Category Archives: Anatomy

The Psoas Muscles and Abdominal Exercises for Back Pain

©2004 Lawrence Gold

certified practitioner
The Dr. Ida P. Rolf method of Structural Integration
Hanna Somatic Education®
See also:
“What You Can Do about Your Own Back Pain”
“What’s the Prognosis on Your Back Pain?”

Common opinion notwithstanding, the proper purpose of abdominal exercises is to improve coordination of the abdominal muscles with the other muscles of the trunk and legs (which include the psoas muscles), to improve alignment, and not to strengthen the back (a nonsensical proposition if one thinks about it). When the psoas muscles achieve their proper length and responsiveness, they stabilize the lumbar spine, giving the feeling of better support and “strength,” and cause the spine and abdomen to fall back, giving the appearance of “strong” abdominal muscles. To improve psoas functioning, a different approach to abdominal exercises than the one commonly practiced is necessary. Instead of “strengthening,” the emphasis must be on awareness, control, balancing and coordination of the involved muscles – the purview of somatic education.

A discussion of the methods and techniques of somatic education is beyond the scope of this paper, which confines itself to a discussion of the relation of the psoas muscles, abdominal exercises, and back pain. (For a view of self-help techniques, click excerpt. For a discussion of methods and techniques techniques of somatic education, article.)

The Relationship of Psoas, Abdominal Muscles and Back Pain

The psoas muscles and the abdominal muscles are agonist and antagonist as well as synergists; a free interplay between the two is appropriate. The psoas muscles lie behind the abdominal contents, running from the lumbar spine to the inner thighs near the hip joints (lesser trochanters); the abdominal muscles lie in front of the abdominal contents, running from the lower borders of the ribs (with the rectus muscles as high as the nipples) to the frontal lines of the pelvis.

Take a moment to contemplate each of these relationships.

  • In the standing position, contracted psoas muscles (which ride over the pubic crests) move the pubis backward; the abdominal muscles move the pubis forward. (antagonists)
  • In walking, the ilio-psoas muscles of one side initiate movement of that leg forward, while the abdominals bring the same-side hip and pubis forward. (synergists)
  • The psoas major muscles pull the lumbar spine forward; the abdominal muscles push the lumbar spine back (via pressure on abdominal contents and change of pelvic position). (antagonists)
  • The psoas minor muscles pull the fronts of attached vertebrae (at the level of the diaphragm), down and back; the abdominals push the same area back. (synergists)
  • Unilateral contraction of the psoas muscles causes rotation of the torso away from the side of contraction and sidebending toward the side of contraction (as if leaning to one side and looking over ones raised shoulder); abdominals assist that movement.

Now, if this all sounds complicated, it is — to the mind. But if you have good use and coordination of those muscles, it’s simple — you move well.

Words on Abdominal Exercises

Exercises that attempt to flatten the belly (e.g., crunches) generally produce a set pattern in which the abdominal muscles merely overpower psoas and spinal extensor muscles that are already set at too high a level of tension.

High abdominal muscle tone from abdominal crunches interferes with the ability to stand fully erect, as the contracted abdominal muscles drag the front of the ribs down. Numerous consequences follow: (1) breathing is impaired, (2) compression of abdominal contents results, impeding circulation, (3) deprived of the pumping effect of motion on fluid circulation, the lumbar plexus, which is embedded in the psoas, becomes less functional (slowed circulation slows tissue nutrition and removal of metabolic waste; nerve plexus metabolism slows; chronic constipation often results), (4) displacement of the centers of gravity of the body’s segments from a vertical arrangement (standing or sitting) deprives them of support; gravity then drags them down and further in the direction of displacement; muscular involvement (at the back of the body) then becomes necessary to counteract what is, in effect, a movement toward collapse. This muscular effort (a) taxes the body’s vital resources, (b) introduces strain in the involved musculature (e.g., the extensors of the back), and (c) sets the stage for back pain and back injury.

The psoas has often been portrayed as the villain in back pain, and exercise is often intended to “knock the psoas out” (overpower it). However, it is obvious from the foregoing that “inconvenient” consequences result from that strategy. A more fitting approach is to balance the interaction of the psoas and abdominal muscles.

