Pelvic Pain of Unknown Origin

by Sam

I am a 30 year old female. Former runner and soccer player and what you would describe as the 'jock' type: always active, strong, and in shape. I’ve never had any horrible injuries during my time as an athlete except for occasional lower right quadrant pain associated with ovulation.

However, I was on the pill for all those years and should not have bee ovulating and the pain almost always occurred on right side. Sometimes I would also get lower back spasms. I was checked many times for appendicitis, gastrointestinal issues, ovarian cysts, etc. but they never found anything and my doctors thought I was crazy.

After having my daughter six years ago the same pain would return, but with more intensity. My daughter was a hefty baby and sat very low in my pelvis during the last trimester of pregnancy. Birth was quick and uncomplicated and my body seemed to return to normal but my pelvis had widened. The last few years I have returned to multiple specialists for the same “pain” and always they tell me there is nothing to be found.

My back actually “went out” a few days ago when I was loading the dishwasher. I reached sideways and there was a “pop” feeling and I was on the floor. The pain kept me on the floor for a whole day and alternated between a pinching knot in my lower back (like the muscle tearing away from the inside of pelvis) and the old familiar lower right quadrant pain (pelvic pain of unknown origin). I knew it had to be connected somehow. Now I knew it wasn't my ovary, appendix, or intestines. There was something else going on.

While trapped on floor I looked up every diagram of nerves and muscles I could find. Somehow I came across this information on the iliopsoas and it was exactly what I had been feeling for years!!! The pain diagram matched me perfectly. I don't like to self-diagnose but I wanted to get off the floor! :)

So I managed to get onto the coffee table and do the recommended stretches and massages. They were painful at first but I was soon able to stand and eventually did more movements and felt a rubber band type “pop” over my hip and femur.

The pain and the pinch was suddenly gone!!!

Now I am almost positive this is what has caused me so much pain and worry over the years (about the possibility of a serious illness). The pain seems to be exacerbated by sitting with bad posture and sleeping on the couch and, strangely enough, when I am a little constipated it really sets it off.

Should I see a chiropractor or someone else??

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Jan 22, 2013
Definitely Sounds Like Dysfunction of the Iliopsoas
by: Stephen from Lower Back Pain Answers

Hi Sam,

I am in the process of producing a self-treatment DVD for Iliopsoas Syndrome and other forms of hip flexor dysfunction. If you haven’t subscribed to my newsletter please make sure you do so I can let you know the release date…

Subscribe here:

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The self-treatment DVD will include self-massage, active isolated stretching, and targeted strengthening to help individuals like yourself to effectively deal with this often pernicious problem.

Until the DVD comes out I recommend the following:

1. Find a massage therapist who knows how to work on the psoas and iliacus. Encourage them to work in a very detailed but very gentle way, especially including the insertion point on the lesser trochanter. Using pressure that is too strong and too intense will only aggravate the issue. I often spend an entire hour treating the iliopsoas. If you don’t know any therapists near you, you can search for one here:

Find a Massage Therapist

2. Make use of the hip flexor video on this site demonstrating the active isolated stretching technique. It’s posted here, third video down the page:

Stretching Videos

My rationale for often preferring Active Isolated Stretching over Static Stretching is explained here:

Static Stretching vs Active Isolated Stretching

That relieving “pop” that you felt is often the joint capsule of the hip resetting itself once the iliopsoas — which has been clenching tight on that side of the joint — is stretched and lengthened enough to allow the hip joint to return to its normal position.

The iliopsoas will likely require regular stretching from now on. In addition you will benefit from strengthening the iliopsoas's antagonist muscles such as the gluteus maximus.

There's lots more but that should get you started.

I hope this helps!


Stephen @ LBPA

Mar 21, 2013
Same same same!!!!
by: Anonymous

This is my story almost exactly!!!! Except I wasn't a jock. I just worked out since I was 12. It just came back after bending to get underneath a table sweeping at work. It drives me mad!!!

Apr 22, 2016
Same story, bad otcome
by: Rachel

Wow! Same story, not an athlete, but very busy mom with four if my seven children and a small business at home. I have suffered for 10 years with "pelvic pain". I was first told ovarian cyst then later on adenomyosis of the uterus. I have undergone two upper endoscopes, four colonoscopies, countless ct, mri, xray, and ultrasounds and ran of thousands of dollars in medical bills all to be told they couldn't find anything of significance. I have been told IBS, fibromyalgia, anxiety, depression, and have been to over a hundred doctors and various medical professionals. I think they were so tired if me that they convinced me that having a hysterectomy would solve my problems. I am not joking and now suffer from PTSD as the doctors exact words were " you will feel like a brand new woman". It destroyed my life. Not only is my original groin pain worse, but I now have back pain, have lost quality of life and live in severe pain daily. I just saw a new Chiro today who was disgusted at this story I told him and clearly said it us your psoas and you have true leg length issues. It is going to take a LONG time to undo. I am praying he can help me, but it sounds painful and scary. I left in pain just from today's exam and small exercise we did. He says it will get better:(. I now warn anyone complaining of groin or pelvic pain to ask for hip or psoas exam. If anyone can give me some advice on getting through the pain or encouragement that 10 years can be undone, I could use it. Kindly!

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Stephen O'Dwyer, cnmt

Neuromuscular Therapist & Pain Relief Researcher

Stephen O'Dwyer, CNMT


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