Stretching/Strengthening for the Psoas Muscle:
Recently we asked our facebook friends what they’d like to know more about from our Physio’s. One friend asked for information regarding stretching and strengthening of the Psoas muscle (pronounced Sow-us).
So let’s start off by talking about where the Psoas muscle is and what it does. The Psoas muscle group is one of your major hip flexors, and is divided into two parts – the Psoas Major (in purple) and the Psoas Minor (in yellow). Psoas Major attaches to each of the 5 vertebrae in your lower back then travels down and attaches itself to your femur bone (thigh bone) just below the hip joint. Along the way, Psoas blends together with another muscle called Iliacus (in red) and forms the muscle group known as Iliopsoas. The main role of the iliopsoas is to move your hip into flexion – bending your hip up. If you are currently sitting down, you can activate your iliopsoas by lifting the back of your knee of your seat. Although you need a lot of hip flexion with walking and running, your iliopsoas only has a minor role during these times as a lot of this hip movement is created by momentum. Your iliopsoas however does play an important part in providing stability during walking and running activities. Because it has attachments to your lower back it can stabilise these segments of your spine. However as good as this muscle can be at helping you during running, it can cause a lot of problems once it gets tight because it attaches to your back – it can put a lot of tension on your spine when it is tight. The muscle can get tight due to prolonged sitting (eg desk workers), excessive running/training or due to your lower back posture. This can cause lower back, hip or groin pain during running or walking activities.
Here are a few stretching techniques to improve your iliopsoas muscle length.
Lunge Stretch: Start in a lunge position, with the hip you are stretching as the back leg. Move your hips and torso as far forward as you can and make sure your back knee doesn’t slide forwards. Keep your torso upright and chest forwards. You can add more of a stretch by incorporating an anterior pelvic tilt – by tucking your buttocks underneath you and moving your pelvic bone towards you.
Thomas Stretch: Lie on the edge of a bed/table and pull your knee towards you. Let the other leg hang from the edge of the bed and keep it relaxed. You should feel a pulling at the front of your hip or thigh. This stretch is for the hanging leg.
These are the main two positions I use to stretch my hip flexors, and the ones I recommend to my patients. However there are lots of progressions incorporating different muscles and different body parts into the one stretch that you can try if you find that these two are not giving you much of a stretch.
Here are a few strengthening techniques:
The Psoas muscle being a hip flexor can be trained using resisted hip flexion exercises such as straight leg raises, sit ups or band/cable resisted exercises. However before I go through a few exercises that I use, I would say that Psoas strengthening is often not required for alleviating pain or improving biomechanics because Psoas weakness is uncommon. The problems involving the Psoas muscle in most cases relate to tightness or overactivity.
Strengthening of the Psoas muscle puts a lot of stress on your lower back, so before commencing these exercises speak with your Physio.
Straight Leg Raise: Lying on your back, lifting one leg up while keeping your knee straight, then slowly lower leg back done. Make sure you don’t arch your lower back during the exercise.
Leg Lifts/Straight leg raise: Lift your feet off the floor and bend your hips to 90°. Keep your knees slightly bent throughout. There are several different variations to this exercise – it can be done as a hold by keeping your feet hovering about 2cm off the ground for as long as possible, or add ankle weights to increase the difficulty. This exercise requires good core stability to perform it safely. If you haven’t got great core strength, or can’t do the exercise without arching you lower back then don’t perform the exercise
Standing Hip Flexion: Start in standing with your one leg slightly behind you and a theraband or pulley around your ankle while the other point fixed behind you. Lift your leg up so that your hip and knee are bent to 90°, then lower back down. Keep your hips level throughout the movement.
Strengthening your Psoas muscle is not always necessary, as it isn’t a muscle that requires large amounts of power during day-to-day activities. However if you are feeling like you are lacking power during kicking or other activities then some of these exercises might be helpful.
If you are experiencing pain or problems at the front of your hip, groin or your lower back then seek the advice of one of our Physiotherapists at Enhance Physiotherapy. They will be able to advise you which type of exercises you need to do to minimise your pain and optimise your performance.