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How Well Do You Know Your Psoas?

This article was edited from my application submission for graduate school so it may be a little dryer than usual, but I assure you it's highly educational and worth the read! 

The iliopsoas is considered one muscle that can be classified as two (and sometimes 3) and has two major functions. The psoas major attaches from the anterior (inside) of the lumbar spine into the lesser trochanter or the femur (located in the inner thigh). Its primary responsibility is flexion of the hip. The iliacus attaches from the inside of the ilium, the large winged like structure of the pelvis, and joins with the psoas major at the lesser trochanter. It also is a strong hip flexor, but plays the roll of a stabilizer in most activities. The psoas minor is present in 41-50% of us and lives just anteriorly of the psoas major and assists in hip flexion. For the sake of repetition, from here on out I will refer to the iliopsoas as the psoas unless otherwise stated.

There are other times when the psoas is at work besides flexing our hips or lifting a leg, but primarily this is its job and it’s a big one. So many of us spend more and more of our days sitting at a desk for work or sitting in a car just getting to work. Our psoas spends the day in a shortened position and after hours and days and months and years it becomes fixed in that shortened position. Muscles do have memory and without proper self care including stretching, strengthening and soft tissue release, they will stay in a contracted position that they have become so accustomed to. This does not often happen without pain. We have all experienced some type of soft tissue discomfort in the form of tight or sore muscles. Simply a night of sleep with our neck turned to just the right angle will welcome the morning with a significant pain in the neck. The psoas often goes ignored and when it starts screaming for help, not many know what the source of the pain is nor how to remedy it.

The primary report of psoas dysfunction according to is low back pain. The other major area of pain may be in the front of the thigh. If the iliopsoas is not able to function properly, weakness in hip flexion may occur, such as inability to do a sit up, as well as having difficulty standing from a seated position. An over tight psoas is often times the culprit of “snapping hip phenomenon” which can be very painful and limit ones’ ability to enjoy activities like running or cycling.

To understand why the psoas would cause primarily back pain symptoms, we must not only know the anatomical considerations, but the nature of dysfunctional muscle tissue and myofascial trigger points which is the bulk of my background training in bodywork. Travell and Simon’s definition of a myofascial trigger point is “a hyperirratable spot, usually within a taut band of skeletal muscle or in the muscle’s fascia (connective tissue). The spot is painful on compression and can give rise to characteristic referred pain, tenderness, and autonomic phenomena.” Each trigger point has a general pattern of referred pain when existent. Common trigger points in the psoas typically refer pain into the low back as well as to the front of the hip and thigh. Due to the strong attachment to the lumbar spine, a tight psoas will physically pull on the low back causing a hyper lordotic curve resulting in pain. In addition, it can be linked to sciatica, sacroiliac joint pain, knee pain, digestive problems and scoliosis among other symptoms of misalignment due to influencing the hip and low back.

Trauma though sudden injury, fatigue from overuse, as well as nutrition and hydration imbalances are all causes of stress contributing to dysfunction of any muscle in the body. If we know this, then we know that the more often the psoas is activated through activity, the more fatigued it will become. Actions or activities that are common causes of psoas specific stress are prolonged sitting, especially in a jackknife position when the hip is flexed at more that 90 degrees, prolonged standing, sit ups, kicking and locomotion (walking/running). There are by far more activities one could list as the psoas seems to always be in use either actively or posturally.

Due to the location of the psoas in our lower abdomen, it can be considered residing in our gut, or “emotional brain”. We can learn more about how this becomes important by looking at the reflex of our stress response or the “withdraw response”. The “Red Light Reflex” in which our daily stressors and moments of fight or flight accrue in our bodies through activation of our flexors as we subconsciously react to protect ourselves. This happens in our face, neck, chest, abdomen, groin and legs. Taken from Thomas Hanna, author of Somatics, regarding the effects of abdominal contraction, “ Contraction of the abdominal muscle not only depresses the rib cage, it depresses the entire contents of the abdominal cavity, creating pressure on the viscera (our organs).” As we begin to breathe more shallow and into the chest rather than the abdomen, everything in our abdomen becomes depressed from tight muscle tissue. The longer we are in this position, the more we will be signaling to the body that there is danger, stress or fear. The body becomes contracted into a withdraw response, and the psoas is at the core.

We feel things in our “gut” intuitively. The area is dense with nerves and arteries which are important in sending and receiving information and circulation. When the psoas is contracted, those pathways may also be constricted. It also lives very closely with our digestive system and it can be greatly affected by contraction of the psoas. Energetically speaking, our psoas can even have an influence on our first, second and third chakra.

In order to reverse chronic issues with the iliopsoas, it first helps to bring our awareness of this deep and often unfamiliar muscle. Soft tissue release not only brings this awareness, but can also be very effective in treating chronic pain due to myofascial trigger points. Lengthening the muscle through stretching reminds the muscle fibers of where their normal resting length should be, especially after any period of time when it has been in a contracted position. A deep lunge will lengthen the iliopsoas, as will a pigeon pose and upward dog in yoga.

Once the psoas is in a healthy state, it is important to keep it toned and happy. A properly functioning muscle will be able to do its job with relative ease and consistency. Staying hydrated, as well as maintaining a nutritious diet, are crucial in the health of the whole body. Mindful abdominal breathing is a great way to not only reduce stress and muscle tension of the psoas and abdominals, but is an important exercise for visceral massage in order to relax the organs in our abdomen and encourage movement of fluids. When our emotional state is calm, our body will reflect that relaxed and rested state. When our body is relaxed, our emotions are more likely to be at ease. A healthy psoas is not only vital for the health of our physical body, but the energetic and emotional state of our being as well.

 

Hanna, T. (1988). Somatics, Reawakening the Mind’s Control of Movement, Flexibility, and Health. Cambridge, MA: Da Capo Press.

Staugaard-Jones, J. (2012). The Vital Psoas Muscle: Connecting Physical, Emotional, and Spiritual Well-Being. Berkeley, CA: North Atlantic Books.

Travell, J. G. & Simons, D.G. (1993). Myofascial Pain and Dysfunction, The Trigger Point Manual, Lower Extremities. Philadelphia, PA: Lippincott Williams & Wilkins.

Grace Peterson