The Psoas and Back Pain

Lately I have had quite a few clients coming in complaining of similar, low back symptoms.  Each of them have also displayed the same postural abnormalities, consistent with someone who sits all day at a desk, which they also all work desk jobs.  If you have, or have ever had low back pain, often times one of the main culprits is a tight Psoas muscle.

 

Where is the Psoas?  The Psoas is one of the largest, thickest muscles in the body.  It is our primary hip flexor muscle, so it lifts the leg at the hip up toward our chest.  If the leg is fixed (meaning your foot doesn’t leave the ground), it helps flex the torso, bringing the trunk and leg closer together.  It also aids in side-bending when only one side is contracted.

Psoas MuscleAs you can see in the picture, it originates at the lower vertebrae of our spine (T12-L5, and lateral aspects of the intervertebral discs), and inserts on the posterior aspect of our femur (lesser trochanter).

 

 

 

 

 

 

 

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How It Can Cause Back Pain

People who sit for a prolonged period of time can develop a tight Psoas because their hip is constantly in a state of flexion.  If the Psoas is always in a shortened state, such as when it is while sitting, it begins to adapt to this position, which will result in the “new normal” state.  The way we walk, or position our hips also can contribute to a tight Psoas. A tight Psoas pulls forward on our lower vertebrae and causes an anterior tilt to our pelvis, creating a hyperlordotic curve (increased low back arch).  This puts extra pressure on the intervertebral discs of our spine, which can result in degeneration, increased risk of injury, and increased pain.  If only one side is tight, this can pull the vertebral column and pelvis laterally, creating a lateral bend, resulting in many more problems, and pain.

How Do You Release a Tight Psoas?

There are many ways to help release, and stretch a tight Psoas.  A lot of it comes from how we live our everyday lives.

  • Move.  If you work a job that requires you to sit at a desk for long hours, make it a point to get up and move routinely throughout your day.  This is one of the best things you can do so that your Psoas doesn’t remain in the contracted/shortened state.

  • Sit with good posture.  Try not to lean forward in your chair too much.  This increases the amount of flexion at your hip, shortening the Psoas.  Sit back and keep your feet flat on the ground.  Don’t hook them under your chair, as this also increases hip flexion.  You may need to make alterations to your work space in order to be comfortable in these positions.

  • Don’t sleep on your stomach.  This is a hard thing to change if you have always been a stomach sleeper (like myself), but it is hyper-extending your lower back, which is only making the problems worse.

  • Get a massage from a trained therapist.  This is one of the most effective ways to release your Psoas.  If you have never had it worked on, be aware that it can be a bit uncomfortable as the therapist needs to work on it through your abdomen.  This can sometimes be painful, especially if your abdominal muscles are tight too.  Not eating right before your session is always a good idea too.

  • Stretch.  Doing a Psoas and hip flexor stretch a couple times a day will help significantly.  There are many ways to stretch this muscle.

    At theHip Flexor Stretch right is a photo of a basic hip flexor stretch.  To get a bit more out of the stretch, you can raise both arms over your head and/or lean to the opposite side.  Keep your core stabilized and don’t arch your back too much.  Contract your glutes as you shift your hips forward.  Hold the stretch for 20-30 seconds, 2-3 times per side.

 

 

 

 

 

 

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  • Strengthen your glutes.  If our hip flexor is being overworked, and constantly contracted, it means that the muscle doing the opposing action is weak, and not working properly to promote balance at the hip joint.  Our gluteus maximus muscles is one of the most powerful muscles in our body, and its primary action is hip extension, opposite of what the Psoas does.  If our Psoas is constantly contracted, through what is called ‘reciprocal inhibition’, our glutes are inactive, and not contracting the way they should.  To reverse this, if we activate our glutes, this will inhibit/relax the Psoas.  A good strengthening exercise for your glutes is the bridge.  Lying flat on your back with both knees up, the key is to keep a straight line with your body from your knees all the way to your shoulders (as shown in the picture below).  Don’t let your low back arch too much, or allow your butt to dip.  Focus on only contracting your glutes to lift your body.  Squeeze them at the top and hold this position for 10 seconds, slowly lower.  Repeat 10-15 times, once or twice a day.  When this gets to be too easy, move on to one-legged bridging.
    bridging1

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