The Psoas and the Iliopsoas are the major muscles that allow our hips to move, flex and facilitate the overall mobility and locomotion in our bodies. Along with the Iliacus, these three muscles form the basis of what are known as the Hip Flexors. The hip flexors interact with several other muscle groups, including the groins and lower abdomen, and play an important role in stabilizing the pelvis along with their major function in promoting the adduction and abduction of leg movements.
Because the Iliopsoas interacts with so many different muscles – weakness, imbalances and injury to the muscle often lead to antagonist muscle groups weakening or becoming injured. For instance a weak psoas major can lead to instability in the hips, causing an over rotation of the pelvis, leading to a ‘sway back’ which can result in all sorts of lower back and hip pain.
Furthermore, chronic injury like iliopsoas tendonitis can affect the groins and their ability adduct the thigh properly. Athletes likely to incur hip flexor injuries are those that require quick, bursts in both lateral and straight line directions like basketball, football, hockey, soccer and martial arts that require lots of kicking. Proper warm-up and stretching of the Psoas muscle can go a long way to the prevention of any injuries or tendonitis. Below we explore the ins and outs of the hip flexors and detail different strength training exercises and psoas stretches for improving mobility and reducing injury.
What is the Psoas Muscle?
There are two layers to the Psoas Muscle. One is deep and the other is superficial. The lumbar plexus is embedded between the muscles. The nerves here are dense and they innervate the oblique and transverse abdominals, deep hip rotators, the pelvic floor, and the thigh muscles. Since the Psoas is able to pass over multiple joints and it attaches in multiple locations plus it entraps the neurological network, it makes perfect sense that a variety of injuries can be blamed on this muscle when it misbehaves.
11 branches of muscle fibers are contained in the Psoas Major Muscle. They are called fascicles that have separate attachments to bony areas. The superior fascicle attaches to the lower thoracic vertebra. Others are attached to other areas along the lumbar spine and the last attachment is on the femur. This muscle joins the Iliacus and forms the iliopsoas and is surrounded by the iliac fascia.
Originating in the pelvic crest, the Iliacus attaches on the femur. The longer of the two muscles, the Psoas Major originates at the lumbar vertebrae and also attaches onto the femur. One of the Quadriceps muscles, the Rectus Femoris crosses the hip joint. In addition to the hip flexor, crossing the hip joint allows the muscle to operate the hip flexor and the knee extensor.
The Psoas Muscle allows the torso and lower back to be brought forward toward the quadriceps. Then the hip flexors, which include the Iliopsoas flexes the spine on the pelvis. Due to the frontal attaching on the vertebrae, the Psoas stretch is accomplished by the rotation of the spine.
Playing a direct role in the upright stature of humans, the Iliopsoas is a very important postural muscle. The Psoas Minor is absent in almost 40% of all individuals. Bending the hip, the strongest hip flexor muscle is the Psoas Major.
Interaction between Iliopsoas, Groin & Quadriceps
Running, walking, and standing all require use of the Iliopsoas, Groin, and Quadriceps. When postural changes occur, the Psoas Major and the Iliacus perform different actions. The Iliac Fascia covers the Iliopsoas Muscle. It starts out as a tube-shape and surrounds the Psoas Major Muscle and the Arcuate Medial Ligament as it passes under. Along with the Iliac Fascia, it will continue downward to the Inguinal Ligament and the Iliopectineal Arch is formed. This separates the Vascular and Muscular Lacunae.
When you decrease the angle or space between 2 bones of the hip joint that is hip flexion. It is like kicking a ball, in that motion you flex your hip and thigh thus decreasing the femurs angle and the Iliac or hip bone.
The muscles responsible for hip flexion are the Rectus Femoris, Sartorius, and the Iliopsoas.
Drawing your legs up for example is flexion. The human body extends, rotates, and flexes with all the muscles working synergistically to maintain balance in the front, sides, and back of the body, giving way for the movements to be completely successful.
