3-D Hip with a focus on the Ililopsoas (Functional Muscle Function)

(Technical Level: Beginner-Intermediate)

First, thank you to everyone who has been reading the blog and commenting. It's been great to get the feedback.

A few of my friends have asked me about the psoas and I thought it would be a great topic to dive in to.

FUNCTIONAL ANATOMY: The iliopsosas is actually two muscles. It consists of the Iliacus and Psoas. However, it is usually referred to as the Iliopsoas. For the most part, I will concentrate on the psoas though.

As we look at function through 3-D glasses, we already know that the psoas is a 3-D muscle. If you take a look at the picture, you will see that the psoas is attached to the spine. Specifically, it is attached to the front-side aspect of T-12 to L-4 and the TRANSVERSE processes of L-1 to L5 as well as a smll slip that crosses the Sacroiliac (SI) Joint.

The iliacus originates from the interior surface of the Ilium.

Now the coolest thing of the ILIPSOAS is that the two muscles combine via the psoas tendon, passes over the ramus portion of the pelvis, twists MEDIALLY and inserts into the lesser trochanter.

Many of the books do very accurate drawings of the Iliopsoas but what I failed to recognize was that the muscle actually does do a little twist as it inserts into the femur. That is HUGE in terms of function. This muscle is pretty biased in rotation or the Transverse Plane.

FUNCTIONAL FUNCTION: What most books say is that the Iliopsoas flexes the hip and it can do that, but that is just part of the a small part of this muscles work.

Quick review of the way muscles function:
The textbooks give muscles the functions of contracting or the CONCENTRIC phase and lengthening of the ECCENTRIC phase. An easy way to think about this is to think of a rubber band. If you pinch the rubber band between the index finger and thumb of both hands and stretch the rubber band, you will be simulating the lengthening or ECCENTRIC phase of the muscle and when you let it go, it will be contracting or going through the CONCENTRIC phase. HUGE HUGE HUGE in understanding muscle function. However, it is even HUGER to understand that the muscles must go through their eccentric phase before they go through their concentric phase. They must effectively LOAD to EXPLODE. Think of the rubber band. You can not make it shoot across the room without stretching it out first and then letting it go.

What unfortunately we get into is that the Iliopsoas gets pretty locked up and tight. It becomes hyperstable/tight and that is when we get into all kinds of trouble. A tight iliopsoas, because of its attachments can be a big cause of Lower Back Pain. Think of those origins at the spine. When the muscles gets tight and contracts, it is directly dialed in into the spine and can pull it into hyperextension pretty quickly. The thing is that it may not just pull it into hyperextension in the Sagital Plane. It can also pull the muscles into tightness into the Frontal Plane and the Transverse Plane. WOW! Tightness in all 3 planes of motion is going to equal some serious discomfort/pain.

This muscle is a big one to consider if you are a student, office worker, driver, etc that sits a lot. This muscle can get so tight and immobilized that it really doesnt know what to do with itself when we ask it to start contributing to movement.

So what are some practical strategies and techniques that can help us mobilize the Iliopsoas?

STRATEGY:   We know that the iliopaoas is a 3-D muscle and it functions in all planes of motion, so if it does that functionally, we need to mobilize it in the 3 planes. However, that may be a bit much for some people so it may be easier for us start in one plane in integrate the other 2.

TECHNIQUE: In the first 3-D Hip post, I suggested using the lunge matrix to start with. Another part of the lunge matrix is a backward or posterior lunge. The key to the backward lunge is that the step doesnt have to be very big. Just step back between 1.5 feet and 2 feet. The other key is to not let that back foot turn OUTWARD. Whenever I teach this, I see that back foot zooming right out. Keep it as neutral as possible. Finally, when you step back, do not let your lower back arch. Try to keep your back as netutral and tall as possible. Think about someone pulling you from your belt as your leg steps back. That way, you really lengthen that psoas in the sagital plane. If you think you would like more, try taking both arms overhead as you step back. Again, do not hyperextend your back. The arms going overhead will take the back into more extension but its doing it from the top down.

After that, you can add another plane of motion. To really get that iliopsoas lengthened, turn your foot inward as you lunge back. Because the muscle is attached to the femur (thigh bone) in an internally rotated position, rotating in the leg more will lengthen it further.

Finally, to intergrate all three planes in at once, you can then step back and to the right which will lengthen the muscle in the frontal plane.

You can do this 8-10 times on each leg.

That last tweak is a super intense one so I recommend you getting comfortable with the first two planes of motion before you integrate all three. Of course this is just a progression and it can be regressed or progressed as you or your client/patient needs it.

I promised my friend Sybelle that I would do a short video on integrating soft tissue work into this 3-D strategy. It's an awesome release for a tight muscle group like this. The only thing is that this muscle is pretty deep so it takes some digging around to find it; however, when you know what to feel for, it gets pretty easy. Will post as soon as possible.

Questions? Comments? Let's hear them.

Happy Tuesday!!!!

Will