The iliopsas, or the psoas, is one of the most important and largest muscles of the body at an average of 16 inches long. The psoas runs the length of the lower mid-spine and connects to all vertebral bodies down to the hip and pelvis, making it crucial to fluid movement and flexibility of the legs, hips, back and pelvis. It stabilizes the body while sitting and standing. It lies partially in the back of the abdominal cavity and the back of the pelvic cavity. Because of this location, the psoas can be responsible for a long list of health issues ranging from abnormal menstrual pains and bladder pain to everyday low back, hip and knee pain. It can cause musculoskeletal problems like pelvic tilt and uneven leg length. It can even be a contributor for serious conditions like degeneration of the hip joints, pinched or herniated discs and scoliosis (abnormal curvature of the spine). Clinically, we very often see the psoas as a major contributor and source of back and hip pain in many cases.
If you have experienced such symptoms and have been given a similar diagnosis, you may be surprised to learn that trigger points in the psoas may be the true cause of the problem! Like the gluteus medius muscle, the psoas often contains latent trigger points that do not cause pain or discomfort until they are touched. Pain radiates from the psoas to other parts of the body due to the trigger points’ referral patterns. Therefore, many health care providers often overlook trigger points as a possible source of orthopedic and pelvic floor pains. Trigger points here frequently cause chronic lower back pain that people typically feel from the lumbar spine, which supports the weight of the torso, into the sacroiliac joints, which are located just beneath the lumbar spine.These trigger points then refer pain down into the pelvis and legs. Functionally, this muscle can cause pain with standing, walking, stair climbing and sitting.
Although pain from psoas trigger points can be severe, it can be treated effectively through a knowledgable physical therapist and a holistic comprehensive exam. We often find that the psoas is not the only factor in someone’s pain, but is a contributor. All the impairments need to be identified to see why the psoas might be involved and how to fix this cause. A physical therapist at Rebalance will assess your body fully to discover if your leg, back or pelvic pain has been misdiagnosed and if these trigger points are the true sources of the problem. They will identify lifestyle factors that may contribute to your pain, such as sleeping in the fetal position, sitting for prolonged periods with the trunk of the body and thighs too close to one another and performing sit-ups incorrectly, and suggest appropriate changes. They will teach you pain relieving stretches and exercises to perform on your own based on your individual needs. They will also take a hands-on and personal approach to treating your pain through techniques like myofascial release, in which the therapist will apply a gentle pressure into the affected muscle groups and connective tissue, and applying ishemic pressure to reduce and eliminate trigger points themselves, bringing the muscle from a shortened to a lengthened state.
Strengthening and lengthening the muscle is key in making sure that psoas trigger points cannot reactivate! If you are struggling with any of the symptoms described here, contact a Rebalance physical therapist to pinpoint the source of your pain and seek a solution.
