Psoas Says, "Work Me!"

Many clients seek bodywork to relieve lower back pain and, oftentimes, the therapist they visit responds by focusing directly on their backs. Makes sense, right? However, the muscles located on the back are not the only muscles that help to maintain lower back function. The result is that some clients do not receive the desired relief from their pain. The psoas is a low back muscle that is often overlooked but requires attention, nonetheless, if a client is to receive complete care for back pain. The following is a brief "lay man's" discussion of the muscle's location, function and symptoms when the muscle is tight so you, the consumer, can play a more informed role regarding your own care.

The psoas, is a long, thick muscle located directly on the anterior (front) sides of the spinal column and can only be accessed by pressing into the mid to low abdomen on either side of the navel. It attaches at the T-12 vertebrae, is connected to the subsequent descending vertebrae leading into the pelvis where it blends with the illiacus (a flat muscle located on the inside of the pelvis), then extends over either side of the pubic bone and then inserts on the medial sides of the lesser trochanters. The psoas primarily activates when you walk. It also helps to stabilize and balance your torso and abdomen when you are sitting, and it helps to support the lower spine and the pelvis. When this muscle gets tight, it pulls at, and compromises the integrity of the bones, muscles, and associated vertebral bodies to which it is attached, creating dysfunction that can result in pain along the front side of the legs, and in the lower back. It can also result in simulated sciatic pain, scoliosis, kyphosis, lordosis, and even menstrual pain, to name a few issues. This may be more information than you want or need to know but it is important to know where the muscle is, what it does, and what problems can arise in order to better understand what is happening in your body.

Treatment of the psoas can be a bit uncomfortable because it requires working past the organs in front of the muscle and applying direct pressure to the muscle itself. Additionally, clients sometimes feel understandably vulnerable in regard to having their bellies exposed and massaged. However, from personal experience (both as a client and as a practitioner) the relief received is well worth the few minutes of discomfort. If you are concerned about the discomfort you might experience, remember that you can ask the therapist to modify the pressure according to your comfort level. If the discomfort feels good, breathe deeply and enjoy the feeling of the muscle as it releases. If the discomfort feels bad and you find yourself tensing up, ask your practitioner to reduce the pressure. Yes, you have the right to request and expect a depth of pressure that you are comfortable with.

While lower back pain can manifest in various ways, from mild discomfort to debilitating pain, psoas work can reduce back pain and support back health. If you do not feel relief after receiving a few massage session, express your concerns with your practitioner and consider exploring additional avenues to treat your issue. Moreover, if you have a disc displacement, rheumatoid arthritis in your lower back, or another medical condition that is affecting your back pain, consult your physician before receiving massage treatment.