The Sartorius muscle is the longest muscle in the body, it begins at the upper portion of the pelvis (the ilium) and descends crossing the anterior compartment of the thigh, attaching to the medial side of the knee. The Sartorius is responsible for both the hip and knee flexion, in both cases abducting the muscles (the movement away from the middle axis of the body) so the hips are able to rotate and the knees able to extend.
Iliopsoas Tendinitis, Bursitis, Hernia & other Hip Flexor Injuries
2-5% of most sports injuries are in the hip and pelvis area. Groin pain is a very common finding among these injuries. Some of the more common injuries are Iliopsoas Tendinitis, Hernia, Bursitis, musculotendinous, adductor tendinitis, and quadriceps strains. iliopsoas bursitis and tendinitis are close cousins because when one if inflamed, inevitably the other becomes inflamed because of the close proximity to each other. In terms of presentation and management, these two conditions are almost identical.
Basically, iliopsoas tendonitis is the inflamed tendon or the immediate area surrounding the tendon. Major causes of this condition are an acute trauma and over usage that is a direct result of repetitive Hip Flexor stretches.
Postural imbalances that are developed leave the Psoas caught right in the middle. It is important to know your body and figure out of your pelvis tends to tip more forward or backward. Next work on releasing the offender muscles. The Iliacus is a partner in crime to the Psoas. They share a common tendon on the attachment point of the femur, however the Iliacus is originated at the pelvis and not the spine like the Psoas. Most often the Iliacus is harder to access than its partner the psoas, but it is worth the consideration because it could actually be the real root of the problem.
Discovery of the troublemaker is actually pretty easy. If you have ever had interior hip bone discomfort and as you try to perform a Psoas Stretch, the pain intensifies you will realize it is due to a tightening of the Iliacus. It is important to understand that Iliacus doesn’t have the same record for causing the spine to be pulled out of alignment, but it is directly affected by the supporting musculature’s imbalances.
A direct weakness of the Iliopsoas might result in “flat back or “sway back”. When the line of gravity drops a bit posterior to the axis of the hip, an extension at the hip is created. In normal conditions, an internal flexion activates the Iliopsoas and counteracts any external force. The “sway back” is also referred to prolonged hyperextension and it increases the stress that is placed onto the anterior hip joint ligaments as well as the anterior joint capsule. This can lead to hip joint instability. Due to overcompensation of the surrounding muscle tissue, this can lead to many imbalances.
When it comes to weightlifting and snatch or dead lifts the impact of these issues can be explained. When it comes to weightlifting, the “power triangle” is something many are familiar with. The hips are flexed and the trunk is in a forward position. When you have an iliopsoas that is weak will prevent you from properly achieving this positioning properly. Initially, you will lose out on power you could potentially create within this area. At the squat positioning, Iliopsoas weaknesses cause instability and discomfort.
Due to the instability in the abdominals and hip flexors, over rotation causes the hip to be misaligned and it can lead to pain or discomfort in the lumbar spine area. Underlying hip pain can be a result of dysfunction in the Sacroiliac Joint. When the pelvic region isn’t properly aligned or oriented, additional stress can be placed on the Iliopsoas tissues and ligaments that is a direct result of the misalignment of the hips.
How to Strengthen the Iliopsoas Using Bodyweight Exercises
When you strengthen the Iliopsoas it can improve your strength, agility, and speed. There are many exercises that can help you accomplish this goal. For the movements that you perform in daily life, a healthy Iliopsoas is essential. Taking the time to lengthen and strengthen these muscles can help you prevent potential injuries and make the most of any workout. When you run into issues in the Iliopsoas it can result into serious hip or lower back pain. You can alleviate some of these issues with the help of a massage therapist to help you with any gait problems that could develop. It is also important to perform some stretches prior to any workout to prepare your muscles and also make them less susceptible to injury.
When returning from a injury to the Iliopsoas or dealing with a tightness that is chronic, remember to start back at a slow pace. Avoid activities that may aggravate the muscles until the pain is able to subside. If the Iliopsoas feels tender or stiff, enlist in a Iliopsoas stretch. Once the muscle has been able to release and relax, then it is time for the real work to begin. The best antidote for a tightened Iliopsoas is stretching. Then move into exercises that are designed to strengthen these muscles.
