MIHP Think Tank Brainstorms… Movement Training Specialists

I’ll let it go… after this….

Let’s talk some more about the article in the October 2009 issue of Men’s Health, Small Muscles, Big Results, by Ted Spiker.  As much as I enjoy this magazine, I have to finish, or at least continue, what I started.

The next muscle that was discussed is the Psoas.  This muscle causes all kinds of problems if it is tight.  The article describes it beautifully: "The psoas muscle runs through your hips to connect the lower portion of your back to the top of your thigh. It's one of your body's main back stabilizers and hip flexors (the muscles that line your hips and allow you to bring your knees toward your chest). If you sit all day, the psoas becomes rounded like a banana; then, when you stand up, the psoas pulls on your back, making you more prone to pain and lower-back injury.  A weak psoas also means you'll end up with assorted knee issues, because other secondary hip flexors take over and cause pain."  The psoas becoming tight is very true and can and definitely does cause back pain, however, I've only seen a "weak" psoas with people who have suffered nerve issues from hip surgeries or other factors.  The way the article suggests to "Improve it" is to strengthen it.  They just explained how sitting too much can tighten the muscle and the exercise they suggest to improve it is to strengthen it?? "...by sitting with your knees bent on a low box or bench (6 - 10 inches high) and lift your knees.”  This is pretty hard to do if you have a weak psoas due to a neurological issue and just wrong if it's already tight. Although sitting all day can make the psoas tight, the majority of the time, the psoas becomes tight when it is overworked because the larger muscles are not doing their jobs.  Which muscles am I referring to, you ask?  I’m talking about the glute max and quadriceps. As described in my previous article “This could be you”, a quick way to inhibit the psoas is to lie on your back with a straight leg on the tight side.  Bring your leg slightly out to the side, turn your foot in, and bring toes towards you.  With the opposite knee bent, perform a straight leg raise ten times, being sure to squeeze the quadriceps (thigh muscle).  Then, get to work making sure to engage the glute muscles and give the poor psoas a rest.

There, finished for now.  Any questions?????

This could be you…

I have been working with this patient who has been experiencing left low back pain for several months.  It’s worse when getting out of bed in the morning and after sitting or driving for more than thirty minutes.  Every time I checked him, he would have the same lumbar dysfunction that didn’t always correct with manual therapy.

I decided to check his iliopsoas (the main hip flexor muscle composed of the iliacus and the psoas) for a tenderpoint. FYI : the iliopsoas attaches to the lumbar spine.  Sure enough, it was there.  Since this has been occurring for so long, I wanted to find a way that he could fix this himself.  So, I had him lay on his back with his left leg straight and his right knee bent.  He was to bring his leg out slightly to the side, turn his toe in and pull his toe up (towards his head).  Then I instructed him to tighten his thigh and do ten straight leg raises.  This exercise requires the quadriceps (thigh muscles) to engage which will automatically inhibit the iliopsoas.  When he was done, the tenderpoint was gone, the abnormal rotation of the lumbar spine was gone, and more importantly, the pain was gone.

So if you have a nagging low back pain that gets worse when you stand up, try this exercise.  It just may work.  If not, come in and we’ll figure it out.

Any questions?