When the psoas and the abdominal muscles counterbalance each other, the psoas muscles contract and relax, shorten and lengthen appropriately in movement. The lumbar curve, rather than increasing, decreases; the back flattens and the abdominal contents move back into the abdominal cavity, where they are supported instead of hanging forward.

It should be noted that the pelvic orientation, and thus the spinal curves, is also largely determined by the musculature and connective tissue of the legs, which connect the legs with the pelvis and torso. If the legs are not directly beneath the pelvis, but are somewhat behind (or more rarely, ahead of the pelvis), stresses are introduced through muscles and connective tissue that displace the pelvis. Rotation of the pelvis, hip height asymmetry, and/or excessive lordosis (or, more rarely, kyphosis) follow, all of which affect the psoas/abdominal interplay.

Where movement, visceral function, and freedom from back pain are concerned, proper support from the legs is as important as the free, reciprocal interplay of the psoas and abdominal muscles.

More on the Psoas and Walking

Dr. Ida P. Rolf described the psoas as the initiator of walking:

Let us be clear about this: the legs do not originate movement in the walk of a balanced body; the legs support and follow. Movement is initiated in the trunk and transmitted to the legs through the medium of the psoas.

(Rolf, 1977: Rolfing, the Integration of Human Structures, pg. 118). A casual interpretation of this description might be that the psoas initiates hip flexion by bringing the thigh forward. It’s not quite as simple as that. By its location, the psoas is also a rotator of the thigh. It passes down and forward from the lumbar spine, over the pubic crest, before its tendon passes back to its insertion at the lesser trochanter of the thigh. Shortening of the psoas pulls upon that tendon, which pulls the medial aspect of the thigh forward, inducing rotation, knee outward.

In healthy functioning, two actions regulate that tendency to knee-outward turning: (1) the same side of the pelvis rotates forward by action involving the iliacus muscle, the internal oblique (which is functionally continuous with the iliacus by its common insertion at the iliac crest) and the external oblique of the other side and (2) the gluteus minimus, which passes backward from below the iliac crest to the greater trochanter, assists the psoas in bringing the thigh forward, while counter-balancing its tendency to rotate the thigh outward. The glutei minimi are internal rotators, as well as flexors, of the thigh at the hip joint. They function synergistically with the psoas.

This synergy causes forward movement of the thigh, aided by the forward movement of the same side of the pelvis. The movement functionally originates from the somatic center, through which the psoas passes on its way to the lumbar spine. Thus, Dr. Rolf’s observation of the role of the psoas in initiating walking is explained.

Interestingly, the abdominals aid walking by assisting the pelvic rotational movement described, by means of their attachments along the anterior border of the pelvis. Thus, the interplay of psoas and abdominals is explained.

When the psoas fails to lengthen properly, the same side of the pelvis is restricted in its ability to move backward (and to permit its other side to move forward). Co-contracted glutei minimi frequently accompany the contracted psoas of the same side, as does chronic constipation (for reasons described earlier). The co-contraction drags the front of the pelvis down. The lumbar spine is bent forward, tending toward a forward-leaning posture, which the extensors of the lumbar spine counter to keep the person upright; as the spinal extensors contract, they suffer muscle fatigue and soreness. Thus, the correlation of tight psoas and back pain is explained.

As explained before, to tighten the abdominal muscles as a solution for this stressful situation is a misguided effort. What is needed is to improve the responsiveness of the psoas and glutei minimi, which includes their ability to relax.

A final interesting note brings the center (psoas) into relation with the periphery (feet). In healthy, well-integrated walking, the feet assist the psoas and glutei minimi in bringing the thigh forward. The phenomenon is known as “spring in the step.”

Here’s the description: When the thigh is farthest back, in walking, the ankle is most dorsi-flexed. That means that the calf muscles and hip flexors are at their fullest stretch and primed for the stretch (myotatic) reflex. This is what happens in well-integrated walking: assisted by the stretch reflex, the plantar flexors of the feet put spring in the step, which assists the flexors of the hip joints in bringing the thigh forward.

