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The psoas muscle, also known as the iliopsoas muscle, is a long, ribbon-shaped muscle located deep in the core of the body. It is one of the largest and most powerful muscles in the body, and plays a vital role in stabilising the spine and allowing movement in the hips and lower back. It is made up of two distinct muscle groups, the iliacus muscle and the psoas major muscle, which can be located by palpation. The Thomas Test is a physical examination technique commonly used to assess the length and flexibility of the psoas muscle.
| Characteristics | Values |
|---|---|
| Shape | Ribbon-shaped |
| Location | Lower back (lumbar region) |
| Length | 16 inches |
| Ends | Groin, near the hips |
| Connects to | Spine, pelvis, femur (thigh bone) |
| Function | Maintains posture, moves hips and upper legs |
| Related muscles | Iliacus, iliopsoas |
| Related issues | Lower back pain, sacroiliac joint dysfunction, hip pain, postural dysfunction |
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What You'll Learn
The psoas muscle's location in the body
The psoas muscle, also known as the iliopsoas muscle, is a long, ribbon-shaped muscle located deep in the core of the body. There is one psoas muscle on each side of the spine, running from the lower back to the groin. These muscles start in the lumbar region of the back, just below the ribs, and run alongside the spine through the pelvis, ending near the hips at the top of the femur (thigh bone).
The psoas muscle is one of the largest and most powerful muscles in the body, and its central location means that it plays a role in a wide range of bodily functions. It is particularly important for stabilising the spine and allowing movement in the hips and lower back. The psoas muscle works with other muscles to maintain posture and move the hips and upper legs.
The psoas major muscle, which is one of the two muscles that make up the iliopsoas, can be located by palpation. This involves lying on your back with your knees bent and sliding your fingers towards your midline. When you lift your foot, you should feel a line of tissue running vertically, which is the psoas major.
The Thomas Test is another technique used to assess the length and flexibility of the psoas muscle. This involves lying on your back with your legs hanging off the edge of a table, bringing one knee to your chest while keeping the other leg straight, and observing the position of the straight leg when the knee is released.
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The psoas major and iliacus muscles
The psoas muscle is a long, ribbon-shaped muscle that runs from the lower back to the groin on either side of the spine. It is one of the core muscles in the abdomen, helping to maintain posture and move the hips and upper legs. The psoas major is a thick and powerful muscle situated on the posterior abdominal wall, lateral to the vertebral column. It originates from the transverse processes of all the lumbar vertebrae and the intervertebral discs.
The iliacus is a triangular-shaped muscle that arises from the iliac fossa of the pelvis. Its fibres merge with the most lateral fibres of the psoas major to form the iliopsoas muscle, which passes anterior to the capsule of the hip joint and inserts into the lesser trochanter of the femur. The iliopsoas is a large compound muscle of the inner hip, composed of the iliacus and psoas major muscles. It is the main flexor of the hip joint, and its simultaneous contraction produces a powerful flexion of the thigh at the hip joint.
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The psoas muscle's role in the body
The psoas muscle is a long, ribbon-shaped muscle located deep in the core of the body. There is one psoas muscle on each side of the spine, starting at the lower back, running through the pelvis, and ending at the top of the femur (thigh bone) near the groin. Its central location and circuitous path make it an important muscle, affecting many functions in the body.
One of the primary roles of the psoas muscle is to help maintain posture and stabilize the spine and hips. It connects the spine to the lower body and helps to keep the lower back stable, especially when sitting down. The psoas muscle also aids in pulling the abdomen up from a prone position and assists in hip flexion and movement. This is particularly noticeable when standing up from a lying or sitting position, climbing stairs, or walking uphill.
The psoas muscle is essential for walking. When taking a step, the brain triggers the psoas muscle to move the back leg forward, initiating the alternation between the front and back legs. However, sitting for extended periods can cause the psoas muscle to tighten, leading to lower back pain and difficulty maintaining a standing position. Tightness in the psoas muscle can be treated with specific stretches and exercises.
The psoas muscle is also associated with breathing. Weakness or spasm of the psoas can restrict the movement of the thoracic diaphragm, impacting breathing. Additionally, the psoas muscle receives small branches from the femoral nerve and is connected to the lumbar spine, which gives it sensation.
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How to palpate the psoas muscle
The psoas muscle is a long, ribbon-shaped muscle that runs from your lower back to your groin. There is one psoas muscle on either side of the spine, connecting the spine to the lower body. It is a key postural muscle and is important for movement.
Palpation is a technical term for touch, used by professionals such as massage therapists, osteopaths, and chiropractors. Palpating the psoas muscle can be challenging due to its deep location in the body. However, here is a step-by-step guide on how to palpate the psoas muscle:
- Lie down on your back and bend your knees.
- Place your hands on your hip points, which are the bony protrusions on the front of your pelvis (anterior superior iliac spine or ASIS).
- Curl your fingers around the hip points and let them sink in slightly, towards the inside of the pelvic bowl.
- Keeping your fingers at the same depth, change their direction towards the spine.
- Lift one leg. You should feel a distinct band of tissue pushing up into your fingers. This is the psoas major muscle.
- To locate the psoas muscle on the other side, repeat the process on the opposite side of the pelvis.
It is important to note that the psoas muscle is deep and can be difficult to access. It is recommended to start by palpating the iliacus muscle, which is often easier to find. Additionally, be gentle and careful during the palpation process.
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The Thomas Test for the psoas muscle
The Thomas Test is a physical examination used to rule out hip flexion contracture and psoas syndrome (injury to the psoas muscle). It measures hip flexor length and distinguishes tightness between one joint and two-joint muscles. The test was named after Welsh orthopaedic surgeon, Hugh Owen Thomas (1834–1891).
How to Perform the Thomas Test
The patient lies on their back on an examination table, holding their knee to their chest. The clinician places one hand behind the patient's knee and the other behind their back, before helping them to lay back on the table with their knee flexed. The clinician will apply a posterosuperior stabilisation force to the ASIS (anterior superior iliac spine) on the side being tested. This stabilisation force ensures the pelvis maintains a neutral position.
The "unaffected" hip is then flexed until the thigh touches the abdomen. The pelvis should be in a neutral tilt. The clinician then passively ranges the affected hip into extension. Once the pelvis begins to tilt anteriorly, the clinician stops the passive range of motion, holds the affected thigh in this position, and measures the angle between the affected thigh and table to reveal the fixed flexion deformity of the hip.
The Modified Thomas Test
The modified Thomas test is used to assess the flexibility of four different types of hip flexor muscle: the iliacus, psoas major, rectus femoris, and tensor fasciae latae. The test is performed in the same way as the Thomas Test, but with the addition of lumbo-pelvic stabilisation. This is because hip extension is important for various athletic activities, and a lack of hip extension may lead to an overstriding gait and increased risk of injury.
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Frequently asked questions
The psoas muscle is a long, ribbon-shaped muscle that runs from the lower back to the groin. There is one on each side of the spine.
The psoas muscle helps to maintain posture and move the hips and upper legs. It is also often implicated in lower back pain.
Lie down on your back and bend your knees. Slowly slide your fingers towards your midline, heading in the direction of the spine. You should feel a line of tissue running vertically.
The psoas muscle is made up of thousands of tiny fibres woven together. These fibres stretch and press together to allow movement in the lower back, hips and legs.
The Thomas Test is a physical examination technique used to assess the length and flexibility of the hip flexor muscles, including the psoas muscle.
