lower back pain

Psoas - Get To Know Your Muscles

Psoas - Get To Know Your Muscles

QUICK ANATOMY REVIEW:

The psoas (pronounced ‘so-az’) is one of the deepest core muscles in the body.

As you can see in the picture below, the psoas is a long muscle, attaching above to the upper part of the lower back as well as the intervertebral discs.

It then travels down through the abdomen and attaches to the inner part of the hip, making it one of only two muscles that attaches the spine to the lower limb.

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FUNCTION:

The psoas has a number of diverse functions, making it a key factor in health.

There is still some controversy concerning it’s exact role in the body.

The psoas is partly a hip flexor - that helps bend your hip when you walk and run.

It also has an important role in stabilising the lower back and posteriorly tilts the pelvis.

HOW PSOAS BECOMES OVERLOADED:

The psoas can become tight from spending extended periods of time in the following positions:

  • sitting

  • sleeping in the fetal position

  • standing with a swayed back and wearing high heels too often

  • sitting in a kayak/canoe

The psoas becomes overloaded with repeated use in the following situations:

  • driving

  • kicking

  • cycling

  • excessive sit-ups

Visceral pain

As it passes through, and has some attachments to the internal organs, the psoas can also be activated when there is irritation internally, (in particular the colon).

Stress

The psoas tends to tighten in response to general life stress (activated during the fight / flight response). Think of the fetal position protective response - that is the psoas causing your spine to contract.

SYMPTOMS:

The psoas is known as the ‘Hidden Prankster’ due to it being responsible for a lot of lower back pain (especially related to disc pain), without many people being aware of it.

Pain from a tight psoas muscle may be projected in a vertical direction in a ‘gutter’ along either side of the lowerback as well as to the sacroiliac region and buttock (see red areas marked below).

Pain may be felt during sitting and walking.

Overload of the psoas can also lead to pain and tightness in the front of the hip. 

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TREATMENT APPROACH:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your psoas issue.

Some common manual therapy treatment approaches include:

  • joint mobilisation to the lower back

  • dry needling to the psoas insertion point in the hip and upper attachment point in the back

  • deep tissue and manual myofascial release on the mid-section of the muscle (pictured below). It is very difficult muscle to dry needle direclty due to its deep location and proximity to major organs.

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SELF-CARE TIPS

  • avoid extended periods of sitting. Think about ‘time in the posture’ vs trying to find a perfect posture

  • consider a standing desk

  • avoid walking and jogging uphills and on sloped surfaces in the short-term

  • apply heat to the front of abdomen 10 minutes each day

  • sleep on side with pillow between knees, avoiding the fetal position with the hip flexed right up

  • use cruise control on long car trips to stretch the legs

  • learn to breathe through your diaphragm and manage your stress

    Some of the following exercises you may find useful:

Psoas stretch  -  gently ease into it tucking the pelvis under as you lean forward  (Picture credit:  Fiona Melder Photography )

Psoas stretch - gently ease into it tucking the pelvis under as you lean forward (Picture credit: Fiona Melder Photography)

Bridge stretch  -  tuck your pelvis, squeeze your glutes but don’t overarch your back. Breathe!  (Picture credit:  Fiona Melder Photography )

Bridge stretch - tuck your pelvis, squeeze your glutes but don’t overarch your back. Breathe! (Picture credit: Fiona Melder Photography)

Diaphragm breathing

As the psoas attaches to the diaphragm, when you breathe deeply you will naturally help decompress the psoas.

You can do this by putting your hands on the outside of your lower rib cage.

As you breathe in, expand the ribs from the sides, front and back - 360 degrees.

Aim for five seconds breathe in and five seconds breathe out for 1 minute.

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Building capacity in the Psoas

Weakness in the psoas causes decreased ability to flex the hip joint.

It’s really important for runners to have adequate capacity in the psoas.

Try this marching exercise below with a theraloop to help build some capacity in your hip flexors.

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Need some help with your lower back or hip pain?

We have a special interest in helping people overcome their pain and get back to what they love.

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813