Here’s what makes it particularly interesting: when the plantar flexors fail to respond in a lively fashion, the burden of bringing the thigh forward falls heavily upon the psoas and other hip joint flexors, which become conditioned to maintain a heightened state of tension, and there we are: tight psoas and back pain. (Note that ineffective dorsi-flexors of the feet prevent adequate foot clearance of the ground, when walking; the hip flexors must compensate by lifting the knee higher, leading to a similar problem.)

Thus, it appears that the responsibility for problems with the psoas falls (in part, if not largely) upon the feet. No resolution of psoas problems can be expected without proper functioning of the lower legs and feet.

SUMMARY

The psoas, iliacus, abdominals, spinal extensors, hip joint flexors and extensors, and flexors of the ankles/feet are all inter-related in walking movements. Interference with their interplay (generally through over-contraction or non-responsiveness of one or more of these “players”) leads to dysfunction and to back pain. The strategy of strengthening the abdominal muscles has been shown to be a misguided effort to correct problems that usually lie elsewhere – which explains why, even though abdominal strengthening exercises are so popular, back pain is still so common. Sensory-motor training (somatic education) provides a more pertinent and effective approach to the problem of back pain than abdominal strengthening exercises.

Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

April 1999

The Psoas – Stretching Revisited

http://www.cascadewellnessclinic.com/articles/97-99art/art32.shtml

By Rick Allen, DC

“Better health leads to better dancing.”

Last December we examined the anatomy and function of the psoas muscle. We saw how it is a hidden influence on posture and low back pain. My January/February article suggested stretches for the psoas. Last month I asked for suggestions from my readers for the April column. Thank you, Dan Roberts, Certified Muscle Therapist from Reading, Pennsylvania for alerting me to a better way to stretch your muscles, including the psoas. It’s called Active Isolated Stretching (AIS). While I had heard of the concept, it took Dan’s rave review by e-mail for me to research it further. Dan had taken extensive training with the developer of AIS, Aaron Mattes, a kinesiologist and massage therapist from Sarasota, Florida. Aaron is a consultant on stretching to the US Olympic Team. Likewise, Jim and Phil Wharton from Gainesville, Florida have worked with many top-level athletes, using the AIS technique to greatly improve their flexibility. The Whartons have popularized this technique in their 1996 book, The Wharton’s Stretch Book, and the associated video, Breakthrough Stretching. I contacted their company, Maximum Performance International (1-800-240-9805 or www.aistretch.com) and obtained permission from Ron Boyle to reproduce the figures shown below which illustrate the AIS technique.

As I pointed out in the January/February article, a key part of the answer to eliminating common mechanical low back pain is to keep the muscles of the low back in balance. This will improve your posture and dancing as well. Since the psoas often becomes tight and shortened from sitting, the answer must include daily stretches and exercises to counterbalance the tightening. I suggest you check out and incorporate AIS into your daily routine. (For further information, I suggest you also check out the good review of stretching techniques that appeared in Outside magazine’s Bodywork Column for March 1999.)

Active Isolated Stretching Technique

Psoas stretch 1Active Isolated Stretching is similar to part of the Proprioceptive Neuromuscular Facilitation (PNF) stretching method used by chiropractors, physical therapists, massage therapists and other muscle specialist. It uses the body’s natural counter-balancing neurological “wiring” to control muscles: when you contract a muscle (the agonist) your body automatically relaxes the opposing muscle (the antagonist). For example, when you tighten your biceps, your body automatically relaxes the triceps. The full PNF pattern is done with the assistance of the doctor or therapist telling you to “contract for about 6 seconds, relax, opposite contract, relax.” It is abbreviated Contract-Relax-Antagonist Contract-Relax or CRACR.

Psoas stretch 1 range chartFor example, to stretch the hamstring using the AIS technique, lie on your back with one leg bent and the other pointing straight up with a towel or soft rope looped around the arch of the foot (figure 1 above). (The Whartons recommend a 9-foot section of 5/8-inch braided polypropylene or dacron rope. I found some at Home Depot for about $.40/foot.) Next, draw that leg toward your chest by tightening the quadriceps muscles on the front of the leg. Go just a bit farther than your natural end point by pulling gently on the towel or rope while continuing to contract the quadriceps. Hold for 2 seconds. Release the stretch before the muscle reacts to being stretched – before it goes into a reactive protective contraction. The safe range is shown in figure 2. Repeat this 10 times for each leg. The Wharton’s video gives you an excellent sense of the extent and timing of the movement.

