An interesting muscle group that deserves it's own post. This muscle is sometimes involved in lower back pain, leg and knee pain, and causes a forward rotation of the hips. It's often involved in overuse injuries, or when lifting something while twisting the trunk of the body, and can sometimes manifest as a 'twinge' in the lower back.
If you've had a session with me (or another therapist) for lower back pain, you may have heard about this muscle. It's a difficult one to describe without the use of visual aid, so in today's post we will unpack what the Psoas muscle group is, and some tips on how to keep it healthy.
The psoas muscle group is a combination of the iliacus and psoas major, and is generally called the Iliopsoas. I often simply say "psoas" to imply both muscles. The psoas originates at the lower spine, and sort of 'fuses' with the iliacus muscle at the inner thigh (a spot on the femur called the lesser trochanter).
It's a little difficult to explain because it is on the front side of the spine. So to actually palpate the muscle, we have to do so through the abdomen. This can seem fairly invasive compared to other treatments, but can be done safely and effectively with manual therapy. There are even some guides on how to do some self treatment.
The iliopsoas is a hip flexor, which means it helps lift your leg forward, or bring your knee toward your chest. It also has a little role in rotating your leg outward, too. Knowing those directions will help when we want to stretch this muscle, because in order to stretch it we have to move it in the opposite direction to how it normally contracts. In day-to-day life the iliopsoas muscles help us maintain our posture, walk, run, and stabilizes the lower spine. They are innervated by the L1-3 and femoral nerves.
When the psoas is tight, it can contribute to a number of problems. One of the most common is Lower crossed syndrome, where the pelvis tilts forward, resulting in a curved and strained lower back. In some cases it can show up as locked lower back with the head tilting forward like a hunchback. In both cases, getting psoas work (massage, stretching, trigger point work) can be beneficial.
Testing the psoas muscle can be helpful to determine the cause of knee and leg pain as well as lower back pain. The hip flexor muscles can be indicated in patellofemoral pain syndrome.
Trigger point work and stretching for the psoas can help to relieve lower back pain, groin and leg pain, knee pain, and can help to correct issues further down the leg and foot, as well as the upper back.
The psoas is in a short position when we are sitting, so for many of us it seems that it is no surprise it might be tight. Moderately stretching this muscle group is useful for most people as a form of general maintenance, and massage can be a great way to help keep the muscle in healthy tone. (I always caution against over-stretching)
The psoas can be stretched by bringing the leg back as in a deep lunge, either standing or kneeling down.
What's going on with me, research articles, interesting little blurbs. This blog is an attempt to consolidate research into an easily digestible format.
Alex Moon has been a Licensed Massage Therapist since 2012, did his undergraduate studies at Utah State, and is currently working on his Doctorate in Physical Therapy.