The Amazing Psoas Muscle

How It Relates to Low Back, Hip and Sciatic Pain

Prior to becoming a mother, I used to have a lot of fun dancing salsa. When my daughter was about 3 or 4 my was-band, Chad, gave me a Christmas gift of salsa lessons for the two of us. As luck would have it, shortly thereafter, we had the opportunity to dance salsa to a live band. I figured 1 & ½  hours of dancing would be okay since my prior dance adventures averaged about 5 hours. I couldn’t have been more wrong!

The next morning I could barely get myself out of bed. Standing up or sitting down was so painful it was scary to contemplate. The first thing Chad says to me: “we should check your psoas”. My response: “it’s not my psoas, it’s gotta be something worse than that!”. But of course, with the gentlest palpation, the psoas was obviously the cause of pain. This came as a complete surprise to me because I was (supposedly) an expert on the subject of the psoas: it had been my favorite muscle for at least a decade & a half at this point. There is nothing like severe pain to teach a person the REAL story.

Fortunately, my misadventure with the psoas was short lived. Daily acupuncture combined with therapeutic hot stone massage got me free of pain in a matter of days. However, my experience changed my whole perspective on this amazing muscle and also inadvertently expanded my repertoire for healing techniques.

Clinically, what I see most often as a causative factor for psoas problems is stress, not injury. This is probably because the psoas is connected to our limbic system, also known as the reptilian brain. This is the part of our brain that is directly connected to the nervous system so that we can get out of danger quicker than processing through our relatively slow cerebral cortex. A good example of this is moving our hand off a hot stove. Another example might possibly be running from predators, back in the days when such things applied. We no longer have saber-tooth tigers, etc., but we do have financial pressures or challenging relationships or any number of modern “saber-tooths”.

To get a better understanding of how the psoas is connected to the Limbic system we have to look at its structure. The psoas is physically connected to the diaphragm, so breath is integral to its function. When we get startled by fear the diaphram immediately contracts, signaling the psoas to contract in anticipation of impending danger.

The psoas is also physically attached to all of the lumbar vertebrae and to the entire inner lining of the ilium (hip bone) and finally ends on the inner upper thigh. This makes it very stable, plus a very important muscle for running and jumping, especially up hill. As a re-cap: it is a huge muscle that is located exactly in the middle of the body, from any direction of view, and connects the upper body to the lower body.

The psoas is perfectly designed to get us out of danger quickly: breath, stability, stamina, legs-plus-back connection.

Because of the location and stabilizing function of the psoas, when it contracts, a lot of other muscles become affected by trying to pull it back to proper alignment. Structural sciatica, versus disc damage, always involves the piriformis as it is located on the underside of the sacrum where the sacroiliac joint is located. When the sacroiliac joint is out of correct alignment then you can get what feels exactly like sciatic pain. However, muscle caused sciatic symptoms are much easier to resolve than disc or spinal issues which are mostly related to deterioration. In that case surgery is generally what is required to fix the issue.

Okay, if any of the above info seems related to your back or hip pain what can you do to assist the healing? One of the best things you can do is a body meditation which focuses on the psoas. Lay down on your back with your legs propped up under several pillows, or in the fetal position on your side with pillows assisting proper alignment. Then imagine your psoas. When you get a good picture, ask it if there is any communication that would be good to share with you. It may not say anything, but just start hurting. That is actually just fine; it means that the stress of the day is being released instead of being added to the muscle’s storage. All muscles have this function, but the psoas is more pronounced, due to its Limbic system connection. By tuning into the psoas specifically we are accessing storage of stress that may have other components besides just physical ones. For example, when a baby is held by its feet and slapped, the muscle that attempts to get baby back into the safe fetal position is the psoas. Future “slaps” from behind can create psoas contraction as a coping strategy. Another example is a car accident. If you are in a severe accident the body immediately activates the limbic system as it knows that death could be one of the outcomes. This dynamic can continue each time you get in a car. Similarly to the psoas meditation you can remind your body that the accident is not going to get repeated every time you get in the car, until fear is no longer present. Fear is sometimes hard to track, but muscle contraction is a direct feedback loop about that.

Other modalities that are useful for supporting the recovery of the psoas are acupuncture and gentle massage: pain during session should never go past a 5 on a 1 to 10 scale. The psoas fights back by getting tighter if treated too aggressively. In the category of massage, I find therapeutic hot stone to be very helpful as the heat relaxes the muscle so that the therapist is able to go much deeper in a session without causing pain.

Standing Chi Kung is also another helpful tool, when taught by a high level teacher. I recommend working with Shanti Webley at Fire Water

Things to avoid when the psoas is healing: stairs, “crunches” or abdominal work (as these utilize the psoas), walking up hill, riding bike up hill, any kind of jumping or kicking, lifting weights that utilize the legs.

Recap:

1. Daily meditation for the psoas at end of day (at least 10 minutes, or until pain lets up).

2. Acupuncture: consecutive treatments are recommended since it is such a large muscle.

3. Gentle massage: hot stone is best &/or self massage which allows patient control of pain level.

4. Avoid hills & ab work.

5. Be gentle & go at the speed your body desires, in terms of healing this truly amazing  muscle.

6. Minimize stress, if possible.

The most important aspect to healing the psoas is patience, closely followed by eliminating or managing stress. The psoas fights back if we try to bully it back into shape. It is a muscle that teaches us to tune in and really listen: a skill that is always a blessing in the big picture.

The other thing to remember is that once it is healed it can then be a warning system in the future. When it contracts again it can bring awareness to the fact that there is something that needs processing emotionally.

I once had a patient, prior to moving to the Rogue Valley, who had (unsuccessfully) gone through two back surgeries. She was a referral from a psychiatrist who was convinced that her pain was psychosomatic. Within one minute of laying on my table it was determined that the cause of her pain was actually her psoas. It turns out this lovely and courageous woman was a nurse. She towered over the attending physician and had to lean forward to assist him in surgeries, hence the psoas contraction.

I mention the above story because the psoas is attached to each lumbar vertebrae, in addition to the leg(s). When it is severely contracted it can pull the vertebra forward thereby making it look like there is a disc problem. It is always important to get a correct diagnosis so that we can properly heal. Back surgery is sometimes the best answer, but obviously not always.

Good luck on your journey to recovery,

Yours in Health & Vitality,

Leslie Shanai