The Ilium is the broad, upper part of the hip bone. The ilium is one of the three major bones that form the hip bone, along with the ischium and pubis. The ilium serves as an attachment site for various muscles, ligaments, and tendons involved in hip movement, pelvic stability, and weight-bearing activities.

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Common Injuries and Conditions Affecting the Ilium

Common injuries and conditions affecting the ilium can result from trauma, overuse, degenerative changes, or imbalances.

Iliac Crest Contusion

A direct blow or impact to the iliac crest, such as during contact sports or falls, can cause a contusion or bruising of the soft tissues and underlying bone. Iliac crest contusions result in localized pain, tenderness, swelling, and bruising over the affected area, limiting movement and weight-bearing activities.

Treatment typically involves rest, ice pack therapy, pain management, and a gradual return to activity once symptoms subside.

Iliac Stress Fracture

Overuse, repetitive stress, or sudden increases in physical activity can lead to stress fractures of the iliac bone, particularly in athletes engaged in running, jumping, or high-impact sports. Iliac stress fractures present with deep, achy pain over the pelvic region, aggravated by weight-bearing and activity.

Treatment includes activity modification, rest, protected weight-bearing, immobilization with a brace or crutches, physical therapy, and gradual return to sport once healing occurs.

Iliac Apophysitis (Sinding-Larsen-Johansson Syndrome)

Iliac apophysitis is a traction-related injury that occurs at the site of the iliac crest apophysis in young athletes, particularly during periods of rapid growth and skeletal maturation. Repetitive stress and tension on the iliac crest apophysis from activities such as running, jumping, and kicking can cause inflammation, pain, and tenderness over the anterior superior iliac spine (ASIS).

Treatment involves rest, activity modification, ice pack therapy, stretching, and strengthening exercises targeting the hip and core muscles.

Iliac Bone Spurs (Iliac Crest Spurs)

Degenerative changes, osteoarthritis, and mechanical stress on the ilium can lead to the formation of bone spurs or osteophytes along the iliac crest, causing localized pain, inflammation, and soft tissue irritation. Iliac bone spurs may result from chronic overuse, biomechanical abnormalities, or age-related changes in the hip joint.

Treatment focuses on pain management, anti-inflammatory medications, physical therapy, activity modification, and occasionally surgical intervention to address severe symptoms or structural deformities.

Iliosacral Joint Dysfunction (Iliosacral Dysfunction)

Dysfunction or misalignment of the iliosacral joint, located between the ilium and the sacrum, can result from trauma, repetitive stress, pelvic asymmetry, or poor biomechanics, leading to sacroiliac joint pain, hip instability, and lower back discomfort. Sacroiliac joint dysfunction may cause referred pain, sciatica, and altered gait patterns.

Treatment options include chiropractic adjustments, physical therapy, manual therapy techniques, sacroiliac joint stabilization exercises, and supportive bracing to restore joint alignment and improve pelvic stability.

Iliac Bursitis (Iliopsoas Bursitis)

Inflammation and irritation of the iliac bursa, located between the ilium and the iliopsoas muscle, can result from repetitive friction, overuse, or trauma, causing pain, tenderness, and swelling over the anterior hip region. Iliac bursitis may be associated with activities involving hip flexion, such as running, cycling, or climbing stairs.

Treatment includes rest, anti-inflammatory medications, corticosteroid injections, physical therapy modalities, and activity modification to alleviate symptoms and reduce bursal inflammation.

Treatment for Ilium Injuries and Conditions

Treatment options depend on the type and severity of the injury.

Rest and Activity Modification

Resting the affected area and modifying activities to avoid aggravating movements or positions can help alleviate pain, reduce inflammation, and promote tissue healing.

Physical Therapy

Targeted physical therapy exercises, stretching, and strengthening programs can improve hip mobility, muscle flexibility, and joint stability, addressing underlying biomechanical imbalances and restoring functional movement patterns.

Pain Management

Nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic medications, topical pain-relieving creams, and corticosteroid injections may be prescribed to manage pain, reduce inflammation, and improve comfort levels.

Ice Pack Therapy

Applying ice packs or cold compresses to the affected area can help reduce pain, swelling, and inflammation, providing symptomatic relief and promoting tissue recovery.

Gait Assessment and Correction

Gait analysis is used to identify conditions that cause abnormal walking and running movements. Orthotic devices, shoe modifications, and corrective exercises may be used to address gait abnormalities and pelvic asymmetries.


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