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The psoas muscle is a large and powerful hip flexor muscle that connects the vertebrae to the top of the femur (thigh bone). It is part of the Iliopsoas system, which includes the psoas and iliacus muscles, which tend to become tight and cause pain together. Psoas muscle pain can manifest in various ways, such as lower back pain, tightness or stiffness in the hip area, and radiating pain down the front of the thigh or buttocks. To relieve psoas muscle pain, a combination of strategies is often employed, including massage/release, stretch, and glute activation. In some cases, physical therapy may be recommended, especially if the pain is caused by tendonitis or a hip labral tear.
| Characteristics | Values |
|---|---|
| Psoas Muscle | A large and powerful hip flexor muscle |
| Location | Connects the vertebrae to the top of the femur |
| Function | Helps attach the lower body to the upper body |
| Related Muscles | Iliacus muscle, abdominal, pelvic floor, and hip muscles |
| Psoas Muscle Pain | Lower back pain, upper thigh pain, hip stiffness, and discomfort pushing the hips forward |
| Treatment | Physical therapy, massage/release, stretch, glute activation, electrical stimulation, and therapeutic exercise |
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What You'll Learn
Physiotherapy
Psoas syndrome is a rare condition that causes pain in the lower back, hips, buttocks, pelvis, or groin. It is often misdiagnosed or underdiagnosed because it shares symptoms with other injuries or health conditions. The psoas muscles are a pair of long muscles that run from the lower back to the top of the hips on either side of the spine. They are essential for everyday movements such as standing, walking, and climbing.
- Lying leg raises: Lie on your back and lift one leg at a time, bringing it towards you while keeping it straight.
- Psoas crunches: Starting on your hands and knees, bring your left knee and right elbow together, then repeat on the opposite side.
- Standing hip flexion: Stand straight with a neutral spine, lift one knee to a 90-degree angle, and hold for five seconds, then repeat on the other side.
- Camel pose: Start in a kneeling position with your buttocks on your heels. Place your hands on your hips and lift your buttocks into a tall kneeling position. Arch your back and reach for your heels or ankles, holding for 30 seconds and repeating three times.
- Straight leg raises: Lie on your back with legs straight, then lift one leg slowly while keeping it straight and hold for five seconds before lowering. Repeat 20 times on each leg.
In addition to these targeted exercises, rest and recovery are essential to allow muscles to adjust to workouts and prevent injuries. It is important to seek advice from a healthcare provider to ensure a correct diagnosis and appropriate treatment plan.
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Massage
A healthy psoas muscle is essential for maintaining good posture, supporting your lower back, and promoting emotional well-being. A tight or dysfunctional psoas can lead to issues such as lower back pain, hip discomfort, and digestive problems. Regular psoas massage can help release muscle tension, improve flexibility and range of motion, and enhance core stability.
To perform a self-massage on your psoas muscle, start by lying on your back with your knees bent and feet flat on the floor. Place your fingertips about an inch below your hip bone, slightly towards the center of your body. Gently press in and down towards your spine, and you should feel a tender spot, which is likely your psoas. Apply gentle pressure and hold for 30 seconds to a minute, remembering to breathe deeply. It's important to be patient and gentle with yourself as the psoas is a deep muscle. While some discomfort is expected, sharp pain is not, so adjust the pressure accordingly.
Foam rolling is another way to indirectly release tension in the muscles surrounding the psoas. Lie face down on a foam roller positioned just below your hip bones and slowly roll up and down, pausing on tender spots. This method can be effective in helping to relax the psoas muscle.
Incorporating psoas massage into your wellness routine can have benefits for your physical and emotional well-being. However, it is important to note that self-massage may not always be sufficient, and sometimes it may be best to seek professional help from a licensed massage therapist.
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Stretching
Psoas tendonitis can be treated through physical therapy, which includes functional therapeutic exercises and electrical stimulation to re-educate the muscles of the abdomen, pelvic floor, and hips. This helps to create muscular balance and correct muscle dysfunction.
Psoas stretches are recommended to alleviate tightness and improve mobility. These stretches are especially useful for those who sit for long periods, as this causes the psoas muscle to shorten and stiffen, leading to pain and tension in the lower back, buttocks, groin, hip, and pelvis.
- Lie on your back near the edge of a bed with one leg bent up to your chest. Wrap your arms around the lower part of that leg and squeeze it close while allowing the other leg to dangle off the side of the bed. Hold for several seconds, then repeat on the other side.
- Start in a kneeling position with your buttocks on your heels. Place your hands on your hips and lift your buttocks by contracting your glute muscles. Push your hips forward as you arch your back and reach for your heels or ankles. Hold for 30 seconds and repeat three times.
- Begin in a half-kneeling position with your front foot flat on the floor and the knee and shin of your back leg touching the floor. Ensure that your knees and hips are in line with their respective ankles and shin. Keep your back straight and buttock muscles tight as you lean into your front leg. Repeat on the other side.
It is important to note that in some cases, the psoas muscle may be lengthened and overused rather than shortened, so additional stretching may not be beneficial and could lead to more pain. If stretching and strengthening the psoas do not provide relief, it is recommended to consult a physical therapist to determine the underlying cause.
