The Importance of the Psoas Muscle
The psoas is a fascinating muscle, crucial to our movement. Without it, walking would be impossible. It’s so essential that I always assess it in cases of musculoskeletal pain and poor athletic performance—even if you come in with pain in your little finger. That’s how vital the psoas is.
Unfortunately, modern sedentary lifestyles often lead to what I call “Ass in the Chair Syndrome,” where the psoas takes a relentless beating. This muscle definitely needs some love—but the right kind. Remember the classic dance song with the line, “Sometimes too much love is worse than none at all”? Hint: Machine.
Breathing Through Your Psoas
The psoas is connected to the diaphragm through connective tissue, impacting breathing, posture, and the fear reflex. Pain and fear can alter breathing patterns, often causing people to hold their breath to stabilize or anticipate pain. This leads to shallow breathing and an imbalance of oxygen and carbon dioxide in the body.
The fear reflex often draws people into a hunched-over ‘primal survival’ posture, which I call the ‘Vulnerability Reflex.’ This forward flexion, or “human cashew” posture, shortens the psoas, causing tightness and stiffness, and often leading to weakness. Remember, “If you don’t use it, you lose it.”
The Takeaway
Always incorporate breathing exercises when working with the psoas.
Spinal Stability Powerhouse
The psoas is a hip flexor and spinal compressor, not responsible for lumbar lordosis. Stuart McGill’s latest book provides great insights on this. So, if you notice an increased curve in your lower back, don’t blame the psoas. Bogduk (Clin Biomech, 1992;7:109-19) argues that the psoas doesn’t have a long enough lever to act as a prime lumbar spine flexor. Instead, it plays a key role in lumbar stability by supporting axial compression with minimal movement. The psoas uniquely crosses the lumbar spine, pelvis, and hip, making it a crucial stabilizer.
The Takeaway If you experience pain in your lumbar, pelvic, or hip areas, the psoas should be assessed for function. Poor stability equals vulnerability. Assess it, no matter where the pain is.
It Doesn’t Always Need Stretching
When people hear “tight psoas,” they often say, “stretch it!” A quick YouTube search reveals hundreds of stretching tutorials. But does it really need stretching? Assess it first. Tightness doesn’t always mean stretching is the solution. Most psoai muscles I evaluate are actually weak and neurologically inhibited, with delayed activation in their stabilization role. Stretching them can be detrimental.
With the delay in stability, your body compensates by relying on other parts, which may eventually cause discomfort in areas such as the hip joint, lumbar spine, or foot. To detect differences in your psoas muscle patterns, you can perform the Standing Hip Flexion Test.
Synergistic Hip Flexor Muscles
- Psoas Major
- Iliacus
- Pectineus
- Tensor Fascia Latae
- Sartorius
- Adductor Longus
- Adductor Brevis
- Adductor Magnus
- Rectus Femoris
- Gluteus Medius (anterior fibers)
- Gluteus Minimus
Standing Hip Flexion Test
- Stand 1 inch away from a wall with your back touching it.
- Slowly raise one leg into flexion, bending at the hip and knee as if standing on one leg. Take 4 seconds to lift it.
- Ensure your knee/thigh crosses the waistline. Relax your ankle and avoid holding tension.
- Keep the flexed leg straight ahead without abduction. Maintain your back against the wall.
- Keep the opposite leg straight with the knee locked. Breathe normally.
- Hold the lifted leg above the waistline for at least 15 seconds. Note any cramping, shaking, forward torso flexion, fatigue, or pain—these indicate possible weakness.
- Slowly lower the leg in 4 seconds.
- Repeat on the other side.
Did you notice any differences? If so, consider further assessment.
Takeaway
Always assess psoas strength before starting any interventions.
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