The answer to many chronic back and hip pains are musculoskeletal imbalances. Often a tight Psoas muscle is to blame.
The biggest factor in back and hip pain is frequently the psoas muscle. Many believe the psoas muscle is one of the most important muscles in the body. The number of problems caused by the psoas is quite astonishing. These include: low back pain, sacroiliac pain, sciatica, disc problems, spondylolysis, scoliosis, hip degeneration, knee pain, menstruation pain, infertility, and digestive problems. The list can also include biomechanical problems like pelvic tilt, leg length discrepancies, kyphosis, and lumbar lordosis.
The psoas primarily flexes the hip and the spinal column. At about 16 inches long on the average, it is one of the largest and thickest muscles of the body (in animals it’s known as the tenderloin). This powerful muscle runs down the lower mid spine beginning at the 12th thoracic vertebrae connecting to all the vertebral bodies, discs and transverse processes of all the lumbar vertebrae down across the pelvis to attach on the inside of the 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.
What is the function of the psoas?
The psoas has a number of diverse functions, making it a key factor in health. The psoas functions as a hip and thigh flexor, which makes it the major walking muscle. If the legs are stationary the action of it is to bend the spine forward; if sitting, it stabilizes and balances 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.
What are the common pain symptoms of the psoas?
When the muscle becomes contracted due to injuries, poor posture, prolonged sitting, or stress, it can alter the biomechanics of the pelvis and the lumbar, thoracic and even cervical vertebrae. Typically a dysfunctional psoas is responsible for referred pain down the front of the thigh and vertically along the lower to mid spinal column. Trigger points are found above the path of the psoas on the abdomen. Frequently the quadratus lumborum muscles develop trigger points, as well as the piriformis, gluteals, hamstrings, and erector spinae.
The psoas can torque your spine to the right or left, pull it forward and twist the pelvis into various distortions. Frequently one psoas will shorten and pull the spine and/or pelvis to our dominant side. The distortions of the spine and pelvis can also show up as a short or long leg. This all results in scoliosis, kyphosis, lordosis, trigger points, and spasms in back muscles trying to resist the pulling of the psoas.
It can also pull the spine downward, compressing the facet joints and the intervertebral discs of the lumbar spine. The pressure can cause the discs to degenerate, becoming thinner and less flexible. This degeneration makes the discs more susceptible to bulging or tearing, especially with twisting and bending movements.
What keeps the psoas in contraction?
The psoas will stay contracted because of postural habits and trauma. The way we stand, walk and sit can distort the psoas. If we walk or stand with our chin in an overly forward position the muscle will tighten. Sitting through much of the day causes the muscle to shorten to keep us bio-mechanically balanced in our chairs. Over time we develop a “normal” way of holding the psoas that is dysfunctional.
Unresolved trauma can keep the psoas short and reactive. This is a primary muscle in flight, fight, freeze or fear responses to danger. When survival is at stake, it propels the body to hit the ground running. When startled, it ignites preparation of the extensor muscles to reach out (grab hold) or run. Until the psoas is released the muscle may stay contracted and go into further shortening and spasm very easily.
So what are you to do?!?
Just move it! Simple but regular stretching exercise which are designed to elongate the muscle and the surrendering tendons will help.
There are several ways to stop your Psoas turning into a hazardous plank of wood. All of which are easy to implement and should be even if you don’t suffer from back pain yet.
1. Postural Corrections. If we stay in a certain position all day, our tissues will want to move into that resting position, in this case, your Psoas. The best sitting posture is one that always changes. Sit Back in Your Chair. This will stop you leaning forward as much, and thus your Psoas won’t be in as shortened position in comparison to when you sit on the edge of your seat.
2. Stop Hooking Your Feet under Your Chair. You put yourself in more hip flexion and therefore, more Psoas activation. Set your feet flat on the floor, or a raised platform if you are a shortie.
3. Stand Up. You sit all day at work and keep your Psoas shortened. Do the opposite in the gym or any opportunity you get. Instead of the bike, get on the treadmill. Sub in Overhead Press instead of Seated Press.
4. Stop Sleeping on Your Stomach. When you are on your stomach, your back goes into hyperextension. This is exacerbating what a tight Psoas already does to your back (anterior tilt). Change it up.
5. Move It! Not staying in a seated position all day will go a long way to stopping you developing a tight Psoas. Get up more frequently, stretch more often, change positions… just move it!
6. Stretch. Add Psoas and Hip Flexor stretches to your daily routine. Get out of your chair at work occasionally and do some stretches. Do some at night before you go to bed.
7. Release. The most effective way to loose your Psoas is through a therapist. But you can do it yourself using a ball slightly larger & softer than a tennis ball. This massage technique releases your Psoas through an active range of motion. Lay on the ball, about 1-2 inches outside your belly button. You’ll feel your Psoas respond as you lower yourself. It will hurt a little. Arch your back; come up onto your elbows. This will result in a more forceful stretch and release on your Psoas.
8. Activate Your Glutes. Active glutes will help inhibit and relax your Psoas. A tight Psoas will stop your Glutes firing and activating normally. This is Reciprocal Inhibition: the Psoas and the Glutes are opposing muscles. Lack of Glute activity plus horrific posture can lead to overcompensation in other muscles of the back, leaving them tight and overworked. Couple this with the referring pain from the trigger points in your Psoas and you will be hurting.
So what are you waiting for?!? Get moving towards a healthier year!