often an agility injury resulting from dogs running, jumping, and changing directions at high speed, it is also seen in dogs who fall or splay out their hind legs on a slippery floor or ice. It can also be seen secondary to a knee injury, so an affected dog’s knee should be thoroughly examined and xrayed to make sure there is no primary problem there. Steve got hurt when he collided with a much larger dog during flyball practice and went rolling.

Angry collie.

Crate rest is no fun.

As in human athletes, soft tissue injuries take a long time and a lot of effort to get to heal. The first order of business is strict rest. No running, no jumping, no fun. He was also prescribed regular treatments with a Cold Laser, which is a little bit controversial in some circles as they don’t believe there is enough hard evidence that it works, though they have become extremely popular among rehabilitation specialists. Cold laser helps increase circulation and reduce inflammation, reduce pain, and speed healing. It’s useful for soft tissue injuries like a groin pull like Steve has, but it is also helpful for arthritis and wound healing.

But by far, the largest and most important part of his treatment was an at-home exercise program that expanded and intensified as his treatment progressed. We began with five minute walks three times a day, passive stretches in which I manually stretched his muscles, and lots of active stretches where he did his own stretching, encouraged by a strategically-placed cookie. As he improved, we added strength-building exercises to help build his core muscles both to help him heal and help protect him against future injuries.

Active stretching “paws up” exercise at a low height.

Unfortunately, iliopsoas injuries frequently become chronic problems. Whether it’s a small bit of scar tissue left behind, or a simple predisposition to the injury, it is not uncommon for a dog who has had this injury once to have it again in the future. It took about five months to completely rehab Steve the first time. He started rehab in June of 2010 and ran his first flyball tournament in November. He had no troubles at all until he came up lame again this past June. We are currently six weeks into a second round of rehabilitation, and while it is going much more quickly this time, it forces me to ask some serious questions about my sport dog’s future activities. It’s no fun to keep my active dog in a box, and while I refuse to keep him in a bubble, I do wonder if he should be relegated to the ranks of active pet and hiking companion rather than agility dog. I am not sure yet what the answer is.

56 thoughts on “Iliopsoas strain: the hind limb lameness you may not know about.

    • Our girl is 31/2 yrs. old and has this injury which occured during an agility event. I hope we don’t have to retire from all the events that we both love. Mocha is a Mini Aussie and of course full of energy, this is such a difficult injury to get through with such a wild child. I figured I’d retire before she did since I’m 71. What a bummer!!

  1. Very interesting. I had to take my dog in to the vet a couple of years ago for lameness in one of her hind legs, and my vet couldn’t figure it out (wasn’t in the knees or hip). While she got over the initial lameness, her trotting gait has not been quite the same. In your experience with this, have you heard of ways to rehab this sort of strain if it is not caught initially?

  2. I believe that you can rehab an injury that’s considered chronic rather than acute, but I think it takes longer and you may not have as good of results. If you have access to a sport’s medicine or rehabilitation vet, it may be worth a consultation.

  3. My dog has had iliopsoas strain following a complex knee surgery. It’s complicated her already difficult rehab. Thanks for writing about it. I do have a sports vet to call on as well as our orthopedist!

  4. Man, I can’t imagine having to deal with both a knee *and* a ‘psoas. What a nightmare.

    I am really grateful to have amazing (if expensive!) sports vets just a couple hours away, and now a trusted rehab vet closer by to depend on. I know that in other areas of the country, they’re not so lucky.

  5. Ugh…I feel your pain, and my dog feels Steves pain! We are going into week-7 of leash-only activities for her iliopsoas injury. Unfortunately, (like many other sport dog owners that do not have access to a vet that is tuned into sport dog injuries) she was misdiagnosed for almost 2 months before I asked for a consult from a canine PT. It’s a tough injury to get to heal, and I thank you for blogging about it…I think it’s a more common injury for active dogs than some people realize.

