Trigger Points – Stiff and Slow When Rising From Seated Position

Client Description

These people complain of stiffness on rising from a chair or getting out of the car. The longer that they sit, the stiffer that they get. They are often stiff in the morning, when rising from bed, but speak of it like everyone has it. They often avoid being seated in stiff positions for long car rides, concerts, etc.

Low seats like soft couches bother them more and are more difficult from which to rise. They often buy SUVs that they neither “sit down into” or “climb up into.”  They may rely on the door of the car or the arm of the chair to get up. One client had ruined the hinge on his car door by using it to support him as he got out of the car.

When pressed for more information, they usually talk about the stiffness, tightness and how the muscles feel weak or tired.  They can be awkwardly upright when rising from a chair with no arms because their “legs feel tired,” or their back is stiff.

These trigger points in the iliopsoas are usually more stiff and tired than sharply painful or fragile. The fragile low back tends to come from trigger points in the quadratus lumborum.

There are other symptoms that often go with this.

When getting into the car, they often have a specific routine. They place one foot in, then their hips, and then assist with their hand to pick up their leg next to the door. They are usually specific about their sleeping position and pillows that they use. They need a pillow under their legs when laying on their back.

Many people take this problem as a part of aging and don’t look at the more serious progressions that follow. I was amazed at the number of ads that I found for chairs and other devices to help people with this problem. I am offering some self-care here but seek help if this condition does not improve.

Self Care

Gentle stretching can help to release the hip flexors and the resistance to unfolding. Backbends also help, but people that can do those are not usually having trouble getting out of their chair.

Core work to balance the abdominals and especially exercises the pull in the abdomen while twisting help. The tension in the iliopsoas and imbalanced abdominals can be directly connected to digestive issues. If you notice that the problem is worse when your digestion is disturbed, you should work with a professional to clean up your diet.

Walking lunges, when done properly, do a great job of opening the abdomen, lengthening psoas and building the opposing erector muscles.

  • Step forward so that the front foot is in front of the knee and the back knee is behind your hips.
  • Keep your shoulders back over your hips.
  • Lower your torso until the front is level.
  • Keep your knee behind your toes on the front leg.
  • Widen your stance, turn your front toe in a tiny bit and focus on keeping your hips between your feet if you are unstable.
  • Step forward while minimizing how much your head and front shin lean forward.
  • Do 6-10 reps on each leg.

Therapy Notes

The iliopsoas is complicated, and there are volumes written on how to approach it. That being said, balancing the abdominals and addressing problems in the local joints seems key for lasting work. Direct work on the psoas lasts longer when the local joints, especially the sacrum, are mobilized beforehand.

I will be posting a therapy notes page soon…
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This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

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Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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