Tuesday, October 19, 2010

Overview of the Psoas Muscle

I had heard of the psoas muscle before since I had been taking Anatomy & Physiology for pre-nursing requisites in college. I don’t think I had ever given this particular muscle much thought except to memorize its name and location for an upcoming test. Now, as a Massage Therapist, all muscles have taken on a new and much more interesting meaning. Muscles are no longer just a list of names and locations to memorize but paint an eloquent picture of the human landscape. Every movement, no matter how small, and every emotion is influenced by our muscles and tension patterns held by them. One muscle that particularly relates to all aspects of one’s life is the psoas. I know that may sound a little bizarre to describe a muscle as affecting ‘all aspects of one’s life’, but the psoas is truly remarkable and responsible for many of our postural and emotional responses. Liz Koch’s The Psoas Book has also really opened up a new way of perceiving muscles for me and I give credit to her wonderful book for most of the information here.

There are technically two parts of the psoas muscle, the psoas minor and the psoas major. The psoas minor is found in less than 50% of the population and is considered a vanishing muscle left over from our evolution into bipedal humans. The psoas major is the main part of the muscle and I will refer to it as the psoas from here on. The psoas is approximately 16 inches long and directly links the ribcage with the legs. It originates superiorly from the vertebral bodies and intervertebral disks of the twelfth thoracic to the fifth lumbar, and from the transverse processes of the lumbar vertebrae. The psoas then inserts inferiorly with the iliacus muscle by way of a common tendon to the lesser trochanter of the femur. These two important hip flexors are collectively known as the iliopsoas.

Internal location of the iliopsoas and external corresponding structures. The red areas on the surface of the body indicate possible areas of pain/discomfort associated with the psoas.

The psoas is located at the deepest core of our structure, where our ‘gut feelings’ reside. Sometimes our first instincts begin here. The psoas is strongly innervated since it inserts directly behind the diaphragm along the lumbar spine. At the L1 vertebrae, the psoas and diaphragm junction at the celiac (solar) plexus, directly linking psoas function to our breathing and digestion. This relationship illustrates that a constricted psoas can adversely affect one’s breathing and digestion. This area holds a lot of personal power and energy, so it is important to understand how interconnected our bodies are physically and emotionally. The lumbar plexus is also embedded in the surface of the psoas, which directly supplies energy to animate the legs and strongly influences both sexual and anal functions.

Starting from the lumbar spine and crossing over the hip joint, the psoas directly affects range of motion of the pelvis and the legs. The psoas has many functions, with the most direct and obvious being its role as a hip flexor. It supports the free swing of the legs while walking and is very important in transferring weight though the trunk to the legs and the feet. Sturdy and balanced walking should originate from the core and not from more superficial muscles. Through the action of walking, the psoas also acts as a hydraulic pump, stimulating and pushing fluids in and out of cells. The psoas plays a big role in posture by acting like a guide-wire that stabilizes the spine. Rectus abdominis counterbalances the tension of the psoas. When this relationship is out of balance it often leads to the ‘chest-out-belly-in’ posture. The psoas also has an intimate relationship with the internal abdominal organs by acting as the psoatic shelf. The psoas creates a support base along the bottom and back of the pelvis, upon which the abdominal organs rest. Therefore, tension in the psoas affects the space and function of the internal organs.