Active Isolated Stretching of the Psoas

Psoas stretch 2a As explained in the Wharton’s book, to stretch the right psoas, “Position yourself on your hands and knees (figure 3). Reach back with you right hand and grasp your right ankle. Reaching it will require that you lift your right foot to meet your hand. Hang on tightly.

Psoas stretch 2bUsing the hamstrings and the gluteus maximus [buttocks], lift the exercising leg up until the thigh is parallel to the ground – or aligned horizontally with your body (figure 4). Be careful not to arch your back (hyperextension). [The safe range is shown in figure 5.] You may use your hand for gentle assistance at the end of the stretch.”

Psoas stretch 2 range chart

Wrapping up

The Wharton’s video and book give full sequences that warm up and stretch practically the whole body, so I suggest you look at them rather than just stretching one muscle. They show both stretching by yourself and with an assistant. Take care in doing the assisted stretches. An inexperienced assistant could use too much force and strain the muscle.

The AIS technique is one I suggest you add to your arsenal. It is not the only technique, so I suggest you work with it and compare the results with your current stretching routine. [You do stretch daily, don’t you?]

Once again, take care of your psoas, improve you posture and improve your life and, especially, your dancing!

Next article: I’ve received a few more ideas from readers. I’ll keep you in suspense until next month.

Dr. Rick Allen is a chiropractor, massage therapist and dance student in Portland, Oregon. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone: 503-257-1324, mail: 221 NE 78th Avenue, Portland, OR 97213, e-mail or World Wide Web: www.CascadeWellnessClinic.com

Lateral view of the pelvis.

Psoas

 
The Almighty Psoas Muscle
http://www.myyogaonline.com/
Your Body’s Center of MovementThe foundation of our bodies and our yoga practice lies at our feet. In order to incorporate both physical and energetic foundations, we must examine our body’s center of energy, movement and balance which begins near the psoas muscle — the pair of deep muscles extending from the sides of the spine to the femur that are activated in postures like forward bending (paschimottanasana) and Boat pose; and lengthened in poses like Warrior I and Bow.To understand the psoas muscles, we first need to describe some of the surrounding structures. Imagine looking at a body from the front (anterior) then stripping the skin away. Peel away the layer of muscles over the abdomen and then remove the organs.

You’ll now be looking at the front of the spine with its large vertebral bodies sandwiching those sometimes not-so- happy, but very important discs. You’re now looking at your back/spine from the front.

Looking down a bit you see the inside of your bowl-shaped pelvis with your sacrum towards the back and the pelvic floor muscles in place connecting from it to your pubic bone. Lying over the front, and to the sides of your pubic bone, is a thick muscle that heads up to the sides of your vertebral bodies and drops down to connect to a spot on the inside and back of your thigh bone (femur). This is the almighty psoas.

The psoas gets a lot of attention, and for good reason. Roughly triangular in shape, the top of the psoas attaches along five vertebral bodies starting at the last thoracic vertebrae (T12) and continues to attach to each vertebral body, usually terminating at the next to last Lumbar vertebrae (L4). This completes one side of the triangle. From the ends of this side, we create two more sides that slowly come together and attach at that spot on the femur.

Because the psoas is triangular, the different portions of the triangle can have different effects on the spine, and therefore the body. Usually when we describe a muscle and the action that it does we talk about the bone that it makes move, in this case, the femur. The psoas insertion is on the femur. Movements happen at joints, so whichever joint is crossed by the psoas has the potential to be moved by this muscle. With the spine stabilized, as it mostly is, the psoas makes us perform flexion at the hip joint as in a forward bend. What happens if we stabilize the femur? Can the psoas then move the spine? You bet, and at this point we’ve reversed the origin and insertion.

If we stabilize the femur, the upper half of the triangle has the potential to pull the spine down and forward as it attaches to the last thoracic vertebrae. The lower half of the psoas pulls mostly on the lumbars and therefore pulls them down and forward, which would make the pelvis, tip forward and down. This sometimes shows up as a sway back. If you stand up and tilt your pelvis down and forward you’ll probably feel how short your low back gets. Back pain anyone?

