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Therapist Notes – Iliopsoas Complex (Deep Abdominals)

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,

Start by Understanding the Anatomy.
About the coloring of the illustrations…

This muscle is highly variable based on race, gender and even varies from side to side in the same person. You can learn more in this post on the anatomy of psoas minor.

Start by Understanding the Anatomy.
About the coloring of the illustrations…

This muscle is seldom illustrated to show both sections, which attach on different vertebrae and wedge the iliohypogastric complex between them. Learn more in this post about psoas major.

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 improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.


Weekly Featured Post

This post shows you how to press out the trigger points and stretch the infraspinatus muscle. It’s a small muscle on the back of the shoulder but creates a number of problems, including:

  • shoulder pain when sleeping
  • loss of grip strength
  • upper neck pain
  • pain along the inside edge of the shoulder blade

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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