I have a guy I see regularly.  I have this terrible fear that I am suffering from some obscure autoimmune arthritis (I mean, I still could be) and I need him to regularly tell me that I am not.  I especially need him when my back is so stiff that I can’t put my pants on in the morning and nothing seems to help.  And I silently rage because I am ONLY in my early 40s and how am I supposed to make it to at least 85 if I can’t even put my pants on?!?  And if I can’t move, how are all the “silver sensations” out there managing???  So I go see my buddy, Jason, and he “tsktsks” me and greases the mobility wheels with a hefty dose of myofascial massage.  In other words, very deep tissue massage, separating and realigning muscle fibers (and what feels like internal organs as well sometimes). I was just there the other day, and as Jason started in with the usual work on my sacroiliac joints (where the pelvis and spine meet), he asked me if I had ever had my Psoas muscles released/massaged.  I most certainly had not. So we worked on it (boy did we work on it), and he started to talk to me about how deeply this muscle group can impact movement and flexibility.  And I started to wonder about all the people I know with chronic back pain and the patients I have treated. Does their pain (and mine) simply boil down to a tense and strained muscle?   Surely I know this as a nurse practitioner….But that’s the thing about modern medicine. Nobody in the traditional Western world of medicine will tell you that your pain could simply be related to how your muscle fibers are aligned and how tight they are–not at first, at least–everyone is too afraid of missing the “zebra” (what if it’s a tumor? Ankylosing Spondylitis? Rheumatoid Arthritis?)  and getting sued.  We merely babble on about “evidence based medicine” and then order a test and prescribe a pill (probably a pill that is wildly contraindicated in the geriatric population). Exhausting. So I settled into the massage and relearned a thing or two about one of the most important muscles in the human body. And then I came home, fairly euphoric from all the pain I did not have any longer (at least for the rest of that day), and started writing this post. 

Understanding the Psoas Muscle

The Psoas muscle, often referred to as the “muscle of the soul” or the “hip flexor,” plays a crucial role in our body’s movement and stability. This deep-seated muscle connects the spine to the femur and is responsible for flexing the hip joint. A tight or constricted Psoas can lead to various issues, including lower back pain, hip discomfort, and even affect our flexibility, posture and overall well-being. 

The Psoas muscle originates from the lumbar spine, crosses the pelvis, and inserts into the top of the femur. It acts as a primary hip flexor, allowing us to lift our knees towards the chest. Additionally, it plays a role in stabilizing the spine and pelvis during movement.

Sedentary lifestyles, prolonged sitting, and lack of regular exercise can contribute to the tightening of the Psoas muscle. When tight, it can alter pelvic alignment, causing discomfort and affecting the lower back.  Incorporating Psoas stretches into your routine can help maintain flexibility, alleviate pain, and promote better overall function. 

Symptoms of Psoas Dysfunction:

Lower Back Pain: A tight Psoas muscle can contribute to lower back pain due to its attachment to the lumbar spine. The muscle’s tightness can cause an anterior pelvic tilt, affecting the alignment of the spine.

Hip Pain: Discomfort or pain in the front of the hip, where the Psoas muscle is located, may occur. This can be exacerbated during activities that involve hip flexion, such as walking or climbing stairs.

Reduced Hip Mobility: Tightness in the Psoas may limit hip range of motion, affecting activities like walking, running, or bending at the waist (hence, can’t put pants on).

Postural Changes: Psoas dysfunction can contribute to postural issues, including an exaggerated lumbar curve or an anterior pelvic tilt. This may lead to poor posture and contribute to musculoskeletal imbalances .

Digestive Issues: In some cases, a tight Psoas muscle may compress abdominal organs, potentially leading to digestive discomfort.

Treatments for Psoas Dysfunction:

Massage Therapy: Massage can help release tension in the Psoas muscle and surrounding tissues. A skilled massage therapist can use various techniques to promote relaxation and flexibility.

Heat Therapy: Applying heat to the affected area can help relax the Psoas muscle. Warm compresses, hot baths, or heating pads may provide relief.

Physical Therapy: A physical therapist can assess your condition and provide targeted exercises to address Psoas dysfunction. They may also incorporate other modalities like ultrasound or electrical stimulation.

Core Strengthening: Strengthening the core muscles, including the muscles around the Psoas, can help stabilize the pelvis and alleviate strain on the muscle.

Postural Correction: Addressing postural imbalances is crucial in managing Psoas dysfunction. A physical therapist or posture specialist can provide guidance on proper body mechanics and alignment.

Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended for managing pain and inflammation associated with Psoas dysfunction. However, it’s important to consult with a healthcare professional before using medication. Often these medications are NOT recommended due to other health problems that are co-occurring.

Rest and Recovery: Adequate rest and recovery are essential for allowing the Psoas muscle to heal. Avoiding activities that exacerbate symptoms and incorporating rest into your routine can be beneficial.

5 Important Psoas Stretches:

Lunging Hip Flexor Stretch:

Start in a lunge position with one foot forward and the other extended back.

Lower your hips toward the ground, feeling a stretch in the front of the hip on the extended leg.

Keep your back straight and engage your core.

Hold for 20-30 seconds on each side, breathing deeply.

Psoas Release with a Foam Roller:

Lie face down with a foam roller placed horizontally under your hips.

Support your upper body with your forearms and engage your core.

Slowly roll over the foam roller, targeting the Psoas muscle.

Pause on tender spots and breathe deeply to release tension.

Knee-to-Chest Stretch:

Lie on your back with both knees bent.

Bring one knee towards your chest, holding it with both hands.

Keep the other leg bent or extended, depending on your comfort.

Hold for 20-30 seconds, feeling the stretch in the hip and lower back.

Switch legs and repeat.

Seated Psoas Stretch:

Sit on the edge of a chair with your feet flat on the floor.

Extend one leg straight while keeping the other foot on the ground.

Hinge forward at the hips, reaching towards the toes of the extended leg.

Hold for 20-30 seconds, feeling the stretch along the back of the thigh and hip.

Supine Psoas Stretch:

Lie on your back near the edge of a bed or table.

Extend one leg off the edge while keeping the other knee bent.

Allow the extended leg to hang, feeling a gentle stretch in the hip and Psoas.

Hold for 20-30 seconds and switch legs.

 Remember to perform these stretches gently and consistently, breathing deeply and listening to your body. If you have any existing health conditions or concerns, it’s advisable to consult with a healthcare professional or a fitness expert before starting a new stretching routine. And remember, this is not an overnight fix–it’s a commitment to a lifestyle change.  By giving attention to the well-being of your Psoas muscle, you’ll be on your way to a happier and healthier body. Oh, and one last piece of advice–find yourself a Jason. 😁