The illopsoas muscle is commonly discussed in the bodywork and movement field as a key player in pain and dysfunction. There are a multitude of theories and approaches to correct this dysfunction. It is my intent to engage in a conversation, as I uncover for myself the mystery that this structure possesses. I will explore the relationship of this muscle network to specific myofascial bodylines, nervous system regulation, the Chinese meridians, posture, body disharmonies, and pain.
Firstly, it is paramount to this subject that we understand where these muscles are and what they do in terms of structural movement and postural alignment. What is commonly known, as the psoas or illiopsoas, are three muscles: psoas major, psoas minor, and illiacus all hidden deep within the abdomen. The psoas’ posterior layer attaches to the transverse processes of the five lumbar vertebrae, and its anterior layer to the side (lateral aspect) of the vertebral bodies and intervertebral disks of T12–L5. The psoas major joins with the illiacus muscle in a common tendon at the lesser trochanter of the femur to form the illiopsoas complex, which is surrounded by the thin, tough iliac fascia. The left and right psoae, together with the left and right spinal erector groups surround the spinal column like four guy-wires around a mast (Luchau, 2015). In sitting or standing, the two psoae work bilaterally to stabilize the spine. In side bending and twisting, they work unilaterally to exert powerful torques on the spine. The movement pattern most associated with the psoas is flexion and extension of the hip and external and internal rotation of the thighbone. As illiacus is attached to the iliac crest, sacroiliac joint disruption could occur if the muscle is in a hypertonic or shortened state. The synergistic muscles are tensor fascia lata, sartorius, rectus femoris, and pectineaus. The antagonistic muscles are gluteus maximus and all three of the hamstrings (Long, 2006). When there is dysfunction these muscles could be associated or have their own imbalanced patterning depending on the individual and the specific holding pattern.
The psoas is an extremely sensitive muscle. This is likely related to its proprioceptive function in an upright postures. If we think of the psoas as a proprioceptive sensor, sending information about spinal position and movement to the central nervous system, rather than solely a motoric muscle, we can more readily understand its relationship to stress and holding patterns. The psoas’ sensitivity is also due to the numerous nerves that pass around, within, and through its muscle mass. Lying alongside the spinal nerve exits, the psoas’ front and back layers sandwich the nerves of the lumbar plexus. These nerve trunks, which give rise to the obturator, genitofemoral, sciatic, and other nerves, pass right though the psoas’ belly. This unique anatomy gives the psoas a potential role in certain types of nerve entrapment pain, such as groin pain, sciatic pain, or femoral nerve pain (Luchau, 2015). Other common disharmonies associated with the psoas muscles are: low back pain, hip pain, digestive irregularities, menstrual disharmony and pain, infertility, and emotional imbalances. Although, this cannot be proven with scientific evidence there are large bodies of eastern knowledge that will be elaborated further on in this paper.
The connection between a deregulated nervous system and an unhealthy psoas muscle, being either tight and weak, or tight and overactive could cause symptoms of anxiety. For example, shortness of breath, heart palpitations, pain, and feelings of fear, which we see from the connection between the nervous system and fascial restrictions created by chronic hip joint flexion in the deep front line of the body. This could negatively affect the different sections of the torso which the Chinese call the upper, middle, and lower jiaos’. Everyday ergonomics or life threatening trauma can cause compensations leading to a shortened and dysfunctional psoas (Koch, 2004). Here we see that traumatic experiences, such as a car accident, or simply sitting for too long in your chair at work can cause harm to the psoas muscle.
In the exploration of myofascial pain and chronic tension, a discussion of trauma is relevant to understand the complex process taking place. Peter A. Levine, a trauma expert with thirty years experience in the field defines trauma simply as a loss of connection. People become traumatized when their ability to respond to a perceived threat is in some way overwhelmed. A residual memory and sensation is left trapped in the body and has the potential to leave a residual imprint of helplessness, hopelessness, and feelings of being out of control.