  6. Our frisbee loving border collie has just been diagnosed with this today. After stressing about the possibility of hip dysplasia, we found out that she has beautiful hips and joints too – but now we will start rehabbing her muscle. Thanks for this information!

  7. As a canine massage therapist, I can’t stress enough the importance of adding massage to the rehab. It will decrease rehab times by relaxing the muscle, increasing blood circulation in the area bringing oxygen and blood and flushing toxins, as well as breaking down adhesions. Adding massage to your training routine will also decrease the chance of reoccurring or happening in the first place. Also, choose your therapist carefully as not all canine massage therapists are familiar with injury rehabilitation and/or sports massage.

  8. My injured dog is in the resting period before strengthening begins. We are 9 weeks post-injury and I am finding it very difficult to get through this. Can you give us an update on how Steve has recovered this time, and what you decided about moving forward? We were at beginning of our agility career after training for two years when she had her injury. I wonder if she will really heal from this. Thanks!!

  9. I feel your pain, we are on round three of rehab and it is breaking my heart to think of not being able to do agility with this fabulous dog, for fear of making him an invalid and old before his time, like some of those retired football players you hear about.

  10. Would you share the exercises you did for your dog’s rehabilitation? I’d like to use this time with my dog to keep him mentally stimulated with new things to do, and it puts a positive spin on a painful and frustrating time for him as he can’t race around for awhile.

  11. Involved mostly rest, ice, massage, chiropractic and cold laser with walking, stretching and underwater treadmill as he progressed. Also using Sasha Foster’s new book “Cainine Cross Training- Building Balance, Strength and Endurance in Your Dog” which may have more of what you’re looking for.

  12. I wrote on April 3rd. After one more month, there have been a few times I thought we were making progress with this injury, and each time my hopes are dashed. This is week 14. I can only get to the rehab PT every few weeks but am doing the small stretches, little exercises, and the slow walks. Last visit I was told the muscle is not in spasm and we can move from the severe resting and begin some strengthening. Yet I feel like every week she is re-injuring or aggravating the injury. Only some of the time do I understand how (such as an oops incident). I don’t want to give up but keep losing hope. Words of wisdom/encouragement? Thanks!

  13. My guy is on generic Robaxin twice a day and that really is helpful for him. It’s a muscle relaxant not an NSAID like Rimadyl, so no nasty long term or potentially dangerous side effects. The benefit is extremely noticeable on him.

  14. My girl was on the Robaxin for 12 weeks, and taken off two weeks ago when our PT said wasn’t needed anymore. Thanks for the reminder that that was one of the changes made two weeks ago for me to consider.

  15. yep, i think my guy’s problem initiates in the spine and sometimes “back” dogs are on robaxin for life. I’m pretty discouraged, we are doing positive, game-based obedience now and it’s okay, it’s just not the same as agility for either of us. I’m trying to wrap my head around no agility till the next dog, which won’t be for about 5 years and it’s pretty depressing, since I’m 56 myself.

  16. Lori, I totally hear you. I too am thinking I might need to turn her into an obedience dog, IF I can get her well enough for that! But I already have a dog I am training for obedience, who I don’t think has the structure for agility. I am 52 and the next time I can get a dog– maybe 7-10 years? I was just starting to get the hang of agility and really miss the chance to do it. :(

  17. Amen to that, this is my third early retirement in a row 1st dog psoas 6 years ago when we didn’t have the rehab options we have today, he died at 10 of cancer. 2 nd dog so extremely reactive I spent all my time managing behavior instead of running agility, did all the behavior stuff ( CU/BAT and meds under the guidance of Dr. Overall) he is much happier now at home and not in a trial setting. It is my boy’s 4th birthday today, he is a joy in all ways, I just hope I won’t be throwing him a retirement party instead of a birthday party. Good Luck!

