These include the gluteus maximus, piriformis, and psoas muscles. The psoas muscle attaches to the vertebrae on your lumbar spine, and then crosses the outer edge of each pubis near your pelvis. It next joins with the iliacus muscle at your inguinal ligament in your groin region , and finally attaches at your femur. Your iliacus and psoas muscles are together known as the iliopsoas. See Lumbar Spine Anatomy and Pain.
You are able to stand and walk upright in part because the curve of your lower spine both bears and transfers the weight above it. The psoas muscle helps to create this curve, as it pulls your lumbar vertebrae both forward and down. The psoas muscle also plays another essential role in helping you walk. When you are walking, your brain triggers your psoas muscle to move your back leg forward—initiating the alternation between the front and back leg. Anatomically, the psoas is usually described as doing the actions of flexing the hip joint and externally rotating the femur at the hip.
But functionally, the psoas muscle was at a minimum designed to effectively and efficiently put one foot in front of the other, which we know as walking. It does the action of bringing your femur forward by flexing the hip joint. Sitting is something that many of us do for many hours in the day.
It is a common place where we run into trouble with our psoas muscle. Psoas is active and contracting to a degree meaning, not the same amount that it would contract if you were running, cycling , or doing a boat pose when we are sitting.
So, this very simple activity has the potential to increase the overall tension in the psoas muscle. The relationship of psoas to the sacroiliac joint is also extremely important. Without taking us to a completely new topic, it is the relationship between the psoas and the piriformis muscle that creates a muscular balance most directly at the sacroiliac joint.
The ligaments and other postural issues are always part of an SI issue, but muscularly the balance of tension between these two muscles is critical. Although there are plenty of strong ligaments around the SI joint, we also have musculature that helps maintain the balance of this joint.
The psoas is part of a pair of muscles that help maintain this functional balance. The other muscle in that pair is the piriformis, with some help from other associated muscles the deep six lateral rotators at the back of the pelvis. The piriformis and psoas relationship is important for maintaining a healthy balance of tension at the SI joint. Fascially speaking, the iliopsoas is connected to the entire wall of the abdominal cavity.
This includes:. What this means functionally, is that excess tension in any of these areas affects the function in the others. Because of the fascial relationship just discussed, there is a chance that a tight psoas muscle can have an effect on the diaphragm above.
Indirectly there may also be a tensional relationship between the psoas and abdominal muscles, which also have a fascial relationship to the diaphragm.
If you zoom out just a little more, you see a relationship between the psoas muscle and the layers of the gluteal muscles including gluteus minimus , gluteus medius , and gluteus maximus. This relationship affects a larger area than just the SI joint. It also has a tendency to draw in the quadratus lumborum QL muscle. This relationship is part of the larger topic of generalized back pain. The muscular balance of the spine and hip joint, along with all of the musculature that connects them together, can play a role in generalized back pain.
The psoas sits at the core of our body and in a sense, the center of our movement. The most fundamental movement we do is walking. Activities that create, in a sense, an excess of this type of movement such as running and cycling, are common causes of psoas muscle tightness.
Of course, these movements are often layered on top of patterns of tightness that may already be in place, exacerbating the problem.
For instance, people who sit a lot for work or other reasons, may have a chronically shortened psoas muscle. This essentially happens because the hip is held in a partially flexed position for long periods of time. This means that muscle activity is required, even if just minimally, to maintain this position and relationship between the spine, pelvis, and femur. If you combine all of these activities together, you cover a large portion of the population. Walking, running, and cycling are probably the most common physical activities that people do.
Sitting for long periods, represents what a large part of the population ends up doing between their movement activities. These are not the only activities that can cause tension, just the most common. The symptoms of a tight psoas muscle can certainly vary. Some may be more obvious than others. What I mean by that is it has become easy to jump to the conclusion that a problem in the back, hip, or surrounding areas is because of the psoas. Having said that, here is a list of things that MAY lead you down the path of recognizing a tight psoas muscle:.
The primary symptom is pain in the area where the lumbar spine and the sacrum meet one another. This is called the lumbosacral region. Be mindful that this can also include the sacroiliac joint. The pain is typical when sitting and standing, and worsens when doing any of the following movements:. Other areas of pain include the gluteals, lower abdomen, groin, iliac crest, and even pain on the front of the thigh. Because this is a syndrome, it means you need a diagnosis.
That can only be provided by a doctor who should be making diagnoses. If you think that you have this condition, please go to a doctor to confirm whether that is true or not. The psoas muscle is often associated with low back pain. The psoas is without a doubt a very important postural and structural muscle. When there is low back pain, we often look to posture as a culprit of this type of chronic pain. The psoas should therefore be part of the assessment of low back pain and its potential cause.
However, so far, there is no research that directly points to a relationship between low back pain and the psoas muscle. These may include some of the following. Rest is usually recommended, and then resuming gentle stretches and strengthening exercises. If your iliopsoas muscle is tight, stretches may be prescribed.
To stretch your iliopsoas:. You can also stretch your hip iliopsoas while lying on your back on a bed or massage table:. If your iliopsoas muscle is weak, strengthening exercises may be done.
Simple straight leg raises on your back or resisted seated marching may be recommended. Resistance can be added with cuff weights or with a resistance band. You can also strengthen your iliopsoas while standing. Simply use a resistance loop that is tied to a stable object. Place the loop around your ankle, maintain upright posture, and flex your straight leg forward. Hold the flexed position for three seconds, and then slowly release.
Strengthening exercises can be done for 15 to 20 repetitions. Two or three sets may be done once a day. Stop if you feel any increasing pain while doing the exercise. If a pinched nerve is causing iliopsoas weakness, getting pressure off your nerve may be recommended. Often this is accomplished by performing lumbar stretches like press-ups or supine lumbar flexion. Sometimes, lumbar side-gliding is helpful. Check with your PT to determine the correct exercise for your specific lumbar condition.
Pain in the front of your hip due to iliopsoas injury may be managed by applying ice or heat to the affected area. After a few days of ice, heat can be used for 15 minutes several times a day. Be careful; heat or ice may cause skin irritation or burns, so be sure to use a covering over any hot pack or ice bag. Your PT can help determine if you should use heat or ice and can be sure it is applied safely.
The procedure, often called a psoas release, is difficult to do, and it may be painful. Psoas massage is performed by having someone place their hands on your lower abdomen and slowly working through your superficial muscles to the deep area where your iliopsoas is located.
Once the iliopsoas is palpated, gentle massage can be done, or a static press on the muscle may be done. After a few minutes of massage, the psoas is released. Plus, psoas massage is painful for the patient and has not been shown to provide any superior outcomes when compared to stretching or strengthening. Before starting any treatment for your iliopsoas injury, visit with your physician and PT to ensure you are doing the correct things for your specific condition.
The iliopsoas muscle is a major hip flexor that also helps to move your spine. The three muscles of the group—the iliacus, the psoas major, and the psoas minor—arise from different areas of your pelvis and lumbar spine to form a common attachment in your hip.
Knowing the anatomy of this muscle can help you make good choices in caring for an iliopsoas injury. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Bordoni B, Varacallo M. Anatomy, bony pelvis and lower limb, iliopsoas muscle. Updated July 21, Anloague PA, Huijbregts P.
Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications. J Man Manip Ther. UC San Diego Health.
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