What is the psoas? Psoas (pronounced SO-az) is a muscle that gets a lot of attention for playing a role in back pain, hip function, spinal function, and sports performance and is often referred to as "the most important muscle in the body." Quite a claim for a muscle none of us can see and very few people really understand.
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The term "psoas" sometimes is used to refer to many things including:
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Anatomy of the psoas (and related muscles)
Psoas major: Skeletal muscle that connects the lumbar spine to the femur; contains deep and superficial fibers.
- Origin: Transverse processes of T12-L5 and the lateral aspects of the discs between T12 and L5.
- Insertion: Lessor trochanter of the femur.
- Action: hip flexion (considered a primary hip flexor), lateral flexion of the lumbar spine, stabilization of the lumbar spine, stabilization of the hip, external rotation of the femur, adductor of the leg when starting in an abducted position, and controller of lumbar lordosis.
Psoas major
Psoas minor: long, slender muscle superficial to psoas major that is present in about 50% of humans.
- Origin: lateral surface bodies of T12-L1 vertebrae and intervening intervetebral disc.
- Insertion: Pectineal line and iliopubic eminence.
- Action: weak trunk flexor, aids in stabilization of spine and hip joint, lateral flexor of the trunk.
Psoas minor
Iliopsoas: a combination of the psoas major and iliacus muscles and, when present, the psoas minor. These muscles are considered together often as one functional muscle group because of a common insertion on the lessor trochanter.
- Origin: Psoas, as mentioned above originates on the transverse processes of T12-L5 and the lateral aspects of the intervening discs and the Iliacus originates on the upper two-thirds of the iliac fossa.
- Insertion: lessor trochanter of the femur.
- Action: hip flexion (primary hip flexor), flexor of the lumbar spine on the pelvis, forward/anterior tilting of the pelvis, lateral rotation of the femur, stabilization of the lumbar spine, stablization of the hip, lateral flexion of the lumbar spine.
Iliacus muscle
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Conjoined muscle and tendon of the psoas major and iliacus.
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Hip flexors as a group: There are many muscles that play a role in hip flexion including: psoas major, iliacus, rectus femoris, tensor fascia latae, pectineus, sartorius, adductor longs, adductor bravis, and gracilis. Note: the anterior fibers of the adductor magnus, gluteus minimus, and gluteus medius all may assist in hip flexion and thus could be considered to be part of the hip flexor group.
Psoas and fear, anxiety, fight/flight/freeze, and emotional well-being.
When we encounter an external danger we experience fear which causes an physiological response in the body including contraction of the psoas. The psoas is a very important pelvic, spinal, and femoral stabilizer which would be important to brace the body to fight. The psoas is the primary hip flexor and its activation is important for running away from danger or flight. The psoas also pulls the body into the protective fetal position, or freeze stance. Anxiety, which is a generalized response to an unknown threat or internal conflict, will create a similar response to fear in the psoas. Fear and anxiety are both normal and healthy human responses, but in our modern society many people live in a constant state of fear or anxiety. 18% of US adults are affected by anxiety disorders and fear-mongering news is mainstream. American's are irrationally afraid of terrorists, diseases, the government, foreigners, and hundreds of other things. This constant feeling of threat keeps our body's and our psoas in a semi-contracted state. A contracted psoas sends our brain the message that we are still in danger and affects our emotional state and ability to function normally - both physically and psychologically. Restoring the psoas to normal length, tension, and function is said to restore normal emotional responses to events and life - otherwise known as piece-of-mind.
Filet mignon
The filet mignon, also called the tenderloin, is the psoas muscle, the most tender and often most expensive steak on the menu at any fancy restaurant.
Psoas and back pain
The psoas major as explained above plays a role in spinal, pelvic, and femur stability, mobility, and function. When the psoas is tight, short, or contracted, it can exaggerate a lordotic posture. For someone with lordosis, a tight psoas will further extend the lumbar vertebrae, tilt the pelvic more anterior, and hold the femur in flexion. This can cause painful compression of the lumbar discs, SI joints, and hip joints which can lead to disc degeneration, facet joint degeneration, SI joint degeneration, and hip joint osteoarthritis. The limited hip extension will decrease performance in all sports and put increased stress on the spine, knees, and ankles who have to compensate for the lack of normal hip extension.
Anterior pelvic tilt and lordosis
If a person has a posterior pelvic tilt and flexed lumbar spine, it can be exaggerated by a tight, short, or contacted psoas. The psoas will pull the lumbar spine closer to the femur resulting in lumbar vertebrae that are loose packed and vulnerable to disc herniation. This posture is a recipe for degenerative disc disease, stenosis, and sciatica symptoms. This posture will decrease performance in athletics by decreasing hip power delivery and decreasing balance and agility.
Posterior pelvic tilt and lumbar flexion
Restoring your psoas and achieving peace of mind
The most effective way to restore psoas length and tension is by doing the Supine Groin Progressive in the Egoscue Tower on a regular basis. The Tower lengthens the psoas to a normal resting length while balancing pelvic tilt and restoring proper lumbar and thoracic spine posture and function. The Tower will help restore left to right balance to your pelvis, femurs, and lumbar spine and this causes a chain reaction up and down the rest of your body. Restoring your psoas will decrease back, hip, and knee pain and improve sports performance. Achieving peace-of-mind by restoring normal psoas length and tension is possible and can be felt physically and emotionally.
Supine Groin Progressive in Tower
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Neutral pelvic tilt and spinal curve
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If you'd like to find out what your psoas is doing (Is it tight? Is it weak? Is it imbalanced? Is it causing your pain?) and what you can do to restore your psoas, contact me today for a free posture evaluation and consultation.
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