  18. Hi folks, nice to read some of your comments. I’m a police dog handler with a very high drive 3 yo bitch that came down with this issue about 5 weeks ago (it’s killing me!). Rehab is progressing but very slowly. She looks better in herself and around the yard etc but cannot walk for more than about 4 mins without ceasing up. The abdominal guarding & back arching is gone (as is the inflamation) but she’s still on pain killers. Might have to look into the Robaxin that was mentioned. Unfortunately, I’ve been given a time frame and a $ spend max which is approaching. If I can’t proove her fitness soon, we’ll be retiring a wonderful working dog that still had so much to give! This injury is a curse to any active dog and I wish everyone well with their respective rehabs.

  19. Hi, the Robaxin is not an expensive drug and seems well tolerated. I would start it asap. Good luck with your dog and I hope you are back to full activity soon. i am now on week 15, Yes it is very hard to get it to heal up, or it is just going to take a long time. Not sure which at this point.

  20. My 4 y/o aussie mix had a TPLO procedure about 18 months ago and about 6 months ago was diagnosed with a pulled groin- we even tried stem cell injections and it still seems to bother him. He is impossible to keep inactive and I hate that this awesome frisbee dog can no longer play :( to make things worse he recently showed early signs of problems with his “good” knee. It is breaking my heart (and bank). Any pointers or encouragment appreciated!

  21. I am the proud owner of a beautiful, big, long haired GSD, just turned 3yrs old, who has, yesterday, been diagnosed with this problem. The comments regarding rehabilitation are really helpful, as my vet has no experience of this condition, so we are both breaking new ground. I have sent the vet this blog, to read about your collective experiences, so thanks to you all for the info.
    We are at the ‘keep him inactive’ phase of the problem, which is pretty unrealistic as we had just added a 10 week old JR terrier to the family!

  22. My 4 year old GR has just been diagnosed with this injury. We are in week 1 of weekly laser treatments, home stretches, home massage, and 15 minute walks 2x a day. No stairs, no running, no jumping, no chuck it, no agility training, no playing with other dogs. Monty is on Robaxin 2xD. My feeling is that I would never want him to go through this again, so I’m guessing future agility training and competition is out. He is also a therapy dog, so we will confine ourselves to visiting hospitals. What a shame!!!! AND as many of you mentioned, this was going to be my last dog – I’m 68. I’m disappointed for him as well as for myself. We both so enjoyed the training.

  23. Claire, don’t give up the ship. I just had a consult with Chris Zink re: our nagging/recurring psoas strain and it was moderately encouraging. We have switched to obedience (much to our mutual dismay) and I had resigned myself to a lot of what you mentioned. However, these things are not fatal and if managed carefully, not debilitating either. Our new sporting life now consists of Obedience in the cold/icy months (we’re in Colorado) Moderate agility with limited/reduced training and trialing in the more moderate weather months. It’s disappointing since agility is our first love and I can’t set any big goals, like MACH’s or qualifying for a national event. But like they say, even a bad day at agility beats a good day anywhere else and my BC is actually starting to enjoy obedience, since we “do it Fenzi style”! Chris helped me customize and focus his multi-modal conditioning/rehab regimen which is appropriate for any performance dog, most of whom have a subclinical/not-yet-observed form of injury anyway. These things are a two-steps-forward-one-step-back thing and are very frustrating, but with some modified expectations and flexibility on my part, it doesn’t have to be all or nothing. This is not my last dog (hopefully-knok wood) but I am 57 so I feel the ticking clock as well. Also, we have an 82 year old woman in our area, who is competing in agility with her two year old BC and living on her multi-acre property with several other BC’s and some sheep.

    • Hi Lori, I am again following up, hoping that many of the dogs in this thread are doing great! My dog is not doing great. I finally got around to getting x-rays to rule out ortho involvement, which came back negative (yay! or not?) We are at 5 1/2 months. Almost a month ago I kind of gave up trying to formally rehab her. I just couldn’t keep her so restricted any more. It was not fair to her. The ortho vets who did her x-rays suggested the next phase would be to go to VOSM in MD, and get either an ultrasound or an MRI (to the tune of $1800) to see what the heck exactly is going on with that muscle/tendon unit. That is not in our cards. But… I have a HAPPY gimpy dog, who gives me great smiles!! Please keep posting about the progress you make using Zink, it might give me the courage to not give up totally. I dream of seeing my beautiful girl do her fast runs again.