How does the psoas show up in our yoga practice? Probably the most powerful place is in back bending in all variations such as Cobra, Bow, and Camel where we lengthen and open the front of our bodies, and important action that reverses most of what we do all day: sitting, driving, working on the computing etc. A tight psoas, along with other muscles makes back bends very difficult. When back bending, it’s often a good idea to tuck your tailbone (the opposite of the action described above). This will give length to your lower back. Yoga is about creating length in your body; find it wherever you can in your poses.

Aside from back bending, the psoas muscles are commonly used in forward bends to pull you down and forward. All too often people rely on their arms to pull them forward. Because the psoas also helps regulate balance, it is used in every standing posture to stabilize the upper and lower half of the body. Our center of gravity is roughly at the top of our sacrum, and psoas just happens to pass on both sides of this sacred bone so it helps regulate balance around our center of gravity, which is where movement comes from.

Chakras, Bandhas and Fred Astaire

If you look at the space between the top and the bottom of the psoas, you will find some interesting pieces of yogic anatomy. Within its’ span are the lowest three chakras which control our instincts for survival, sexual energy and power. If you incorporate bandhas (internal energetic valves) into your practice you’ll find the mula and udhiyana bandhas within the realm of the psoas.

If you come from this place, both physically and energetically, you will have an amazing practice. An example of someone who moved from this space is Fred Astaire who gingerly floated a few inches above the ground as he danced. His movement originated from his psoas. I doubt that he was consciously aware of it, but his movements emanated from his psoas to his toes and fingertips. I’m sure he didn’t know it but he also utilized the bandhas and the energy to move his body. Just like any of the great yogis teaching out there now, Astaire mastered this area of his body and called on it regularly for strength and energy.

Using The Psoas In Sun Salutes

Let’s do a sun salutation paying special attention to our psoas. With your weight evenly balanced on both feet, become aware of the space near the level of your navel. Imagine finding length from your psoas as your spine lifts from your center. Every time you inhale, feel yourself getting longer from your psoas and spine. Do your first sun salutation very slowly and imagine every movement growing and blossoming from this area of your body. After you’ve done a few Sun Salutations, find your way into Warrior I. Sink into your legs and feel how grounded you are. From that very grounded and strong foundation lift your torso out and up through your psoas; your arms are reaching from your psoas, your spine and head growing longer from — yes you got it — your psoas.

This article was reprinted with the permission of David Keil. This article is the Copyright 2005 of David Keil and may not be reproduced without prior written permission.

David Keil was introduced to yoga in 1989 by his Tai Chi Chuan teacher. Both the Tai Chi and Yoga practice at the ripe age of 17 began his research into his own mind-body connections. As an Instructor of Kinesiology at Miami’s Educating Hands School of Massage, David had developed a fun, informal and informative style of teaching. David has a private practice where he uses bodywork techniques to relieve chronic pain. A Licensed Massage Therapist and Certified Neuromuscular Therapist, David has taught seminars in Body Mechanics for Massage Therapists and has also worked with other local and national audiences. David’s current practice is Ashtanga Vinyasa Yoga. For the past four years he has had the honor of studying with Sri K. Pattabhi Jois, in Mysore (four separate trips) as well as with John Scott, author of Ashtanga Yoga, who he also has the extreme honor of teaching with. David is authorized to teach Ashtanga Vinyasa Yoga by Sri K. Pattabhi Jois. For more information on David’s Ashtanga yoga schedule visit Ashtanga Yoga Miami or visit his other site www.yoganatomy.com

The pelvis: A keystone for yoga

By Liz Koch

http://www.yogachicago.com/sep99/lizkoch.shtml

The pelvis is the keystone of our physical structure and the foundation of a centered yoga practice. To feel centered and supported from within, our pelvis needs to be balanced and functioning as part of our torso without torques or twists. A balanced pelvis becomes a base of support for the spine, rib cage and head. It becomes a bowl containing and supporting the organs, nerves and viscera. A balanced pelvis frees the illiopsoas, the core muscle and increases range of motion in the hip sockets, preventing lower back and knee injuries.

