Goodheart points out that there exists an intimate link between psoas behaviour and sternomastoid behaviour (a psoas in spasm will influence SCM on the opposite side of the body and vice versa. Increased tonus in one will produce similar increase in tonus in the other).
Psoas fibres merge with (become ‘consolidated' with) the diaphragm and it therefore influences respiratory function directly (as does quadratus lumborum).
If the lumbar erector spinae group of muscles is in a weakened state then bilateral psoas contraction/spasm/shortening will result in a loss of the lumbar curve, or even a reversal of it.
If however the erector group are hypertonic then similar psoas problems will produce an increase in lumbar lordosis.
It is useful to assess changes in psoas length when treating by periodic comparison of apparent arm length.
Patient lies supine arms extended above head, palms together so that length can be compared. A shortness will commonly be observed in the arm on the side of the shortened psoas, and this should normalise after successful treatment.
Basmajian informs us that the psoas is THE MOST IMPORTANT postural muscle.
If it is hypertonic the abdominals will weaken and a chain reaction of imbalance will result.
Treatment of Shortened PSOAS
1. Psoas can be treated with the patient lying face down. The operator lifts with one hand the thigh (knee bent or straight) to its EASY resistance barrier (no force). The other hand stabilises the sacrum to prevent arching of the back.
The patient takes the thigh towards the table with a slight effort for 7 to 10 seconds and the releases and relaxes. as the leg is extended through the resistance barrier for a short stretch. This is repeated until no further gain is possible.
2. A better position is to treat from the supine position, in which the patient is at the very end of the table, non-treated leg flexed at hip and knee and held in that state by the patient.
The leg which is to be treated hangs down.
If the condition is acute the leg is allowed to commence treatment from the restriction barrier, whereas if chronic it is taken into a somewhat more flexed position to be in the mid-range.
The patient’s effort is to lift against resistance.
After the isometric contraction, using effort suitable to the degree of acuteness/chronicity, the thigh should either be taken to the new restriction barrier, without force, if acute, or through that barrier with slight, painless, force if chronic and held there for 10 seconds or so. Repeat until no further gain is achieved.
Note: Direct inhibitory pressure techniques onto the origin of psoas, through the mid-line is an effective alternative approach.
Massage therapists / Aromatherapists have in Soft Tissue Manipulation a powerful additional set of methods combined with simple and accurate diagnostic methods.
1. Karel Lewit Manipulative Therapy in Rehabilitation of the Locomotor System Butterworth Heinemann 1992
2. Irvin Korr Neurobiological Mechanisms in Manipulation Plenum Press 1980
3. J. Basmajian Muscles Alive Williams and Wilkins 1978
4. Leon Chaitow Soft Tissue Manipulation Thorsons/Harper
5. Leon Chaitow Palpatory Literacy Thorsons/Harper Collins 1991
6. David Simons and Janet Travell The Trigger Point Manual William and Wilkins 1983