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Exercise
Psoas syndrome is a rare condition that causes pain in the hips, lower back, buttocks, or groin. It occurs when the psoas muscles, which extend from the bottom of the ribs to the top of the hips, are injured or irritated. This can happen due to overuse, underuse, or an injury. The psoas muscles are important hip flexors that help lift the thighs, enabling activities such as walking and climbing stairs.
Prolonged sitting or other sedentary behaviours can cause the psoas muscle to become tight or weak, leading to muscle imbalances and pain. Therefore, it is essential to incorporate movement and stretching into your daily routine. Here are some exercises to help fix and strengthen the psoas muscle:
Clinical Somatics Self-Pandiculation Exercises:
Pandiculation is a neuromuscular re-education technique developed by Thomas Hanna, the founder of Clinical Somatic Education. It involves gently contracting and releasing muscles in specific ways to send accurate feedback about muscle tension to the nervous system. This technique can help release years of built-up tension in the psoas muscle.
Yoga and Camel Pose:
Camel pose is a yoga posture that helps open the hips and stretch the psoas muscle on both sides simultaneously. Start by kneeling with your buttocks resting on your heels, then place your hands on your hips. Contract your glute muscles to lift your buttocks into a tall kneeling position, keeping your hips over your knees and shoulders back. Continue pushing your hips forward while arching your back and reaching for your heels or ankles. Hold for 30 seconds, then relax and repeat three times.
Leg Lifts:
Stand with your feet shoulder-width apart. Lift your legs in front of your body to strengthen the psoas muscle. This exercise helps to improve muscle strength and flexibility while decreasing muscle imbalances.
Lunges:
Lunges help stretch and strengthen the hip flexors, psoas muscles, and rectus femoris muscle in the hip. Stand with your feet hip-width apart and bend your back knee towards the floor, keeping your back straight. Aim for a 90-degree bend in both knees and ensure your front knee doesn't extend past your toes. Do two sets of 10 repetitions with each leg forward.
Arch and Flatten:
This exercise helps release and regain control of the lower back and abdominal muscles, improving pelvis and lower back alignment. It is beneficial for individuals with a tight psoas, as they often have tight lower back muscles as well.
Back Lift:
This exercise releases the back muscles, which tend to be tight in people with a tight psoas.
Yoga Ball Exercise:
Kneel on the floor with a yoga ball in front of you. Roll your upper body onto the ball until your hands and toes touch the ground, keeping your body in a straight line. Balance on your hands and left leg while lifting your right leg towards the ceiling, bending at the knee. Repeat on the other side, performing several repetitions. This exercise strengthens the buttock muscles and allows the psoas muscles to relax and strengthen.
It is important to note that you should always consult a healthcare professional or physical therapist before starting any new exercise routine, especially if you are experiencing pain or have an injury. They can guide you through specific exercises and ensure a safe and effective recovery process.
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Healthy eating
- Maintain a Healthy Weight: Excess body weight, often a result of a high-carb diet, can strain the psoas muscle. A study in the Asian Pacific Journal of Clinical Nutrition found that even moderate weight loss can improve psoas muscle mass and functionality. A nutritious low-carb diet and intermittent fasting can be effective tools to achieve and maintain a healthy weight.
- Vitamin D: Vitamin D is essential for muscle health, and low levels can contribute to muscle aches and tightness. Spending time in the sun or taking vitamin D supplements can help ensure adequate vitamin D levels.
- Cholesterol: Maintaining healthy cholesterol levels is important for overall muscle health, including the psoas.
- Gut Health: Psoas syndrome may be linked to gut health. Nutritional therapist Fiona Waring suggests that retaining healthy gut function is facilitated by eating healthily, taking regular exercise, managing stress, ensuring good quality sleep, and considering foundation nutritional support such as fibre, multivitamins, minerals, probiotics, and L-glutamine.
- Avoid Excessive Sitting: Prolonged periods of sitting can lead to a tight psoas muscle, causing pain and discomfort. It is important to take frequent breaks, move around, and stretch to keep the psoas muscle relaxed and flexible.
It is always advisable to consult a healthcare professional or a nutritional therapist before making significant changes to your diet or taking supplements, especially if you are on medication.
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Frequently asked questions
Psoas is a large hip flexor muscle that connects the vertebrae to the top of the femur. It is part of the Iliopsoas system, which includes the Psoas and Iliacus muscles. Psoas muscle pain can manifest in a variety of ways, including lower back pain, upper thigh pain, hip stiffness, and discomfort pushing the hips forward.
Psoas muscle pain can be caused or worsened by certain activities and movements such as sitting for long periods, standing up after sitting, marching, kicking, doing sit-ups, sprinting, jumping, or carrying heavy objects.
Relieving Psoas muscle pain involves a combination of strategies to reduce inflammation, relax the muscle, and address the underlying causes of the discomfort. This includes massage/release, stretching, and glute activation exercises. In some cases, physical therapy or electrical stimulation may be recommended. It is important to consult with a healthcare professional for a proper diagnosis and treatment plan.