The stable pelvis and the psoas muscle work in harmony-they form a partnership. The psoas muscle, a large, massive muscle, bridges the trunk to the leg. When used properly, it is a guide wire and as such, sensitively responds to the movement of the spine and the legs. When misused, the psoas muscle becomes rigid, limiting movement. Over time, misuse shortens the psoas muscle. A shortened psoas flexes and pulls on the pelvis, compressing the hip sockets and destabilizing the lower back.

As in any relationship, a dance occurs between pelvis and psoas. What often shortens the psoas is a destabilized pelvis, one that can no longer properly transfer weight from the trunk to the two legs. The psoas is then called upon to hold the trunk and leg together. Becoming a weight-supporting element, the psoas no longer can function freely as a muscle. It begins to function as a ligament and over time loses its suppleness as a muscle (i.e. begins to shorten).

In yoga asana, overextending, forcing a stretch and poor positioning can all stretch or tear pelvic ligaments, destabilizing the pelvis and shortening the psoas. Ligament damage or the overstretching of ligaments happens when they are under inappropriate tension. The pulling away of the bones one from another pulls, stretches, or tears the ligaments. Like the chicken and the egg koan, looseness in the sacrum and SI-joints calls upon the psoas to help hold the bones together. The body then further compensates by overdeveloping external muscles such as the hamstrings, gluts and adductors. This in turn pulls the bones further out of alignment and engages the psoas in holding the person together.

Proper positioning of the pelvis and releasing, toning and lengthening the psoas muscle is an integral part of stabilizing the pelvis. It is also an essential step in using the proper hip, pelvic and leg muscles, protecting the lumbar spine from compression and thus assuring the accuracy of each yoga posture. Focusing on the pelvis centers the work squarely inside the very core of your being.

To release the psoas, place yourself in the constructive rest position before you begin to practice asanas. Lie down on your back with the knees up and your feet on the floor. Arms rest below shoulder height to the sides, across the chest or on the pelvis. Place feet as wide apart as the width of the hip sockets, which are on the front of the pelvis to both sides of the pubis bone. In this position, the psoas will begin to release. No force is used to flatten the back. Just simply be in the position and focus your attention on the weight. Where is weight felt in the pelvis? Is one side heavier than the other? Do nothing but notice. As the psoas begins to release, after 5-10 minutes, the weight will begin to even out.

To tone the psoas, begin on all fours (cat pose) and explore the ability to shift weight from four points to three points. The position demands accurate placement of each bone in its socket perpendicular to the floor. Begin by releasing the psoas in the front of the right hip socket. Without shifting the pelvis, begin extending the right leg behind you, only releasing the leg to extend out. The movement begins at the hip socket-in the front of the socket-not in the dropping of the spine or the tipping of the pelvis. You can only extend the leg as far back as you can maintain a stable pelvis.

This is very exacting work. You cannot tone unless you can voluntarily release the psoas. Toning is the act of engaging the psoas properly. It is an eccentric muscle which means it never shortens. Engaging or toning the psoas means it never contracts, but falls back along the spine, always lengthening both the front and the back of the body.

For lengthening the psoas, the modified or full pigeon, when properly performed, is a psoas and iliacus stretch. Once again, positioning is crucial. Most people twist the pelvis in this pose. Rather, keep the pelvis balanced and stable, and release and stretch out from the core. Keeping the pelvis forward and stable may change the range of movement, but the stretch is deeper and you can isolate the stretch the psoas and iliacus muscle rather than pull on the pelvis. Lunges are psoas stretches.

__________________________________

Liz Koch is the author of The Psoas Book, a comprehensive guide to the iliopsoas muscle and its profound affect on the body/mind/ emotions. Liz was recently featured in Yoga Journal (May/June 99) and Yoga & Health (London England Oct 98).

Liz comes to Chicago Friday, October 22, 7-10pm, to Transitions Learning Center, “A Beginner’s Guide to the Psoas” (lecture and demonstration; October 23, NorthRiver Chicago, “A Full Day Psoas Intensive,” and October 24, Lakeside Yoga in Evanston, a 3-hour yoga class for teachers and advanced students. To register for Friday night’s introductory class, call Transitions, 312.932.9076; for Saturday or Sunday workshops, call Lakeside Yoga Center, 847.866.2818. Liz Koch’s website is www.guineapigpub.com.