Round about: The Psoas muscle
 - an overlooked cause of many health problems


By Dorthe Krogsgaard and Peter Lund Frandsen, Denmark

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 toolbox.

The Psoas
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 Iliopsoas muscle.

Testing the Psoas
This is a procedure for assessing tightness of the Psoas. (See figure 2):
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 the knees.
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 therapist!


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 countries.
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 treatments.
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
www.coreawareness.com