The Psoas Major: A Major Player In Back Pain

Have you ever had back pain or know someone who has? If so, this post is for you, my friends!

There are many muscles that could cause back issues, but today I’m going to focus on just one, that being the psoas major; mainly because I’ve come across too many new clients whom never had them treated before… And this surprises me. Another reason is because I’ve noticed that many people think that only back muscles should treated because it’s their “back that hurts”. Believe it or not though, there are muscles in the front of our body that have an effect on back pain as well. Before I go on though, let’s go over the anatomy…

THE ANATOMY (per Tortora & Derrickson, 11th edition)
Origin: Transverse processes and bodies of lumbar vertebrae.
Insertion: With iliacus into lesser trochanter of femur.
Action: Psoas major and iliacus, acting together, flex thigh at hip joint, rotate thigh laterally, and flex trunk on the hip.
Innervation: Lumbar spinal nerves L2-L3.

NOTE: Some people refer to this muscle as the “iliopsoas” because the psoas major and iliacus share a common tendon and end-point, but they are in-fact two separate muscles, which is why I’m only going to refer to the psoas; however, they do work in-conjunction, in some circumstances.

The function of the psoas is to increase flexion of the thigh at the hip. It can either bring the femur towards the spine or the spine towards the femur; just depends on what movement is taking place. An example of when it would be active—or contracting—is when you swing your leg forward during walking or running. The psoas is also a strong lateral flexor and stabilizer of the vertebral column (ipsilaterally—same side); as in when you bend to one side or the other.

How do you know when the psoas could be influencing back pain? Well, let me share a few examples—which also happen to be indicators for treatment—with you…

  • You have back pain when lying on your back; without a pillow under your knees
  • You have back pain that is vertical, but is relieved when in the reclining position
  • You have difficulty straightening after prolonged sitting

Taking it one step further, let me share some additional indicators for treatment with you…

  • An increase—or possible decrease—in your lordotic curve
  • You stand with your weight off the affected psoas side
  • You have unexplained pelvic floor pain (neural entrapment issues)
  • You have rotational distortions of the spine (Scoliosis)
  • You have groin pain

Please keep in mind that muscles have synergists and antagonists, so even though you have this information at your fingertips, there are other muscles not mentioned in this post that can cause a person pain and dysfunction in the back; anywhere in the body, really.

As always, I hope you find this information to be informative!

IMPORTANT NOTE: The psoas is a deep muscle in the abdominal area and great caution should be of utmost concern when treating this muscle. I mention this because of the possible presence of an AAA—Abdominal Aortic Aneurysm—which would be a serious contraindication for treatment, due to the fact that it could have potentially disastrous consequences.

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“Neutral balance alignment is key to becoming pain free!”™ ~ Me

The Infraspinatus Muscle

In my last post, Trigger Points (TrP’s) In Detail, I briefly mentioned a TrP in the infraspinatus and thought I would go ahead and write about this muscle more thoroughly since it is a big player with shoulder issues.

THE ANATOMY (per Tortora & Derrickson, 11th edition)
Origin: Infraspinous fossa of scapula.
Insertion: Greater tubercle of humerus.
Action: Laterally rotates and adducts arm at shoulder joint.
Innervation: Suprascapular nerve.

The infraspinatus is one of the four deep muscles that join the scapula to the humerus. The four tendons merge together to form the rotator cuff. The rotator cuff strengthens and stabilizes the shoulder joint and is comprised of the supraspinatus, infraspinatus, teres minor, and subscapularis; think S-I-t-S (small “t” representing the teres minor–not major).

The prime function of the infraspinatus is to decelerate forward motion of the humerus. Repetitive movements with the arm in over-the-head positions—such as in throwing a baseball, a tennis serve, spiking a volleyball, and swimming—can result in injuries. This happens because much of the work of the infraspinatus is done in eccentric contraction. Eccentric contraction is when the muscle fibers lengthen during contraction… More on muscle contractions in my next post.

Great info, Nicole, but how does one know if the infraspinatus needs some TLC from a CPNMT (Certified Precision Neuromuscular Therapist)?

LOL! That last sentence is so ridiculous. 🙂

Well, some general indicators for treatment could include, but are not limited to:
1) Difficulty brushing or combing your hair;
2) Inability to sleep on your side at night;
3) Inability to reach behind your back and touch the opposite shoulder blade.

There are other—more medical—indicators for treatment, which is why I recommend contacting myself or another CPNMT for an evaluation if you are experiencing problems within the shoulder girdle.

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“Neutral balance alignment is key to becoming pain free!”™ ~ Me