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Over the last two weeks I have been treating a top triathlete who had back pain and was struggling to run at his fastest pace. He explained that every nine miles of running he had a bit of pain that started around his left groin area and slowly moved up towards the left rib cage affecting his breathing, the pain was severe enough that it made him slow down and sometimes he even had to stop. The pain was effecting his time and ability to perform.

After a thorough assessment of his movements I came to the conclusion that his left psoas muscle was a major cause of the problem. Psoas is a deep muscle in the pelvis, most people know it as a hip flexor muscle. There are also other predisposing factors that relate to his problem for example stiffness in the thoracic (upper back) area, hip rotation which can cause the left leg to turn outwards as well as a stiff lumbar (lower) spine. The psoas muscle is a big muscle and can effect all these areas as a result it is a very important one and it is essential that it is functioning correctly.

Why Psoas Muscle involvement?

Psoas muscle is thick and strong muscle which is found in the right and left side of your pelvis deep in your core area. It originates from the vertebrae of the lumbar spine and runs down towards groin and pelvic area and attaches to the upper part of your leg. It shares same attachments as the Iliacus muscle and that’s why often is known as Iliopsoas muscle.

Due to its position deep in the belly area very often this muscle is neglected by therapist and athletes. Psoas is a complex muscle and even though it is still studied by many scientists, it is still not fully understood.  What we do know about it is that it is the only muscle that connects your legs directly to the spine and it helps to bend your hip towards your chest and plays a major role in controlling hip extension and medial rotation of your back leg when running or walking.  In other words, this muscles causes you too run or walk from your spine rather than from your hips!

Psoas has a significant fascia connection (connective band) to the surrounding muscles and bones i.e spine, pelvic bone, core muscles and diaphragm.

Psoas dysfunction, when it is tight and short, is very common but it often goes unnoticed until it becomes chronic.  This is commonly due to the prolonged hip flexion i.e. sitting, cycling and running without a good stretch or rehabilitation.  Untreated Psoas can lead to many problem such as chronic back pain, hip pain, shoulder pain, leg length discrepancy, knee and foot problems and breathing difficulties. This is because the tight and short  Psoas muscle is unable to do what it designed to do therefore the surrounding muscles get involved, such as your leg muscles, core muscles, spinal muscles and your breathing muscle, the diaphragm.

This is exactly what happened with my patient who I have mentioned above,  his left Psoas was not functioning properly during running intervals and therefore his diaphragm tried to take over which it is not designed to do causing him fatigue and breathing difficulties.

The treatment and rehab included, deep tissue massage and muscle energy techniques to the Psoas muscle, Quadrates Lamborum and the Thoracic area,  weight bearing multidirectional functional squats and passive quads and lats stretches. Linking all of these muscles and treating them together has showed a significant improvement to the triathlete, he is now running at his fastest pace with no pain. During his treatment with me I advised him to continue with his normal training routine, as I wanted the psoas muscle to improve with training rather than without.

Please don’t hesitate to contact me for information on Sports Therapy or if you would like to book an appointment: Fisnik 07773454707