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The Psoas: The Sneaky Muscle Behind Your Hip and Back Pain


Anatomical rendering of the seep abdominal muscles
"OpenStax AnatPhys fig.11.16 - Muscles of the Abdomen - English labels" by OpenStax, license: CC BY. Source: book 'Anatomy and Physiology', https://openstax.org/details/books/anatomy-and-physiology.

The Psoas is an Abdominal Muscle, but a Tight Psoas can be a Pain in the Lower Back.

If you've been experiencing low back pain that won't go away no matter how much you stretch and massage the areas that hurt, you may be dealing with a tight psoas muscle. What the heck is that, you ask? Allow me to explain.


Meet the Psoas and Its Partner Iliacus

The psoas is a deep abdominal muscle originating from the low back vertebrae (T12 - L5). This long, thick muscle runs down the body and into the pelvic girdle. The iliacus is a broad, flat muscle that spans the triangular surface of the interior hip bone. You can't look at the psoas without also considering the iliacus because these two muscles work so hand-in-hand that they combine and require their own power-duo name, like Bennifer or Brangelina. Introducing the power-duo you won't hear mentioned on TMZ: Iliopsoas. The iliopsoas begins where the psoas and iliacus meet inside the pelvic girdle and combine into one unit that continues into the lower body where it attaches to the femur.


This trio of muscles: the psoas major, iliacus, and iliopsoas are responsible for the flexion of the hip joint and flexion and rotation of the trunk - the mechanics we engage throughout ordinary daily activities like walking, climbing stairs, standing from sitting, bending and lifting. When not properly functioning, these muscles also account for much low back and hip pain, but most people aren't familiar with them or the pain patterns that signal psoas dysfunction.


When your low back starts screaming at you, you're probably not rubbing your abdominal muscles to feel better, right?


When Trouble Arises: Psoas Dysfunction

Like any other muscle the psoas muscles can become tight and inflexible, resulting in pain and discomfort. All-too-common activities like improper lifting, jogging, and regularly sitting for a prolonged period can lead to a locked psoas. Let's look at some common ways our psoas can become bound up.


Prolonged sitting

Hours and hours sitting at a desk means hours and hours that your psoas is in a contracted position. Without proper intervention the muscle ends up locked in that contraction. The shortened muscle now creates pain when standing or walking - actions that lengthen the psoas. If you spend long hours sitting at a desk or driving, there's a good chance your achey back is psoas related.


Excessive running, walking or hiking

Every step we take begins with the activation of the psoas muscle. If you're an avid runner, walker or hiker, stretch and rest afterward in order to continue to enjoy these healthy activities pain free.


Repetitive lifting, improper lifting or lifting too much

The psoas enables our body to bend, rotate, and lift. However, bending and lifting the wrong way can result in injury. Improper lifting form, repetitive lifting and lifting objects that are too heavy are sure ways to cause psoas strain and pain. To avoid injuring yourself, lift with your legs, not your back, and stick to a weight you can comfortable carry.


Side sleeping

If you tend to sleep on your side in a way that contracts one or both legs up toward your naval, like in a fetal position, you may find that your back feels stiff and creaky when you wake up. Like sitting at a desk for long hours, sleeping this way puts the psoas group into contraction for an extended amount of time.


Symptoms of a Psoas Dysfunction

A tight or injured psoas generally presents as low back or hip pain but can present in several ways. Symptoms include one or more of the following:

  • Low back pain

  • Hip pain

  • Groin pain

  • Pelvis pain

  • Glute pain

  • Knee pain

The psoas stretches across the lower abdomen and neighbors loads of nerves. Because of this, a compressed or inflamed psoas can cause seemingly unrelated symptoms, such as:

  • Bladder pain

  • Radiating leg pain

  • Stomach Pain

  • Bloating

  • Constipation

  • Acid reflux

  • IBS

A Healthy and Happy Psoas

If you're suffering from pain that you believe is related to a compromised psoas there are steps you can take to relieve your pain now and keep your psoas in good shape moving forward.


Strengthen

When your core is weak, more of the workload relies on fewer muscle groups, creating strain and imbalance.

A strong core is the answer to many biomechanical related pain issues since a strong core means the muscles work together better to share the workload of moving your body. Teamwork makes the dream work, and when you have a strong core, more of your back and abdominal muscles share the load of walking, bending, lifting and maintaining good posture, preventing excessive strain on any particular muscle group. Balanced strength training will build your core strength, leaving you less suseptible to psoas imbalances that lead to pain. Incorporate exercises that target abdominal and back muscles like leg lifts, planks and bridges to support a strong, flexible and healthy psoas.





Active sitting

Active sitting is a way to engage your core when sitting for long periods of time is unavoidable. You do this by sitting on an unstable surface such as a yoga ball, wobble chair or active seating disc. Sitting on an unstable surface keeps your core muscles active and firing. It's not a perfect solution - your psoas still shortens for a prolonged period - but with active sitting, the muscle fibers remain on and engaged, which is a better option than the disengagement of muscle activity that generally comes with sitting.


Seek Professional Help

If you're in the middle of a psoas flare and experiencing persistent back or hip pain, consult a massage therapist, physical therapist, or chiropractor. They can help provide pain relief by calming and releasing the muscles and offer guidance on psoas-specific stretches you can do at home.


The Nitty Gritty

If you've had enough of your nagging low back and hip pain consider paying attention to the psoas muscle group. These majorly important muscles are responsible for basically all body movements that involve your trunk including walking, climbing and lifting. To ease the pain, focus stretching and massage on the muscles of the abdomen, upper inner thigh and inside the hip bone.


Stay curious. Stay humble. Stay kind.

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Hey there, I'm Juliette (She/her) – I'm a Bodyworker and Writer.

I run a thriving massage practice in the East Bay California, where I've helped thousands of people feel amazing in their bodies.
 
When I'm not helping people feel better in their bodies or writing about wellness, practice-building and the messy art of being human, you can find me hanging with my family, curled up with some chocolate and a book, drinking room-temperature tea or hiking the gorgeous Bay Area with my pup.

My daily grind involves battling my brain to carve out a space for healthier living, personal growth, and a pinch more self-love. It's an ongoing challenge!

Join me as I explore wellness of the head, heart and body. 
 
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Stay curious, stay humble, stay kind.

XOXO, 

Juliette

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Juliette Wilk is a licensed and certified Massage Therapist with 20 years of experience. She runs a thriving private practice in East Bay California, where she's helped thousands of people feel better in their bodies. When she's not helping people achieve a state of bliss or writing on wellness and practice-building topics, you can find her hanging with her family and pup, curled up with a book, drinking room-temperature tea or hiking the gorgeous Bay Area. Work with her or read more @ lifebalancemassage.net

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