The Psoas Muscle & Its Role in Low Back Pain
The psoas muscle forms part of the iliopsoas muscle group that are vital for stabilization of the spine and for strength and balance.
Deep within the abdomen, two psoas muscles run symmetrically on either side of our lowest lumbar vertebrae (L1-5), through our pelvic area to attach to the femur bones of our legs.
These muscles are involved in flexing the hip, bringing the knee and upper leg up towards the body, and are exercised when we walk, run or bend forward. Its length and function can impact our spine, hip and pelvic joints and their range of motion.
Chronic shortening or strain of the psoas muscle, often from long periods of sitting, can lead to:
low back pain,
spine and hip stiffness,
tears in the muscle & even the surrounding musculature due to overcompensation,
tendonitis (inflammation of tendons, where the muscle attaches to bone),
pelvic and spinal dysfunction and imbalance,
and even a disc herniation or prolapse.
The psoas muscle is one of the only muscles to attach to the vertebral discs in the lumbar region!
A contracted psoas muscle can create huge compression and sheer forces on the low back and surrounding structures.
What can cause tension and shortening of the psoas muscles?
Long periods of sitting, is the most common cause.
Sleeping in a curled position
Excessive use and strain with athletic exercise
Poor posture e.g. slouching and leg crossing
How can you relieve tension in the psoas muscles?
Avoiding long periods of sitting and driving is most important. If your job makes it challenging to do this, then consider setting timers throughout the day for stretch breaks.
One of the best ways to relieve the psoas muscle is stretching.
Massage and chiropractic adjustments are the other two, and all are discussed below.
Relieving tension in these muscles can sometimes provide immediate relief of low back pain!
The runner's lunge is the most well-known psoas or hip flexor stretch. It can be performed with the back knee on the floor or elevated off the ground.
It is important to not allow the front knee to go over your toes. The front knee should stay directly above the ankle. You may need to move the back leg or knee further behind you to avoid this happening.
Also, it is best for the upper body to stay upright, not leaning forward. Be sure to stretch both sides.
There are also a myriad of yoga poses that can help stretch this muscle.
Some are shown below. Half bridge is one of my favourites.
Please be aware that overstretching can aggravate the psoas further and cause more pain, so care is needed. Take it slow.
2. Chiropractic adjustments
Low back, hip and pelvic alignment reduce stress on the psoas muscle and its attachment points.
Plus, improving the brain-body connection through chiropractic adjustments enables your brain to "see" more clearly what is going on in and around your body.
The research also suggests chiropractic care can be highly beneficial for those with recurring low back pain. Learn more here.
Many practitioners, including chiropractors, know how to massage these deep muscles to provide relief. At the time of the massage, it may be incredibly painful though!
Often one side is tighter and more painful than the other, indicating a pelvic and spinal imbalance, and another reason to see your chiropractor and avoid leg crossing.
To massage this area yourself, you can try to dig your fingers into your abdomen just above the bones at the front of your pelvis. I love doing this while in half bridge pose to more easily access these muscles. You may need to move the position of your fingers a number of times to find the perfect spot. It should feel tender and tight. Hold for as long as you can, until you feel a release.
Another self-massage option is to use a massager ball.
Grab the ball and position it about 5-7 cm to the side and 2-3 cm down from the belly button.
Lie on your stomach, and support your upper body with your arms.
Roll the ball up and down the psoas muscle and apply pressure while you roll.
When you reach an area that feels extremely tight, breathe deeply and rest there for 10-20 seconds.
You should not roll higher than the belly button.
Listen to your body and please stop if the pain is too intense.
Another option is to use a hand-held vibration massager machine.
In our office we use one designed by an Australian chiropractor, Dr Graeme. They are also available to purchase in the office.
This massager has multiple head options, and vibration intensities. In our practice we prefer vibration massagers over percussion, jack-hammer style ones and you can discover why here.
If you're suffering from recurring low back pain, these techniques and tools can be game-changer. Share with your friends and family, and make regular chiropractic visits part of your family's health care plan.