By Dorthe Krogsgaard and Peter Lund Frandsen,
The Psoas muscle is often involved in a wide
variety of problems, ranging from low back pain, lumbar disc
degeneration and sciatica over menstruation pain and other painful
conditions in the pelvic area, to infertility, kidney problems, and the
list goes on…
In all these conditions it is important to include treatment of the
Psoas muscle, where indicated. Skills for testing and treating the Psoas
are therefore invaluable, and should be available in any reflexologist’s
The Greater Psoas is the primary flexor muscle of the hip joint. It is a
large slender muscle situated deep in the abdomen (see figure 1). The
origin is from the side of the last thoracic (T12) and all lumbar
vertebrae (L1 through L5). From here the muscle runs deep in the pelvis
and forward to the groin area, where it curves over the pubic bone and
down to the insertion on the medial side of the Femur (the minor
trochanter). In the lowest part of the course the muscle joins with the
Iliacus muscle. Together, the two muscles are also known as the
Testing the Psoas
This is a procedure for assessing tightness of the Psoas. (See
1) The client sits at the far end of the table.
2) Ask the client to hold around both knees pulling them towards the
chest, while you offer support.
3) Help the client to lay down in the suppine position, still holding
4A) The client stretches one leg at a time and let it hang loose and
relaxed over the edge of the table. The other leg still being pulled
firmly to the chest.
If the Psoas is too tight the thigh in the same side will be unable to
reach down to the table top.
4B) In a normal situation the leg should be able to reach down and rest
against the table surface.
5) Repeat with the other leg.
(Figure 2 - Testing the right Psoas muscle)
How to treat a tight Psoas
If the Psoas test turns out positive (i.e. restricted lowering of the
leg), instruct the client to do a daily stretching exercise (fig. 3),
and treat with reflexology.
Figure 3 – Stretching the Psoas
For treatment we suggest the following scheme:
Start with the spinal origin of the muscle (T12-L5), thereby you also
treat the nervous innervation of the Psoas (L1-L3), continue with the
nerve reflex point for the Psoas muscle (fig. 4), then do a thorough
treatment of the muscle zone (fig.5) and the inner organs connected via
meridians and/or the sympathetic nervous system.
After treatment you could repeat the test, and if the therapy was
effective, you will notice an immediate improvement = less restriction.
This gives you a valuable clue, that you are on the right track, and is
of course both convincing and motivating for client as well as
Figure 4 – Psoas nerve reflex point
Figure 5 – Muscle reflexes: 1) Greater Psoas 2) Illiacus
Low abdominal pain could be a tight Psoas
- or maybe ovarian cysts or endometriosis, or something completely
different. But often the cause can be found in a tight Psoas muscle.
Testing the Psoas is therefore often a shortcut. Maybe the whole
explanation is to be found here. Then there will be no effect doing
reflexology for the hormonal system, womb, ovaries, colon, lymph, etc,
as most reflexologists would include in cases of lower abdominal/pelvic
pain. Sometimes it would be a waste of time, whereas a good treatment of
the Psoas would be necessary to obtain a good result.
The Psoas may hurt the back
In case of a tight Psoas muscle the lumbar spine is pulled forward and
the lordosis increased. To counterbalance this tendency the dorsal
extensor muscles will also increase their tension. We now have a
situation with tight muscles on both sides of the back – like the
backstays holding up the mast of a boat. The result is increased
compression of the lumbar spines and possible irritation and pain in
muscles and facet joints. In the long term problems in the
intervertebral discs may develop (degeneration, herniation, prolaps).
The practical conclusion is: Always test and possibly treat the Psoas
muscles in low back pain situations.
And the list goes on…
As indicated in the introduction the Psoas is involved in a plethora of
connections. One of the reasons is the position of the muscle as it sits
deep in the very core of the body in intimate relation to the lumbo-sacral
nervous plexus and to abdominal and pelvic organs. At the same time
stretching across the area where the greatest forces are acting, the
transition from the trunk via the pelvis to the legs. These forces are
of mechanical nature, but certainly also psycho-dynamical. There is a
well established connection between Psoas tensions and emotional
qualities like fear.
Another reason for the central role of the Psoas muscle is the
connection via the meridian system between the Psoas and the kidneys. In
this sense, energetically speaking, the greater Psoas is inseparable
from the kidneys and thereby the original reservoir of chi-energy.
A more efficient treatment
With the ever increasing public awareness and use of CAM modalities
comes a growing demand for efficiency and professionalism – also for
reflexological therapy. New generations of therapists require more and
more knowledge, even though the educational standard for reflexology in
Denmark and in the UK has a quite high level compared to many other
The more detailed knowledge you posses about the construction and
function of the body, and the more theories you know – alternative as
well as conventional –about the appearance and disappearance of
diseases, the better your ability to assess the condition of your
clients and plan a goal directed reflexological treatment.
The examples above serve to illustrate some of the many connections
where the Psoas muscle turns up, but also in a more general sense, how a
detailed knowledge of the multitude of connections in the human body may
help to guide the therapist towards a more direct approach in the
And best of all, this is possible while still maintaining the holistic
bird eyes view of the client. After all holism doesn’t mean including
all reflexes in every treatment!
Treatment of the Psoas muscle is included in the
Touchpoint seminar "Round about: The Spine".
We also recommend a book solely on the Psoas:
Liz Koch: The Psoas Book, Guinea Pig Publications, ISBN: 0965794407