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Lower back pain is one of the most common complaints clients have when coming in for a massage. So it would make sense to focus on the low back right? Yes, BUT massaging the opposing muscle groups are also important. In fact they are key to a successful outcome, which is usually reduction in pain, increase in ROM, or more fluid mobility and balance. The often overlooked muscle which can be a cause of low back pain is the psoas.
The psoas is a common name for the properly called muscle illiopsoas. It includes the illiacus muscles that line the front of the hip bones. The psoas muscles themselves lie buried behind your abdominal muscles and your intestines. The primary action of the psoas is to flex the hip; or raise your thigh toward your stomach. The psoas muscles also play a large role in raising your body to a sitting position when you’re lying down.
Psoas muscles are often overloaded from falls, strenuous running or climbing (such as stairs), abdominal exercise and sitting for long durations. Frequent stooping, leaning, or slouching also causes tightness of psoas muscles because they are constantly contracting to maintain upright body position. This overload can lead to trigger points. Trigger points in the psoas muscle refer pain to the low back on the corresponding side of the body. This is why pain is felt in the low back but the source of the pain may not be there.
Psoas trigger points are found deep in the abdomen about two inches from each side of the belly button. They are easier to find when lying flat on the back, knees falling to the side to move the inner organs out of the way. A strong pressure is rarely, if ever, needed in the approach to the psoas. It’s delicate, proprioceptive nature means it responds quickly and easily to gentle touch. Your massage therapist may cue you to breathe normally as they sink into the abdomen area slowly looking for tightness and trigger points. As these trigger points are released your back pain subsides. There may be additional muscles involved in causing back pain but the psoas is not one to leave unattended.