The Psoas

Even though it's a hip flexor, the Psoas can be a source of back pain.

The Psoas muscle attaches at the lumbar spine, comes down inside the Pelvic bowl, and inserts on the inner side of the femur (see image).

When you sit too much, the Psoas gets short, and often stays short.

When chronically shortened, it can keep you in a perpetually doubled over position. You may have seen people walk with a shortened jerky stride on one leg. Their hip (and leg) not able to extend back fully. Or the people who walk like a chair is still attached to their behind - they cannot straighten up. The Psoas is the likely culprit.

Once a new client booked a 30-minute appointment to work on his hip and back pain. He only wanted me to focus on his right side of the lower back where he felt the most pain. He mentioned that his primary care doctor could not identify the cause of the pain, and suggested that it may be in his colon, and prescribed pain medication.

The client described the pain as constant and shooting into the front of his pelvis and hip (that was my first cue that it may be the Psoas). When I asked him what he does for work, he said he was a taxi cab driver, sitting for long hours every day (second clue).

I asked him to flex his hip against my resistance on the right side, which he could not do. At this point, I was certain that the culprit of his pain was the Psoas. 

When I attempted to gently and gradually 'melt' through the abdominal wall, the man cried out in pain, and almost jumped. I had to tell him to breathe, and waited for him to relax. After the session, he got up without pain, in mild shock from disbelief that the pain was gone, and called me later to confirm that his pain never came back. 

That's the thing with Psoas. Once it gets tight, it can stay in the tight/short position for a long time. Something has to be done to release it.

You have a few options:

1. Do Nothing (if it's not too bad), get used to the short stride, and let the rest of your body find ways to compensate (Not Recommended);

2. Get a massage to release the Psoas. (Highly Recommended)

The Psoas Release is not very pleasant. It involves slow deep compressions into the muscle through the abdominal wall. It may send sharp sensations into your back or down the leg. 

But when it's released, you may gain an inch in height and feel like you can take deeper breaths. 

Not all massage therapists are trained in the Psoas Release. Ask us who we recommend for this type of work.

3. Strengthen it. (Also Highly Recommended)

Strong muscles stay relaxed, i.e. do not get chronically tight. Only weak muscles get chronically tight.

Ask a fitness specialist about how to strengthen the Psoas with exercise. (Or you can ask Slava at East West). 

Strong healthy Psoas acts as a primary hip flexor without pulling on the back.

4. Stretch it. (Recommended Only for Non-Injured Muscles)

Stretching the Psoas on a regular basis will help you keep that fluid stride, and ease of movement.

However, if the muscle is injured, stretching will make it worse. It's best to start with #2 and #3 recommendations, and then add a stretching routine when it's strong and healthy.

About Other Hip Flexors

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