Having low back pain? Look to the front! Specifically the anterior thigh and the hip flexor muscles.
The Psoas major and Iliacus muscles, together called Iliopsoas, is a large muscle that is involved in the action of hip flexion. With muscle fibers originating from the lateral aspect of the twelfth thoracic vertebrae, all lumbar vertebrae and their corresponding discs, and the iliac fossa, and then attaching to the lesser trochanter of the femur, which is high up on the interior thigh, this large muscle is also involved in lateral rotation and adduction of the hip, and flexion of the torso.
The psoas initiates walking while the iliacus is active throughout walking. Iliopsoas plays a significant role in postural stabilization, contributing to the natural curve of the lumbar spine by controlling the pelvic tilt.
Although these two muscles, psoas major and iliacus, are often viewed as one muscle and as a singular discrete unit of movement, it’s important that anyone doing manual therapy can also differentiate the muscle fibers of psoas and iliacus individually in order to fully assess and treat.
In a recent seminar entitled Releasing the Iliopsoas presented by Peggy Lamb MA, LMT, NCTMB Ms. Lamb discussed the manual therapy technique she developed and named Muscle Swimming used to work this muscle. The core components of Muscle Swimming are:
1) Warming the tissue and freeing the fascia before any deep tissue work using Swedish massage strokes.
2) Pin and rock which, after passively shortening the muscle, combines pinning the muscle with a broad, dispersed pressure while using a slow rhythmic rocking of the joint. Rocking stimulates a parasympathetic response and allows the patient to relax and thus the tissue can soften and now be worked deeper.
3) Pin and move where the patient is now an active part of the technique. The muscle is first placed into a shortened state and then stretched to just the first barrier and pinned. The patient performs, in a slow controlled motion, the actions of the muscle. This is repeated 4-5 times then check-in with the patient for any noted change. If none or little change, then the therapist can either add resistance to the movement or try a different movement pattern.
4) Work the muscle from different positions. Ms. Lamb also detailed specific protocols using her Muscle Swimming for working/releasing iliopsoas and the secondary thigh flexors. When working the iliopsoas muscles it is always a good idea to first begin work with the secondary hip flexors: rectus femoris, adductors longus, brevis and magnus, Sartorius, TFL as these muscles can also be involved when the iliopsoas is problematic.
Address Low Back Pain and Other Symptoms
So, what are some indications that you need to have the iliopsoas worked on? Low back pain, pain in the anterior thigh, pain the in the lateral thigh due to active trigger points, and difficulty rising from a seated position are just a few that a Portland chiropractor can address by working on the iliopsoas.
