Logan Steele
The psoas muscle, commonly referred to as the hip flexor, is a significant muscle that lies on either side of the vertebral column and the brim of the pelvis. At its distal end, it combines with the iliacus muscle to form the iliopsoas muscle. The iliopsoas muscle is primarily responsible for hip flexion and plays a critical role during walking and running. It also aids in external rotation of the leg and spine stabilization during hip flexion. The psoas muscle is prone to tightness and weakness, which can lead to back pain, hip pain, and other issues. The oppositional muscle to the psoas is the gluteus maximus, which can be activated through specific exercises and movements.
| Characteristics | Values |
|---|---|
| Muscle opposing the psoas | Iliacus |
| Psoas major origin | T12 through L5 vertebrae |
| Psoas major insertion | Lesser trochanter of the femur |
| Psoas minor origin | T12 to L1 vertebrae |
| Psoas minor insertion | Iliopectineal eminence |
| Iliacus origin | Iliopsectineal eminence, iliac fossa/sacral ala |
| Iliacus insertion | Lesser trochanter of the femur |
| Psoas syndrome symptoms | Back pain, groin pain, pelvic pain, buttock pain, difficulty standing |
| Psoas muscle release | Should only be performed by a licensed and capable soft tissue therapist |
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What You'll Learn
Iliacus tightness
The iliacus muscle is a strong hip flexor and a huge contributor to lower back pain when tight. The iliacus muscle is shaped like a triangle and fits exactly into the iliac fossa, the curved surface of the largest pelvic bone. It is located deep inside the hip bone and is not easy to palpate without proper guidance. The iliacus muscle is shortened during activities that flex the hips, such as sitting. Because it increases the arch of the lower back, a tight iliacus muscle is notorious for causing lower back pain.
A chronically contracted iliacus can cause a variety of compensations or distortions in the body. For example, if a tight iliacus reduces movement in one hip, then the other hip or the spine or other parts of the body may be called upon to compensate and change their normal pattern of movement. A chronically contracted iliacus can promote pelvic torsion, resulting in a functional leg-length difference and disruption of the body's neutral relationship with gravity. This can lead to pain being experienced in a variety of places in the body.
The iliacus muscle is supplied with nerves by the branches of the second and third nerves of the lumbar area through the femoral nerve. The iliacus muscle flexes and externally rotates the femur. It is also one of the key muscles that help to maintain proper body posture. When combined with the psoas muscle, they are considered the strongest hip flexors in the body. The iliacus muscle can also add to an anterior tilt of the pelvis. The iliopsoas is responsible for hip flexion and is involved in trunk flexion, such as when performing a sit-up or bending down.
The best way to release the iliacus muscle of its tightness and pain is through intentional, targeted deep tissue massage. Deep tissue massage is important because a knotted, tight muscle is nearly impossible to stretch. Effective iliacus massage can be done with the hands of a professional or with an iliacus release tool like the QL Claw, which is designed for deep, targeted massage. After releasing the knots and tightness in the iliacus, a hip flexor stretch can be performed to lengthen the muscle and relieve tension in the lower back.
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Femoral nerve compression
The iliopsoas muscle is a large compound muscle of the inner hip, formed by the psoas major and iliacus muscles. The psoas major is a thick and powerful muscle situated on the posterior abdominal wall, and the iliacus is a triangular-shaped muscle that arises from the superior two-thirds of the iliac fossa, the iliac crest, and the lateral aspect of the sacrum. The iliopsoas is the prime mover of hip flexion and is important for standing, walking, and running.
The femoral nerve is one of the two major leg nerves that provide motor and sensory functions to the lower limbs. It is the largest nerve of the lumbar plexus, a network of nerves in the lower spine. The femoral nerve controls movement and feeling in the hips, legs, and feet, and it helps you bend and straighten your hips and knees.
Femoral nerve damage, also known as femoral nerve dysfunction or neuropathy, can occur from an injury or prolonged compression. Compression of the femoral nerve can lead to dysfunction, causing leg weakness and sensation changes such as decreased sensation, numbness, tingling, burning, or pain. The femoral nerve can be damaged during penetrating trauma to the thigh, hip replacement, abdominal, or pelvic surgeries. It can also be damaged by mechanical injury, such as stretching or compression, resulting in temporary nerve dysfunction. Ischaemic damage can occur due to restricted blood flow, often caused by compression.
Treatment for femoral nerve dysfunction aims to increase mobility, maintain muscle strength, and promote independence during recovery. Physical therapy and occupational therapy are common approaches, and braces or splints may be prescribed to aid in walking. If the cause of the dysfunction can be identified and treated successfully, full recovery is possible. However, in some cases, there may be a partial or complete loss of movement or sensation, resulting in some degree of permanent disability.
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Hip flexion
The iliopsoas is the prime mover of hip flexion. It is formed by the union of the psoas major and the iliacus muscles. The psoas major is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the pelvis. The iliopsoas is the body's most important hip flexor.
The psoas major and iliacus muscles are separate in the abdomen but usually merge in the thigh. The iliopsoas joins to the femur at the lesser trochanter. It acts as the strongest flexor of the hip. The iliopsoas muscle is supplied by the lumbar spinal nerves L1-L3 (psoas) and parts of the femoral nerve (iliacus). The iliopsoas muscle is a composite muscle formed from the psoas major muscle and the iliacus muscle. The psoas major originates along the outer surfaces of the vertebral bodies of T12 and L1-L3 and their associated intervertebral discs. The iliopsoas gets innervation from the L2-4 nerve roots of the lumbar plexus, which also send branches to the superficial lumbar muscles.