      For Claire with the GR, take it slowly and I hope you make steady progress. It seems like most dogs do, I think it depends on the severity of the strain.

      • we did the ultra sound on our dog and it was very informative and was much less expensive than an MRI. We went to VOSM and they were awesome!

        • I’ve been to VOSM last year with my now 10 yr. old. Diagnoses Psoas strain. He’s still struggling. What did the ultrasound tell you?

    • If you’re looking for something a little more…upbeat than OB (but still less rough on the joints), you might look into either K9 Nosework or Treiball. When my oldest dog got diagnosed with Degenerative Joint Disease, I had to retire her from agility, which sucked. But we’re doing a combination of Rally and nosework right now, and we’re just about to begin treiball, and she’s (almost) as happy there as she was in agility. My girl is definitely not an OB type (though she likes Rally pretty well), so it’s been a little bit of a challenge to find something awesome for her to do. But nosework is great, and I have high hopes about treiball!

  24. Hi All,

    My dog is a 2 year old, very active, airedale terrier who was just diagnosed with this on the weekend. He was wrestling with a dog in April and injured it. We got xrays at the vet, which showed no problems. Finally we took him to a rehab specialist. My husband and I are having a very hard time dealing with this diagnosis because it seems like the rehab is going to be long. To make matters worse we have a very touch sensitive dog which makes doing the passive stretches, or anything for that matter, difficult. Anyone have any recommendations on things to try with him? Will swimming help?

    • swimming is the absolute last thing to do, under water treadmill might be of help but they say swimming is very bad for ilio strains.

  25. Sorry to hear about your dog. My understanding is that true swimming, where the legs are off the bottom, is too stressful for this muscle while healing. But, walking in water, like an underwater treadmill, is useful. If you have a beach or some place where you can walk the dog, I’m not sure optimal depth but maybe someone else can chime in, perhaps up to the hip bone?. I would do it on leash and control the dog’s pace to walking where each leg is used individually. So no surging, leaping etc. And do it in limited amounts, start with a few minutes and work up gradually. Good luck.

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  27. I have diagnosed and treated iliopsoas injuries for over 20 years now.here is my approach. I start with conservative management (rest, NSAIDs, no stairs, no accelerations etc). If this treatment is unsuccessful or if there is frequent recurrence of the condition, I recommend a muscle release. In most dogs, muscle releases are highly successful, even in chronically affected patients. Pain is gone, and they are able to do everything they like to do again, often at their previous level.

  28. Hi Gert, By muscle release, you mean where they cut the muscle? But wouldn’t this be destabilizing to the hips for intense running & jumping activities? I would be worried about other injuries occurring after this. Please share more info. for those of us whose dogs are now “chronic”. Thanks.

  29. I believe he means muscle release as in massages and manipulation of the damaged area to break up the scar tissue- not actually cutting- ouch!!!! Do you know a person in northern va that does this?

  30. Well, there is a last ditch surgical option to cut the muscle for dogs who are not improving. So I hope he will share more details on this. If massage & manipulation can improve it that much it would be wonderful, but betting you need a really good practitioner.

  31. Yeah, I am anxious to see what he says- my poor guy has dealt with this for over a year :( I am desperate to get him back on the playing field!

  32. Enough already with the sales pitch Jenn whoever you are!!! Cut it out. You are not adding anything real to the conversation.

    • Sarah, yes, thank you. MOD NOTE: sound wave people, you are bordering on spammy (and in fact, I have marked all of your duplicate comments as spam and deleted them.) Your point has been made: now kindly knock it off.

