Iliopsoas

KATHLEEN LENINGER, PT, DPT.

Everyone has had their experience of frustration with NYC traffic. Sometimes there is a lot of traffic up and down the West Side. Then, after an hour or so, that will seemingly be connected to random traffic up and down the East Side! At first glance it seems like one has nothing to do with the other, but then you remember… the cross town bus! The same thing happens with the iliopsoas muscle.

The iliopsoas is one of the harder muscles to understand and can be blamed for a lot of nagging hip and back pain. Let’s talk about it.

The iliopsoas is actually two muscles: the psoas and the iliacus. The psoas originates from the vertebrae T-12 vertebrae (the vertebrae where the lowest rib attaches) down to L-4. The iliacus muscle comes from the inside of the hip bone. Once the two merge, they attach to the top of the femur (thigh bone), on the inner surface. The abdominal muscles counterbalance the iliopsoas on the front of the abdomen. Together, with the quadratus lumborum (or “QL” muscle), they control the rotation of the pelvic girdle, but the iliopsoas is also a hip flexor muscle.

When the abdominals are weak and the pelvis is rotated forward into an anterior tilt, the iliopsoas is under constant tension. Combine this with long periods of sitting, and the hip flexor portion of the iliopsoas is chronically shortened, often leading to pain in the hips and spine.

There are a few key points to improving this scenario:

  • strengthen the abdominals with the iliopsoas in a lengthened position (staying out of hip flexion!)

  • increase spinal extension

  • stretch the hip flexors from a neutral or extended hip

Not sure if you are doing this correctly? Let’s talk about it.

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