The psoas major combines itself with the iliacus muscle. It crosses the hip joint to insert on the lesser trochanter of the femur. The iliopsoas is classified as an "anterior hip muscle" or "inner hip muscle". The psoas minor does contribute to the iliopsoas muscle. The inferior portion below the inguinal ligament forms part of the floor of the femoral triangle. The psoas major is innervated by direct branches of the anterior rami of the lumbar plexus at the levels of L1-L3, while the iliacus is innervated by the femoral nerve.
The psoas major functions as a static and dynamic muscle. It sits at a juncture between the upper and lower body. Due to its respective origin and insertion points, it also functions as a "front to back" muscle given its placement with various superior, medial, and inferior portions of fascial tissue as it descends through the pelvic cavity. With this contribution, it acts as a hip flexor in both supine and standing positions. When in a static position (sitting), it acts as a stabilizer for the lumbar spine. The psoas major muscle also stabilizes the femoral head within the acetabulum of the hip in the first 15 degrees of movement.
Tight hip flexors can cause lower back pain, hip pain, and injury. Hip flexor exercises, including yoga poses, can help strengthen and relieve tension.
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External rotation of the leg
The psoas muscle is a hip flexor that also acts as a hip external rotator. It is a long fusiform muscle on either side of the vertebral column and the brim of the lesser pelvis. The psoas major is one of the most significant muscles that overlie the vertebral column. It is also responsible for stabilising the femoral head within the acetabulum of the hip during the first 15 degrees of movement.
The psoas muscle has two segments, one on each side of the body, which assist with lateral and bilateral motions. It originates from the first four lumbar vertebrae and the twelfth thoracic vertebra, and it inserts on the lesser trochanter of the femur. The distal end of the psoas muscle combines with the iliacus muscle to form the iliopsoas muscle, which is encircled by the dense iliac fascia. The iliopsoas muscle has important fascial relationships in its lumbar abdominal portion, its medial portion in the iliac fossa, and its femoral portion in the lower limb.
The psoas muscle is often associated with low back pain and disability. Stretching the psoas muscle can help reduce these symptoms. However, it is important to note that in cases of psoas tendonitis, tendinopathy, or strain, constant stretching may not be beneficial and can delay recovery.
The iliacus muscle is commonly targeted before the psoas due to its shorter length and stronger tendency to tighten. The psoas is considered relatively weak and underactive, especially in individuals with unilateral disc herniation and sciatica. The gluteus maximus is an antagonist to the psoas, and a tight psoas can inhibit the function of the gluteus maximus.
In summary, the psoas muscle is a hip flexor and external rotator that plays a crucial role in stabilising the hip joint and lumbar spine. It works in conjunction with the iliacus muscle, and its tightness or weakness can impact the function and stability of the hip and spine.
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Stabilization of the spine
The psoas muscle is a significant muscle that lies on either side of the vertebral column. At its distal end, it combines with the iliacus muscle to form the iliopsoas muscle. The psoas is often referred to as the "hip flexor" and tightness in the psoas muscle is a common issue.
The iliopsoas muscle is primarily responsible for hip flexion and plays a critical role during walking and running. It also aids in external rotation of the leg. The iliopsoas is considered an antagonist to the gluteus maximus (Glute max). A tight psoas can inhibit the function of the gluteus maximus, impacting the force closure of the sacroiliac joint.
The psoas muscle can be a cause of back pain, especially in athletes and those who sit for extended periods. Psoas syndrome results from iliopsoas muscle dysfunction and can lead to low back pain, groin pain, pelvic pain, and buttock pain. Sitting for long periods can weaken the psoas muscle, contributing to psoas syndrome.
Stretching the psoas muscle can provide relief in some cases, but it may not be effective for everyone. It is important to note that certain conditions, such as psoas tendonitis or tendinopathy, and psoas strain, may require alternative approaches other than stretching.
To address psoas dysfunction, the NASM Corrective Exercise (CEx) model suggests inhibiting overactive muscles with ischemic pressure and then lengthening the psoas muscle through static stretching. This can help improve hip extension and reduce neural overactivity. The next phase involves activating the underactive and inhibited gluteus maximus to restore optimal athletic function and improve movement patterns.
In summary, the psoas muscle, particularly the iliopsoas, plays a crucial role in hip flexion and spine stabilization. Its tightness or weakness can lead to various issues, including back pain and hip discomfort. Treatment options include stretching, exercise, and in some cases, surgery.
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Frequently asked questions
The psoas muscle is also known as the iliopsoas and is considered an antagonist to the Glute max.
The psoas muscle is responsible for hip flexion and external rotation of the leg. It also stabilises the spine during hip flexion.
A tight psoas can pull your lumbar spine into extension and increase an anterior pelvic tilt. This can put more pressure on the intervertebral discs and inhibit the function of the Glute max.
Psoas syndrome is a disorder of the iliopsoas muscle that can cause back pain, groin pain, snapping hip, buttock pain, and difficulty standing.
