| The Psoas |
| Tuesday, 10 March 2009 10:51 |
The source of lower body injuries revealed.
Muscular stability of the body, described in 2005 as “pillar stability” by Verstegen and Williams, is of primary importance to manage or prevent injury. There are three areas of stability that make up the pillar: shoulders, spine, and pelvis. These areas form the hub from which all movement is produced and controlled.
Tight hip flexors lead to a wealth of running injuries.
Why is the gluteus medius problematic, and why do runners continue to get injuries of the lower body? The CauseSimply put, the root cause of most lower extremity injuries is due to excessive tightness of the psoas muscle(s), commonly known as the hip flexors.The EffectMuscular stability of the pelvis is primarily maintained by the psoas, gluteus maximus, and gluteus medius muscles, and each have important actions in the body. The psoas and gluteus maximus are opposing muscles and are significant for stabilizing the sacro-iliac joint and hip joint.The gluteus maximus (the largest of the three gluteal muscles) strongly stabilizes and controls movement of the leg allowing for optimal functioning and support of the lower body structures and musculature during activity. However, often the psoas muscle becomes excessively tight and shortened. This can be due to prolonged sitting, repetitive strain or overuse in exercise, or reasons that are unknown. As described by renowned neurologist and physiatrist, Dr. Vladimir Janda, the excessively tight psoas not only restricts movement of the hip, but also lengthens and inhibits by the gluteus maximus by a neurological mechanism known as reciprocal inhibition. This mechanism, first reported in 1907 in pivotal research by Charles Scott Sherrington, is quite simple: when a muscle contracts its opposing muscle must relax. So, when the psoas contracts or is excessively tight and shortened, the gluteus maximus (the opposing muscle) is neurologically forced to weaken by this inhibitory reflex. This imbalance of the muscles of the pelvis develops a pelvic muscular instability. The weak gluteus maximus muscle(s) (also known as ‘dormant glutes’) will not provide adequate stability and control of the pelvis and leg. This will overload all of the muscles of the lower body, and force them to compensate and work harder—beyond their capability. CompensationThe imbalance of the pelvis results in restricted hip range of motion and movement alterations of the hip and leg that recruit improper muscles in incorrect sequences.As a result, the muscles of the lower body are forced to compensate. The primary compensation muscles are the gluteus medius, piriformis, quadriceps, adductors, hamstrings, calves, and even the low back. However, these muscles are not capable of performing the compensation and are therefore overloaded in an attempt to manage the weakness. The overtaxed muscles tighten as a protective effect due to the overloading. The overloading may lead to injury, including symptoms of excessive muscle discomfort, soreness, or pain to the runner, specifically hip pain, thigh pain, hamstring strain, calf strain, deep buttock soreness, sciatica, and even low back pain. Excessive TightnessOver time, muscles excessively tighten. This does not allow a muscle to elongate to its full length as the muscle is in a mild state of contraction. The excessively tight muscle, when forced to stretch to its full length, will excessively lengthen the tendon.Repetitive lengthening of the tendon can lead to subsequent tendon injury resulting in hip pain, knee pain, groin strain, shin splints, Achilles tendonitis, or plantar fasciitis, injuries which ultimately result from a tight psoas muscle. For this reason stretching may be inappropriate when muscles are excessively tight and/or injured and further, ineffective to loosen up the extremely tight muscles. ManagementTo address the issue of pelvic instability the runner must follow a step-wise process.The Release Phase This phase begins with releasing or loosening up the psoas (to re-activate the gluteus maximus). Stretching is often ineffective to address the excessively tight psoas. An efficient method to loosen or release the psoas is manual hands-on myofascial release therapy. A proficient Active Release Techniques (ART®) provider can perform this service safely and effectively. It will take an average of six to eight treatments to correct the imbalance and normalize the excessive tightness. At this time, the hip and leg muscles must be loosened up to facilitate recovery, manage associated symptoms, and restore function. An effective strategy is Roll Release™ with the use of a foam roller. The Strength Phase The goal in this phase is to get the gluteus maximus engaging in the correct sequence and movement pattern. This is achieved with full-range, hip extension isolation exercises, such as the Quadruped Kick Back As well, the gluteus medius must be strengthened to maximize recovery and optimize function to assist the gluteus maximus in its hip stability role. By releasing the excessively tight psoas muscles, the inhibition of the gluteus maximus is resolved and balance of the pelvis musculature and stability is restored. The pelvic stability will provide optimal control and function of the lower extremity, thereby managing the root cause of the injury, preventing reoccurrences, and even maximizing athletic performance. About the AuthorsRyan Emmons is a chiropractor, ART® and medical acupuncture provider, and personal trainer, focusing on biomechanics and sports performance therapy. He practices out of Kensington Fitness Studio and runs the Golfitt Golf Performance Program at BodyPrint in Calgary, Alberta. Reach him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .Angela Pucci is a chiropractor and is certified in Kinesio Tape, ART®, acupuncture, orthotics, and personal training. As an avid athlete, she has a keen interest in treating athletes of all sports and calibre. She practices out of Kensington Fitness Studio in Calgary, Alberta, focusing primarily on biomechanics and soft-tissue therapy. Contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it . "The Psoas" was originally published in IMPACT Magazine's March/April 2009 Running Issue. |
| Last Updated on Wednesday, 08 July 2009 14:14 |
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