21 Jul What are the psoas muscles?
As you can see in this image the muscle attaches from the top of the leg bone (femur) and travels up through the pelvis and inserts into the spine. They are used to lift the knee closer to the chest and also helps with bending sideways. They also have a stabilising effect when moving generally but like any muscle – they can become really tight.
Why do they become problematic?
If you can imagine that when we sit down the ‘spine end’ of the muscle is closer to the ‘leg end’ of the muscle which after hours of sitting will soon become tight. This happens as the muscle adopts this shortened position. Most of us sit down during the day and some of us sit down for far too long. So long in fact that most of the patients I see in clinic who are desk bound spend on average 13 hours sat down. This is too much and isn’t a natural position for us humans.
The issue comes when we stand up again after being sat down for so long (see inset photo below) If the muscles become tight (after having sat down for most of the day) then when we stand they will be heavily stretched. This stretching effect drags the ‘spine end’ of the muscle down towards the ‘leg end’ which in turn compresses the spine. Compression of the spine causes pain and is one of the causes of facet joint degeneration. The biggest issue is when your brain programmes itself so it learns the that way you hold yourself should be with tight psoas majors.. When the brain and central nervous system thinks it has to maintain this position it will do unless treated with physiotherapy and a home management plan.
How is it treated?
The first step to treat this is by increasing the length of the muscle and keeping it that way. This is done in two steps. The first is to stretch the muscles using very specific stretches and the other is using exercises to teach the central nervous system to learn how to move the body without making these muscles tight all the time. Stretches are the easy part – its the rehabilitation which is tricky and requires a physiotherapist to teach you how to manage and learn the new movement.
Best stretches for the psoas major
Lumbar extension with resistance band
Laying on your front – hold a resistance band across the lower back with both hands holding either end of the band with both hands next to the hips. Press yourself up slowly so you are maximum stretch and hold. Whilst in the stretch try and take some deep slow breathes to help with the stretch as this will increase it. Hold this for 1 minute and repeat x 2.
Psoas major muscle stretch with band
Laying on your front use a resistance band or strap to pull you heel towards your buttock. Make sure you are up on your elbows to get the most out of the stretch. You should feel it along the front of the thigh and hip. You may also feel a tightness in the lower back – this is good so hold it for 2 minutes with deep breaths x 2. Then when you release – the back should feel a bit looser.
Psoas stretch with step and side bend
Kneeling on one knee – place the opposite foot on a step (bottom step of the stairs). Make sure your knee on the floor is reasonably far back so your front knee is 90 degrees bent. Then with a very straight back bend the front knee so your knee is over the front foot. Whilst in this lunging position – raise the hand on the same side as the knee on the floor and stretch the lower back towards the opposite side. This will stretch the lower abs, the front of the hip nicely. Hold for 2 minutes with deep breathes x 2
Psoas stretch on step
This is an easier version of the one to the left – but is much the same. Use this if the adjacent stretch is too difficult or paniful. Its helpful to hold the front knee to push your lower back – bakwards so increasing the stretch to the psoas muscle. Hold for 2 minutes and do this 3 times.
Want to ask a question - then click here!