Because the psoas is so integral to the makeup of our body it is important to understand how it affects us in everyday life. First it is worthy to note that the prime function of bones is to bear weight and act as a lever system, whereas muscles serve as the pulleys that move the bones. This is an important fact because as soon as muscles start being used to support weight and resist gravity they no longer serve their original purpose. Over time, this improper use can put stress on the bones changing their shape, effecting the articulations of joints and even decreasing blood circulation in surrounding tissues. The psoas is a core muscle and therefore sets the tone for other muscles in the body. The resting length and condition of the psoas influences the relationship of bones and therefore influences the range of motion and articulation of the joints. A shortened psoas can cause many postural problems limiting range of motion in spine and limiting movement of the pelvis and legs. This may be seen as a forward thrusting of the pelvis and can be caused by the psoas being continually contracted or misused, sometimes stemming from poor body mechanics learned at a young age. A shortened psoas can lead to exaggerated curves in the spine known as lordosis – excessive forward curvature of the lumbar spine (saddle back); kyphosis – excessive backward curvature of the thoracic spine (hunch back); and scoliosis – abnormal lateral curvature of spine (side-ways S curve).
A shortened or chronically constricted psoas can affect many aspects of a person’s life, physically and emotionally. A shortened psoas can lead to a chest-out posture where the ribcage is thrust forward. This posture emphasizes thoracic breathing instead of abdominal breathing and prevents the diaphragm from contracting fully. The limited range of motion of the diaphragm leads to decreased massaging/stimulation of the internal organs which subsequently can lead to impairment of nerves and blood circulation. When the psoas is shortened it decreases the space in the lower trunk of the body and can affect many other internal structures in the area. This includes the abdominal aorta, which runs next to the psoas and may affect circulation; pressure on the lumbar plexus and autonomic ganglia can affect adrenal and kidney function; and many menstrual cramps in women can be caused by a contracted psoas putting pressure on the organs. Having muscles supple and open in the pelvis allows for the free circulation of sensations. Without this, sexual dysfunction and loss of connection with the sexual organs may also result. Sexual energy can become blocked and restricted leading to inability to orgasm in women and even impotency in men.
Because the psoas lies at the core of our or body and is one of the main flexors, it is important to note its role in the fear reflex. The fear reflex is one of our most basic instincts that is integrally part of us with the purpose of protecting us from any stimulus that our body may perceive as harmful. This reflex signals all flexor muscles to contract and results in what is known as the fetal position, giving the body a form of defense and protection. Our instincts during the fear reflex give us an option to fight or flee (the famous fight-or-flight response), preparing us to take action or evade a stressful/dangerous situation. In today’s world it may not seem like we encounter this reflex all that often, but with the constant stimulation and stressors present in modern society we are exposed to much more than we are aware of. The constant barrage of stimuli that we are subjected to on a daily bases gives our bodies a certain level of stress and activates our nervous system and fight-or-flight response. How one handles such stress greatly depends on how one has been conditioned over their lifetime. Those that have learned to relax deeply and return to a more neutral functioning after the reflex has been activated will have a lot less tension held in their body. This could mean just letting yourself unwind at the end of the day or even meditating. This gives the nervous system and muscles a break and helps to bring your body back into a more balanced state. For many people it does not work this way and they do not, or can not, avoid the constant stimulation and stress, and therefore there is no refractory period from the fear reflex. In other words, there is no recovery time between the body’s reaction to one stressor before another one comes along. What happens here is that the fight-or-flight cycle is never finished so stress and disharmonies with in the body begin to build up. As the tension and stress accumulates in the body it begins to affect different aspects of one’s health, namely in the manifestation of anxiety. Anxiety in the body can be expressed as many different things form digestive issues, muscular pain or weakness, and even decreased immunity.
Since we are constantly dealing with so many stressors in daily life it is easy to see how this can negatively impact our bodies. Muscles hold physical and emotional tension so it is important to have an understanding and awareness of our bodies so that we can deal with stress appropriately. The psoas, being a major flexor and postural muscle, goes through a lot during a lifetime. Working with the psoas to help it release and elongate is a very intimate process in body awareness. At first you must become aware of your body and the subtle sensations within. The Constructive Rest Position is a great way to begin to understand and become more aware of the psoas and the core of your body. This position allows for passive release of the psoas by letting gravity do all the work. To take this position Liz Koch says to “lie on your back, bend your knees to about 90 degrees, and place your feet on the floor in line with your hip sockets, 12 to 16 inches from your buttocks. Be careful not to flatten or exaggerate the curves in either your lumbar or cervical spine.” This may be uncomfortable at first but relax and make sure to use no force and allow your body to rest naturally on the floor. Bring your awareness to your pelvis and notice what feels tight, restricted, or areas that are resisting the pull of gravity. After hold this position for a while you will notice your low back will release and sink further towards the ground. “This is a result of the psoas muscle releasing.” Make a conscious effort to stay in the moment and pay attention to the sensations of your hip sockets and low back. “Being in the moment forges new nerve pathways by letting go of old conditioning”, allowing us to better understand and communicate with our body. You can stay in this position as long as you like, usually about 10-20 minutes.

