Do we need to really squish on the psoas?
I get people in my door thinking they need their psoas released for a number of reasons – poor alignment, lower back pain, and other therapists telling them it’s their psoas that’s the source of their problems. Some clients think because it hurts or it’s sensitive that it necessitates work on the area. Or they’ve had their psoas reportedly pressed on which sucked so much but it helped their issues so they jump to the conclusion that the psoas is the source of the problem.
I’m fine dishing out a bit of deep pressure but I have my reservations about the psoas/abdominal area. Though I used to get into the psoas, or at least think that I was actually doing this, I’ve thought better of it. I don’t think it’s necessary to pry into an area that can feel very sensitive and vulnerable to help a person feel better.
I’ve also been on the receiving end. It feels nauseating and something I can live without. I haven’t had it in years and I do not need it to feel well or recover from whatever funkiness I may feel.
First of all, what is the psoas?
The psoas muscle is a deep core muscle, or the filet mignon cut of the cow. There’s much debate on its actual function – some say it doesn’t do much because the amount of force the muscle fascicles generate are small. Its compression and shear forces are greater than generating any motion in the lumbars so the conclusion was it primarily helped with forward bending and lifting (1).
Some say the dominant action by way of its location is lateral bending (side to side) and it creates stiffness throughout the lumbars when bending to the side or rotating around the spinal axis. (2). Consequently, there’s a general agreement that psoas activation increases as hip flexion increases (3).
It’s very safe to say that the psoas muscle is a deep-seated one with plenty of structures all around it and it doesn’t need messing with. Which brings me to my point that claiming one can specifically pin point the muscle with their bare hands is likely a spurious one. You’d have to push through abdominal fat, 3 layers of ab muscle, organs, and all types of nerves you don’t want to mess with. It’s hard to get to because the muscle sits in and back towards the spine (look at picture above).
There’s a lot in the guts
The abdominal region is sensitive for a reason. It’s a complex region with lots of structures going this way and that throughout. To say that we can use our hands to directly manipulate the psoas means we are going through the intestines/colon and pressing on nerves which line the muscle. It’s not worth the risk whether you use someone else’s hands, foam rollers, tennis balls, etc.
To offer perspective, this interview with a general surgeon who performs surgeries for a living says she treats the colon and intestines with the ‘utmost respect.’ She talks about how there’s so much in the way to get to the psoas because it sits in the back of the abdominal wall. It took her 30 minutes to carefully expose the psoas muscle. To claim manual intervention can pinpoint the psoas in a matter of minutes seems a less likely after watching this.
The video is worth 11 minutes of your time.
It stands to reason that a) we can’t specifically reach the psoas muscle;
b) it’s difficult to specifically claim the psoas is the issue if we have trouble in the abdominal/lower back regions;
c) it is a reassuring factor for clients who believe something is wrong with this area because of the implausibility of accessing the area;
d) if you’re going to work the abdominal area, start off gently. We can still feel relief by doing something nicer for your body;
e) if it feels quite horrible to deeply work in the abdomen, then there might be a reason not to do it. All the harsh sensations should be a solid reason not to deal with it even for the sake of therapeutic payoff. In other words, all that horrid discomfort is your body and brain saying, ‘get the hell off me!’
1. Bogduk N, Pearcy M, Hadfield G. Anatomy and biomechanics of psoas major. Clin Biomech. 1992;7:109–119. doi: 10.1016/0268-0033(92)90024-X.
2. Santaguida PL, McGill SM. The psoas major muscle: a three-dimensional geometric study. J Biomech. 1995;28:339–345. doi: 10.1016/0021-9290(94)00064-B
3. Andersson E, Oddsson L, Grundström H, Thorstensson A. The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. Scand J Med Sci Sports. 1995;5:10–16. doi: 10.1111/j.1600-0838.1995.tb00004.x.
4. [ The Movement Fix ]. (2014, March 19) Rolling out your psoas – Good idea? With Special Guest! [Video File] Retrieved from https://www.youtube.com/watch?v=XjJw0srmpeI