Therapist are usually very opinionated about their approach to the iliopsoas complex. Its impact on posture, digestion, emotions, and much more is fodder for lengthy bodywork discussions. Even after 30 years, I’ve learned more by putting together these illustrations and posts.
I find that craniostructural work is always the first step for lasting relief, followed by balancing the structures around the psoas. Direct treatment of the iliopsoas, for me, is infrequent but can be an essential part of low back relief. The longevity of relief after direct treatment can also be a key indicator of the next step in treatment. This post is about a fairly standard approach for the seasoned therapist,
There is a condition known as “Psoas Paradox” or “Psoas Minor Syndrome.” In both descriptions, the upper sections of psoas major/minor have tightened to lock the low back in a compressed reverse curve. Psoas minor is frequently not present, but when the psoas minor is involved, the taut tendon can be palpated through the abdominal wall.
Care must be taken during treatment as attempts to stretch or work directly on the psoas, while the client is supine, can be problematic. Staring with techniques to restore the lumbar curve while prone can be helpful. Effective and safe treatment of this requires a good working knowledge of the dynamics of deep abdominal and low back work.
Some medical professionals resolve this with a minor surgery that clips the psoas minor tendon.
Pelvic balancing provides longer-lasting results so that direct treatment is easier, more effective, and longer-lasting.
Each therapist has their own method of pelvic balancing. I prefer craniostructural work with SOT blocking but also use METs, strain-counter strain, and some NMT techniques. Use the pelvic balancing approach that works best for your particular bodywork approach.
Mobilization of the lumbar spine releases supporting structures and fixated joints that perpetuate imbalances in the iliopsoas complex. It is almost always a part of treating the iliopsoas complex. It depends on the scenario, but I almost always work through the lumbar spine before the iliopsoas to avoid lengthy work in the deep abdomen.
Treatment of the iliopsoas complex is more effective and longer-lasting when the abdominal wall is balanced. Rectus abdominus is an antagonist of the iliopsoas complex as it posteriorly tilts the pelvis.
Releasing the superficial abdominal muscles also allows easier access to the deep abdominal muscles. This protocol relaxes and stores proper tone to the rectus abdominus.
Direct treatment of the iliopsoas complex should occur after the structures around it have be balanced. Treatment in this area can be complex and requires attentive sensitivity by the therapist. There are important precautions and contraindications in this treatment approach.
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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This post covers the basics of Ice-and-Stretch, a toll that is used extensively in these posts combined with Active Isolated Stretching and Yoga poses.
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