Constructive Rest Position

Once you become aware of the internal sensations and skeletal positions associated with releasing the psoas you can move on to more actively working the muscle. There are many positions to elongate and stretch the psoas, but the most important thing is appropriate body awareness so that the muscle is isolated while the rest of the body is relaxed. After releasing the psoas in the constructive rest position one can easily move into the active supine stretch. Continue lying in the constructive rest position. Begin by bringing your right thigh up toward the trunk of your body and gently hug your right knee. Be very aware to not move or tilt the pelvis while raising the right thigh and focus awareness to softening the hip joint. Now you are ready to stretch the left psoas. Slowly begin to extend the left leg out while keeping the pelvis still. The goal here is to isolate the movement of the leg from the pelvis. Focus your attention to the left hip socket and allow it to soften and release, feeling the psoas lengthen. Use no force and extend your left leg slowly into the stretch. Notice any sensations that you experience and STOP if anything is painful in the low back, and go back to the constructive rest position to help release the psoas again.
The active supine stretch is a gentle and easy way to begin working and elongating the psoas. Any variation of the lunge, or runners stretch, also focuses on stretching the psoas. Yoga also offers many great poses that work with lengthening the psoas, most notably pigeon pose (Eka Pada Rajakapotasana). For more information on specific stretches you can visit YogaJournal.com (http://www.yogajournal.com/practice/169) where Liz Koch has put together a nice summary on 10 poses beneficial for the psoas.
Releasing and stretching the psoas are both very important to the overall health of the body. By gaining better awareness of our bodies and being able to understand our bodily sensations we can start to change some of the negatively conditioned muscle patterns and practice proper body mechanics. To do this we must also strengthen our muscles. Before you begin to tone the psoas you must make sure that it is released. If the psoas is not released, your body will try to compensate incorporating the wrong muscle groups to perform the movement. To practice this next move for toning the psoas we will be using the same position as in the Active Supine Stretch (can also be done with the right leg planted at a 90 degree angle on the floor). Be sure to keep your pelvis stable so that the proper muscles are engaged. Once you are able to fully extend the left leg (or whichever side you are working on) you are ready to start toning the psoas and leg muscles. Begin by lifting the left leg about 6 inches up to the height of your hip socket. Slowly move the extended leg up, down, sideways left and right, and diagonally. Liz Koch says “When lifting your leg, think of the psoas muscle falling back along the spine and scooping the leg off of the floor.” This imagery will help isolate the appropriate muscle groups.

There are many different approaches for working with the psoas. They vary from indirect, such as the movement arts, to direct, such as manipulation in bodywork. The movement arts include such things as Jujitsu, Aikido, Tai Chi, and other martial arts. The stance and posture of Tai Chi utilizes gravity to one’s advantage. “In Tai Chi the body is placed in a position where the six outward rotators are eccentrically contracting with the abdominals and gluteals relaxed. This eccentric contraction of the six outward rotators counteracts the short resting length of the iliopsoas as well as gravity.” To sum it up, the use of the appropriate muscles and gravity are utilized to stretch the iliopsoas and associated hip flexors. Tai Chi posture and movement are great for the entire body and with regular practice and discipline can help stretch and tone muscles while opening joints and increasing range of motion. Yoga is another form of mindful body movement that can help to stretch and strengthen both body and mind. It is very important to be aware of your own body and own limitations during yoga. Never push yourself further than where you feel comfortable. This can be severely counterproductive and even lead to injury. Finding a good instructor who understands the appropriate approach to postures and can guide you through the correction of postures is essential. This will insure that you are using the correct muscle groups and learning a proper technique. All together, any of the movement arts that focus on mindful body movements will benefit not only the psoas but the entire body, mind, soul.
Bodywork for the psoas, and just bodywork in general, comes in many different styles and options. Finding the one that appeals and suits you is as important as finding an experienced practitioner that you trust. There are some practitioners that focus souly on the psoas and deeper core muscles and then there are those that work with the entire body. One form of bodywork that works by directly manipulating the psoas is Rolfing. Rolfing is a "holistic system of soft tissue manipulation and movement education that organized the whole body in gravity" (Wikipedia – Rolfing: http://en.wikipedia.org/wiki/Rolfing). Rolfing releases bound up and adhered fascia by directly manipulating the psoas and connective tissues around it. This form of therapy can be powerful and overwhelming for some and is not recommended for everyone. Others may find it exactly what they need. A less intrusive method that focuses more on refining awareness of one’s body and works to change muscle tension patterns is The Feldenkrais Method. Feldenkrais really emphasized developing the mind-body connection and awareness through movement as ways to learn one’s own body. These are only two of a vast array of bodywork options. Look into local practitioners in your area to find out what is available to you and what will work for you.
As you can see, the psoas is a very powerful muscle, responsible for much more than we give it credit for. Developing and attuning the body-mind connection is very important to understanding our own bodies, how they work, and what we can do to help achieve harmony with in. As Liz Koch says, “An understanding of the influences of the psoas muscle on skeletal balance, muscular tone, and the health of the breath, nerves and viscera, builds the foundation for comprehending the indispensable role the psoas plays in having not only a healthy physical life but also a healthy emotional life.”

1 comment:

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