The psoas is one cool muscle and hopefully you will agree after this post. It’s a fascinating powerhouse of function and dysfunction. Without it you wouldn’t be walking around. It’s so fundamental to human movement that I always assess it in every case of musculoskeletal pain and poor athletic performance. I look at it even if you come in with pain in your little finger. It’s that important. Sadly, the psoas takes a relentless beating from the bombardment of sit patterns in modern society. Ass in the chair syndrome. The psoas definitely needs some love, but the right kind. ‘Sometimes too much love is worse than none at all.’ Can ya name the classic dance song that line is from? Hint: Machine
And so it begins…
1. Breathing Through Your Psoas
The psoas is connected to the diaphragm through connective tissue/fascia which affects breathing, posture and the fear reflex. Fear and pain alter breathing patterns. Often people in pain will hold their breath for stabilization and/or anticipation of pain with movement. Fear and pain causes shallow breathing, altering non-optimal oxygen and carbon dioxide ratios in your body. The fear reflex draws people forward into a hunched over ‘primal survival’ pattern that Thomas Hannah aptly called the Red Light Reflex, closing off of the body. I call it the ‘Vulnerability Reflex.’ Pulling in for safety and stability reducing risk. The forward flexion human cashew posture shortens the psoas causing tightness/stiffness and often weakness. ‘You don’t use it, you lose it.’
The Takeaway: When working with the psoas always work on breathing.
2. Spinal Stability Powerhouse
The psoas is a hip flexor and spinal compressor, not a producer of lumbar lordosis. Stuart McGill’s new edition book has awesome information about this subject. So just because you have an increase in your lower back curve, don’t go blaming the psoas. Bogduk (Clin Biomech, 1992;7:109-19) does not believe the attachment of the psoas muscle has a long enough lever to act as a prime flexor of the lumbar spine. The psoas has a fundamental stability role in the lumbar spine for axial compression and minimal movement function on the lumbar spine. The psoas is the only muscle to cross three zones (lumbar spine, pelvis, and hip). Probably makes it an important stabilizer.
The Takeaway: If you suffer from lumbar, pelvic, or hip pain the psoas should be assessed for function. Poor stability IS vulnerability. Note: Assess it no matter what hurts in the body.
3. It Doesn’t Always Need Stretching
Quick, what’s the first thing most people say when you mention a tight psoas? STRETCH IT! Just surf YouTube and there are hundreds of stretching examples to choose from. How do you know it needs stretching? Assess it, don’t guess it. Just because something is tight doesn’t mean stretching is the right answer. Most psoai muscles I evaluate are actually weak! They are often neurologically inhibited (down regulated) in their timing and activation. There is a delay in their primary role of stabilization and stretching is the worst thing you can do.
With that delay comes a need to compensate with stability from somewhere else in the body. Your body simply uses something else instead of the psoas for stability. Eventually that something else may begin to hurt. (Examples could be hip joint, lumbar spine, foot, etc). One way you can sense the feel of one psoas pattern to another is by doing the standing hip flexion test. Good friend and Strength Coach Mike Boyle uses this test often and I like it too. I just added a slight variation. Now there are a ton of other muscles that flex the hip, so it’s impossible to completely isolate the psoas, but it’s a good functional pattern test to start with.
Before I describe the test let’s list the other synergistic hip flexor muscles: (Resource: Trail Guide)
Tensor Fascia Latae
Gluteus Medius (anterior fibers)
Now the Standing Hip Flexion Test:
Stand approximately 1-inch away from a wall with your back touching the wall. Slowly raise one leg into flexion (hip and knee bends) like you are doing a single leg stance. Go slow, taking 4-seconds to bring it up. Make sure the knee/thigh crosses over the belt line of the waist. Relax the ankle! Do not hold tension in the ankle with dorsiflexion. Keep the flexion leg pointed straight ahead. Many people will want to abduct the hip to compensate. Maintain back against the wall. Keep opposite downward leg straight with knee locked. Do not hold your breath. You should be able to maintain position of leg above belt line for at least 15 seconds. Notice if you feel cramping, shaking, forward flexion of the upper torso, fatigue, pain. These indicate possible weakness and inhibition. Slowly lower for 4-seconds.
Repeat on the other side
Did you feel a difference? If so, further assessment is encouraged. That’s what we go over in my Primal Movement Chains: Moving Beyond Mobility course. How to determine which rabbit hole to go down and how far.
The Takeaway: Always assess the psoas strength before diving in with interventions.
Bonus Coolness Factor:
The plural of psoas is psoai. Just a cool word in and of itself.
Thanks for reading and feel free to share. Happy New Year to you and your psoai.
STOP CHASING PAIN by Perry Nickelston
A Vital Guide for healing your body, moving well, and regaining control of your life