      Much much much support to all of our TU friends who are dealing with this horrible thorny issue. We here at the mod team are following this thread closely and wishing good things for all your dogs.

  33. Our surgeon recommended 6 weeks of total rest for our dog and that he only be taken outside to do his business. Our dog is 2 years old with boundless energy so we restricted his activity but continued to take him out for short 10-15 minute walks. We’re on week 5 and the stiffness is still visible plus he had a slight limp for a moment when he got up yesterday. So now my husband and I are going to fully follow the surgeon’s instructions and put him on strict rest. What I want to know is, has this worked for other people? He will likely drive us nuts with no exercise and I want to know if it’s worth it.

  34. My English Cocker Spaniel who turns 12 in a couple of weeks has enjoyed a long relatively injury-free agility career. Two weeks ago, while taking our usual summer off and trialing very little, she managed to hurt herself. It was in the middle of the night, she decided to find a different place to sleep. In the process of finding her comfy place in the front of the motorhome, she apparently caught her leg in a small opening between the front seat and a console between the two front seats in the cab. I heard her yip and rolled over to see her pathetic little face looking at me….on three legs, One rear leg was tucked up tightly against her body. After x-rays at my regular vet showed no structural issues, my chiro-acu vet diagnosed a psosas muscle pull. I have a cold laser and an using it twice each day. I’m hoping she will be able to return to the sport after the first of the year briefly to finish her next PACH and round off her agility career. It breaks my heart to pieces as I know injuries such as this can become chronic problems. She’s had a great career but would rather have her sail off into the sunset than be sidelined from an injury she got while taking the summer off.

  35. I have a 6 yr old Corgi that suffered an acute ilio strain a few years ago, we did robaxin 2 times a day, ultra-sound with dexamethazone gel, cold laser therapy and strict leash walks for 10 weeks. He has been doing great until this past Sunday when he decided to chase a fox up a long hill at top speed. Monday he could barely get up – he is back to square one but we will only do the robaxin and laser therapy and see what we get – it was mentioned to me 3 years ago that if it was a continuing problem that he should have it surgically released… ugh! I just finished the online course on Daisy Peel’s website, The Enigma of the Iliopsoas, they are offering it again and it is well worth the $$, I am not trying to sell it, just found it very, very informative. I also have Chris Zink’s new book which has a whole chapter dedicated to the ilio! Good luck everyone, I feel your pain!

    • Annie, please share any details you can about the ultrasound at VOSM, like what they were able to see, what the procedure was like and about how much it cost? Did having the info from the ultrasound change your treatment plan/outcome? Are they the ones who made the suggestion about “releasing” the muscle for recurrent strains?

      I also took the online Daisy Peel class and learned a lot. I confess to having some trouble applying it partly due to being too darn busy with 2 kids and 2 dogs etc. Does Chris Zink’s ilio chapter give much more info than the online class did?

      Good luck with your Corgi for this round. Hope it is a mild recurrence– Sarah

  36. Online class gave a ton more info than the book.
    The ultrasound could show the tears in the muscle fibers and compare one side to the other and we did it twice, once when in the acute stage and then 8 weeks later in the healed stage – I don’t think treatment protocol would have changed however it did give us an idea whether or not he was healed. I can’t remember the cost of the diagnostic ultra sound but I believe it was under 500.00. It really depends on whether or not they need to sedate the dog which in my case, they did not!
    robaxin is a life saver! I have a standing order for it at my pharmacy and whenever he gets tight, he goes right on it. It is cheap and it is safe…

  37. What dosage of Robaxin on your dogs on? My Vet recommended 500mg up to 3 times daily but it’s on back order. I can only find 750mg pills. My dog is 50lbs.

  38. my dog weighs 33 lbs and gets 250 mg twice a day. My smaller corgi weighs 20 lbs and was on the same dose, 250 am and pm.
    Can you cut the 750 in half and give him half three times a day until the 500mg gets in?

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