Psoas
"Where you think it is, it ain't"
The psoas muscles (also known as the hip flexors) can be a tricky beasts. The psoas originates on the bodies and transverse processes of the lumbar spine and inserts on the lesser trochanter of the femur. The psoas flexes the hip, may laterally rotate the hip, flexes the trunk, tilts the pelvis forward and assists to laterally flex the lumbar spine.
Sitting puts our hips in a flexed position and our trunk flexed with the seat supporting our legs and our lower back typically in a rounded position. With the seat doing the work for us, there is no need for the psoas muscles to fire. The psoas muscles go to sleep when they are no longer needed. When they are not firing they tend to lock up to create stability. When we stand, move and lift and our psoas muscles are asleep, other muscles with compensate. Your lumbar erectors with become tight and overactive, as well as your quads. Over time this can cause lower back pain. So the first thing we do is to try to roll out the lumbar erectors with the foam roller thinking this is what the problem is. Doing this may create a short term fix but does nothing to fix the initial cause.
Creating a plan to wake up the psoas muscles is a must. So what is that plan? We need to release the psoas muscles and activate them. Releasing the psoas is NOT very comfortable. There are a few ways to do this. A soft ball, a kettle bell, a rolling pin (or something similar) can be used to shove into your gut to release them. I typically start 1-2" out from the belly button and start to apply pressure lightly. The psoas run from the bottom of the sternum to the inside of the thigh bones in an inverted V formation. You can move up an down in the gut but be gentle, as you want to be able to breathe during this process. I like putting a softball on a box and slowly draping myself over the ball - with the ball placed 1-2" next to my belly button. You can also lay on the kettle bell or lay on your back with the kettle bell placed on top of you. (There are pictures below.) We will want to release the psoas muscles for 3-5 minutes per side.
Next we want to activate the psoas muscles. We can do this a few different ways as well. Just pick one that suits you best. The first way is to stand up with your back against the wall and raise one leg to or above hip level, with your foot and ankle relaxed, and hold it there. The goal is to hold it there for a minute. If your leg starts to shake, take a rest. We don't want other muscles to compensate. We can do the same thing laying on our back, but we will want to push down on the knee with our hands and actively push up on the hands with the knee and hold for 5-10 seconds at a time. The last way can be done at your seat. Place your hands on top of your knee and apply pressure down with your hands as you actively pull your knee up.
Weak or inhibited psoas muscles can be a huge reason for lower back pain and it is often overlooked. Check your psoas today or come into the office to have them checked if you are experiencing lower back pain.
In this image, you can see the psoas attaches to the front on the lumbar spine and travels down to the upper leg.
In this release, I places a kettle bell (or ball) on the table and am slowly and gently laying on top of it with the kettle bell places 1-2 inches next to my belly button.
This is an alternative setup. I am laying the kettle bell on top on me - 1-2 inches outside of my belly button.
Another alternative set up. I am laying on the handle of the kettle bell and gently sinking into it.
This is the activation exercise. After releasing the psoas, I will do this exercise to activate it. I bring my knee up to or above hip level, I will press down on my knee with both hands while resisting the pressure with my leg. Hold for 5 seconds and do this 5 times per side.
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