Begin lying down. With the knees bent at a ninety degree angle, lift the lower legs off the floor toward the torso. Place your hands directly on the shins as you lift your upper body. Begin releasing the hands forward toward the sides of each of your legs. If you have the strength, both legs should be lifted upward and not forward. Hold this position for up to fifteen seconds and repeat for ten repetitions.
Lie down on your back and extend both legs. Your hands should be placed underneath the gluteus or above the head. When the hands are above the head, you need to be aware of the lower back and leave it flat on the ground and avoid any curvature. Think about pressing the belly button toward your spine in this instance. Lift one leg at a time a few inches off of the ground. Perform up to fifteen repetitions on each leg.
Bird Dog Plank:
Begin in a basic plank position. The hips should be tucked with the gluteus contracted. Leave the back straight and maintain a tight bridge. While the plank is maintained, extend one arm and with the opposite leg, perform a leg raise in the same time. Alternate sides and repeat returning the arm and leg to the start position simultaneously.
Warrior Pose III:
Begin in the Mountain pose. Move the right foot forward while shifting all of the weight forward onto that leg. As you inhale, bring the arms over your head and intertwine the fingers allowing the index fingers to point upwards. On the exhale, lift your leg up and out. Let it hinge at the hip flexors and lower the arms and torso down to the floor. Pick a point on the floor to stare at for balance. Reaching through the toes and your crown and your fingers until you are in a straight line. Breathe in and out and hold the position for two to six breaths. To release the position, inhale up through the arms moving back into the Mountain pose. Repeat to the other side.
The 5 Best Psoas Stretches
Kneeling Psoas Stretch:
To prepare, grab a padded mat. Move into a lunge position with one knee on the matt. The foot should be positioned beyond the forward knee. Hands should be placed on the knee. Push the hips forward and straighten the hip of the rear leg. Hold this stretch for ten to fifteen seconds. Repeat on the other side. Perform ten repetitions.
Standing Lunge Psoas Stretch:
This stretch will also work as an Iliopsoas stretch. In a standing position, take one long forward step. Bend the knee until it is in direct positioning over your ankle. The opposite knee should be straight and the torso should remain upright. The hands should be placed on the bent knee or the hips. Lower the hips slowly while moving forward until you feel the stretch in the hip. Hold for a period of 30 seconds and then change legs. Repeat for ten repetitions.
Thomas Stretch, aka (Seated Psoas Stretch):
This Hip Flexor Stretch gets its name from the Thomas Test. It is used in assessment of tight hip flexors. The stretch itself is the exact same positioning, but it is held for a longer period of time to improve flexibility of the muscle. Begin by lying on your back. Pull one leg into the chest and the opposite leg is extended and allowed to hang off the couches edge. Hold this stretch for thirty to forty-five seconds and change legs.
Table Psoas Stretch:
Begin by standing beside a table that is a bit lower than hip level. You can also use the arm of a couch or a bed. Lift one leg onto the table with the knee facing down. Slowly sink down into the stretch. With Psoas Stretches, you want your hips to be square and sink down until you begin to feel the hip stretching.
Warrior Pose I, II and Reverse Warrior:
Warrior I: Begin with one foot forward to the edge of the mat. The left heel should go to the floor and turn out to an angle of 45-degrees. Begin bending the opposite knee over the ankle. The length of your stance might need adjustment from front to back. For increased stability, simply widen the stance. Keep the hip positioning forward. As you inhale, bring the arms over the head.
Warrior II: Rising up and releasing your arms, let one arm come forward and the opposite go back. As you open the hips, lengthen your stance. The forward knee should be deeply bent over the ankle. Make sure you can see your toes on the interior of the knee. Sink the hips a bit lower and engage the quadriceps.
Reverse Warrior: Raise one arm over your head and let the opposite arm slide down to the opposite leg. Keep a slight touch on the leg, but don’t rest your weight there. The front knee should remain deep as you open into a backbend.