The Psoas (pronounced “so as”) is the only muscle to connect the lumbar spine to the legs.
The Psoas is perhaps the single most involved muscle, and it is the cause of most grief in the low back, neck, shoulders and especially the hip joint. Often, the patient will complain of feeling sore in the groin.
A contracted Psoas will significently reduce performance in athletes and accident victims and has a detrimental affect on our ability to function properly at work. When it is released, it gives a profound feeling of relief, and is likened to a heavy weight being removed from their hips and lower back.
The psoas major plays an important role in maintaining the lumbar lordosis. Contractures of one or both psoas (major and minor) through over use or muscular imbalances will definitely affect pelvis rotation.
In most back and hip pain complaints, the cause is often the psoas muscle which is one of the most important muscles in the body. Problems related to the Psoas include: low back pain, sacroiliac pain, sciatica, disc problems, spondylolysis, scoliosis, hip degeneration, knee pain, and menstruation pain. The list can also include pelvic tilt, leg length discrepancies, lumbar lordosis and kyphosis
Primarily, the Psoas flexes the hip and the spinal column with an average length of 400 millimeters. It’s a very powerful muscle, and runs down the lower mid spine beginning at the 12th rib connecting with the vertebral bodies, discs and transverse processes down the lumbar vertebrae. Then it passes across the pelvis to attach on the inside top of the leg at the lesser trochanter.
The lower portion combines with fibres from the iliacus muscle, which sits inside the surface of the pelvis and sacrum, to become the Iliopsoas muscle as it curves over the pubic bone and inserts on the lesser trochanter.
The psoas functions as a hip and thigh flexor, which makes it the major walking muscle.
If the legs are stationary, its action is to bend the spine forward. If sitting, it stabilises the trunk. The lower psoas brings the lumbar vertebrae forward and downward to create pelvic tilt.
When we think of smooth, elegant and graceful movement in dancers and athletes we are looking at the psoas functioning at its optimum. It requires that the psoas maintains the pelvis in a dynamically neutral orientation that can move easily and retain structural integrity. This creates positions of the spine that require the least muscular effort.
Sore back, shoulders and knees are common complaints of people who lead a full and active live. Let’s face it, there are many occupations that are not kind to muscles.
In most cases, one of the major common denominators of these problems is imbalance in a muscle group known as the Iliopsoas aka Psoas Major, Psoas Minor and Iliacus muscles.
These are the hip flexor muscles and extend from along the side of the spine from about mid-torso down to the base of the spine then across the front of the hips to the top of the leg.
Most people are familiar with muscle names like quadriceps (quads), hamstrings, calves, “abs,” biceps, triceps, “lats,” etc because they deliberately exercise them. But I doubt if even .001 per cent of the population knows they have this Iliopsoas muscle group let alone its actions and the musclar imbalances it can cause in the rest of the body.
Because Iliopsoas muscles flex the hip, they contract every time you walk, run, jog, climb, sit or bend. Think about how much and how often this happens every day!
They are also postural muscles – in other words, they help hold you upright while you are standing and sitting – and are designed to take a lot of hard work and punishment before they ever feel sore.
But that does not mean they are not tight. If they are, they can put all sorts of uneven pressures on the hip.
They are quite substantial muscles and pull the front of the hips downwards, causing muscles in the lower back and along the spine to tighten as the back of the hips tilt up (hence the back pain).
Among these lower back muscles is the Quadratus Lumborum from the top of the hip on an angle to the spine. It acts like guy ropes for the spine, helping to stabilise it and keep it balanced.
If the Psoas muscles from one side of the spine pull tighter than the other, it tilts one side of the hips higher, putting uneven pressures along the back of the spine and on several major leg muscles which go across the hips and knee joint.
Because the Iliopsoas group can cause tightness in muscles controlling flexibility of the spine (including Quadratus Lumborum), they also can have a big impact on shoulder muscles.
When you start to raise your arm above your shoulders, at about 150 degrees the shoulder blade begins to rotate upwards and the spine flexes to accommodate this.
If the spine is too rigid from tight muscles, then the muscles moving the shoulder blades need to work harder and can fatigue or become sore.
Pain in your back, shoulders or knees is usually due to tight or strained muscles in those areas but, in fact, it is often the hip flexors that have caused those muscles to be tight in the first place.
Hopefully from the above, you will agree the reason for muscle and joint pain is not always what it seems and that the therapist should look at the bigger picture to give you the most effective treatment.
A good tip if you’re ringing around to find a remedial massage therapist is to ask the masseur, “Can you do a Psoas (pronounced so-as) Release?”
A qualified and competent therapist will know straight away what you are referring to.
A Psoas Release is a technique used to help release tight hip flexor muscles across the front of the hip, to balance the hip and get it back in correct alignment. This then helps reduce or remove some of the uneven pressures on other muscles in your back and legs.
It involves putting pressure from the fingertips into the Psoas muscles just above the hips and lowering and raising the leg against this pressure to stretch the muscle.
It can sometimes be quite uncomfortable or painful, depending on how tight the muscle is, but the results are well worth a possible few minutes of discomfort well within your normal pain tolerance.
Without this technique, therapists who only treat the areas you say are sore are often only doing half a job (if the hip flexors are part of the problem)
In reality, they may only be treating a symptom of the problem, rather than the probable cause as well.
Health care is expensive enough without having to make repeated visits for problems which often can be fixed or greatly relieved quickly when a Psoas release is included in the treatment.
If you haven’t tried massage therapy for a bad back or that pain in your hips, make a call today. Make an appointment and experience the many benefits that massage has to offer. With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.