Posted by: Mae | September 2, 2010

FAQ: What is the Psoas, and Why Would You Massage It?

Anterior Hip Muscles

Image via Wikipedia

I recently, as part of a biology class, had the privilege of viewing two human cadavers. I am humbled and touched that people willingly donate their bodies so that others may learn. (I, myself, plan to donate my body after death.) As we were viewing the individuals, I was able to refresh my concept of some of the muscles located on the front of the body.

My instructor, who knows I am a massage therapist, asked me if I ever massaged the psoas muscle. One of the other biology instructors is also a LMT, and has one client who specifically requests this. Many people “in the know” think it’s amazing we address this muscle at all because it is located along the front of the spine underneath all the muscles and guts in the abdomen. Not an easy muscle to reach, and not an easy thing to convince people you need to reach it, as evidenced by my classmates’ collective shock when my instructor pointed to the psoas and said, “She massages that!” (Exclamations of “Ouch!” were followed by “Why?” all around.)

If you consider the anatomy of the psoas major muscle, you can see that it joins with a muscle on the inside of your pelvis, called the iliacus. These muscles are often spoken of as a group, the “iliopsoas” because they work together to flex your hip, like when you “put your best foot forward.” Another thing these muscles are responsible for is your upright posture. If they are unhappy, your posture is imbalanced, and low back or hip pain is the usual result. Oftentimes, when you get lots and lots of frequent massage on your low back, with minimal results, it is because your psoas is the culprit.

Now, how to reach the pesky critter, when most people would rather pretend that they don’t have a belly, let alone let someone massage it? I was taught a few different approaches when I was in school. The traditional, and most invasive, method is to have the client lie face up, uncover the abdomen, and slowly (oh, so slowly and respectfully) press down from the side of the abdomen, diagonally, toward the spine. The slowness of the press allows the surface abdominal muscles to relax. The diagonal direction helps shift the “guts” out of the way. A skilled therapist can then feel and gently massage the psoas muscle.

A less invasive variation on the above positions the client on their side, so that the intestines and other abdominal structures are shifted out of the way, thanks to gravity, and makes it a little more comfortable for the client (as well as less work for the therapist). This is the method I prefer if I need to directly massage the psoas muscle.

“You mean there’s a better way to treat the psoas?” Yes there is. And it’s one the client can continue at home. Traditional wisdom says that it’s hard to stretch the psoas. This is true. (However, one way you can try is by performing yoga’s Pigeon Pose.) It’s called Proprioceptive Neuromuscular Facilitation (PNF) which is a long word for a type of assisted stretching.

Basically PNF works on the premise  that if you slightly contract and hold a muscle, then release, you will get a greater stretch (and subsequent relaxation) than if you just “force” the muscle to stretch. One way to use PNF with the psoas is to lie, face up, on a table. Scoot to the edge, far enough to let your leg hang off the side of the table while your pelvis remains supported. Try to keep your pelvis from rolling forward as your leg hangs off (a friend can help by placing their hand on your hipbone). Resisting gravity, and picturing the psoas in your mind, slightly bring your knee toward the ceiling. The idea is to engage the psoas, but not flex it as hard as you can. Hold it for a count of eight, then slowly relax. You should find that your leg hangs a little lower off the table. Repeat two more times. For a deeper stretch, you can ask a friend to gently push your thigh, just above the knee, toward the ground as you relax. Don’t ever force it, or your muscle will contract in order to protect itself, and you will have to start all over again.

A combination of PNF for the psoas and core strengthening exercises will keep your back and hips happy!

(If you have any burning questions related to massage therapy, post them to the discussion board, or add them to my Facebook page.)

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