Exposure to trauma affects brain development, the immune system, the hormonal system, and even how DNA is read and transcribed (Burke 2015). Trauma affects the nucleus incumbent, the pleasure and reward center in the brain, leading to substance abuse and addictions. Trauma inhibits the prefrontal cortex, in charge of impulse control. Additionally, the amygdala, the fear response center mechanism is critically disturbed. We can see that trauma has real neurological implications (Burke 2015). The hypothalamus pituitary axis (HPA), the brain and bodies stress response system, which governs our “fight or flight” mechanism of the sympathetic branch of our autonomic nervous system is also involved. It works like this: the hypothalamus sends a message to the pituitary gland, which then send a message to the adrenal gland to release adrenaline and cortisol. A persons heart begins to pound, pupils dilate, they are ready to fight and run. This system is either adaptive and life saving or mal-adaptive and health damaging (Burke 2015). In Chinese Medicine the body is seen as a holistic interconnected organism that is not constructed of separate parts. Therefore, exposure to trauma could negatively impact this unifying muscle, the psoas, that connects the upper and lower body. When a person experiences stress or a sympathetic charge to the nervous system blood rushes from the core of the body (middle jiao) and the vital organs (zang fu) leaving the muscle and fascial tissue less hydrated and innervated with blood flow, causing hypertonic or restricted state of functioning.
As described by Lonny Jarrett, an internationally regarded scholar, teacher, and practitioner of Chinese medicine, shock or trauma is a loss of our original nature. Through this process we become identified with our ego self. Children often respond to early trauma by shutting off their heart and suppressing their respiratory system. From a constitutional acupuncture model, there is a separation between the five elements and a loss in the heart and kidney or shen and jing access. Shen can be translated as spirit or the heart-mind, and implies our consciousness, mental functions, mental health, vitality, and embodied presence. Jing can be translated as essence. It is considered to be the underpinning of all aspects of organic life. This is the foundational axis of alignment between spirit and the potential virtue of each human being. The treatment of trauma is seen to begin with the restoration of the heart and kidney, with many other specific protocols access to support ones evolution and life (Jarrett 2006). The heart and kidney channels are located in the deep front myofascial line in close proximity and relationship with the psoas muscles.
Our postural holding patterns are shaped by our experiences, surely by our traumas. The hypothesis that our emotions (psychology) affect our physiology is one that has been long discussed in eastern philosophy, spirituality, and medicine. Stanley Keleman says, “Life makes shapes. These shapes are part of an organizing process that embodies emotions, thoughts, and experiences into structure. This structure, in turn, orders the events of existence. Shapes manifest the process of protoplasmis history finding a personal human shape—conception, embryological development and he structures of childhood, adolescence, and adulthood. Molecules, cells, organisms, clusters, and colonies are the beginning shapes of life’s movement. Later on a person’s shape will be moulded by the internal and eternal experiences of birth, growth, differentiation, relationships, mating, reproducing, working, problem solving, and death. Throughout this process, shape is imprinted by the challenges and stresses of existence. Human shape is marked by love and disappointment.”
The psoas is located in the region of the hara, in the medical tradition of Japan, hara refers to the soft belly, the energy field of the body. It is also referred to as the diantian, which loosely translates as “elixir field”, “sea of qi”, or simply “energy center” is where Qi flows and focuses. This is very important focal points for meditative and exercise techniques such as qi gong and thai qi in Chinese Medicine. This area of the body has been associated with the second chakra, svadhisthana, in energetic yoga anatomy (Long, 2006). This chakra or energy wheel meaning sweetness is correlated with the water element, feelings and emotions, sexuality, desire, pleasure, procreation, the uterus, ovaries, kidneys, bladder, and testies. Associated with low back pain and impotence or infertility (Judith, 1999). We see that the level at which the psoas is located, the health of the tissue will affect the functioning of these power centers.
In terms of posture, chronic flexion of an overactive tai yin posture, of curling in upon oneself, within the six stages, that associated with the spleen and lung meridians could be present. This would be a frozen nervous system expression. A running and standing up posture, that of an overactive psoas, is an overcharged tai yang posture, of standing rigidly upright, including the bladder and small intestine meridians. This body organization represents the fight or flight mechanisms of the sympathetic nervous system. The Chinese meridians and correlated sinew channels that are affected by their overlapping location are: stomach, kidney, spleen, Liver, ren mai, and bladder. It is said that the heart is closely connected with the uterus through the uterus vessel (Bao Mai) and this explains the profound influence of mental-emotional problems affecting the heart on the uterus. The uterus is related to the kidneys via a channel called the uterus channel (Bao Luo), which runs through the upper, middle, and lower jiao (Maciocia, 2017). Within the six stages shao yin, the heart and kidney relationship and as discussed by Jarred in response to trauma by the body would affect the postural malfunction of subtle bilateral spiral movement or pain patterns.
I would be remise if I did not mention the diaphragm, as it is the myofascial bridge between the upper and lower jiao. A healthy and nourished breath is key to healing the psoas and chronic holding patterns. The diaphragm muscle being an important pathway of information involving the entire body, specifically the upper and lower portion of the trunk. The diaphragm muscle extends from the trigeminal system to the pelvic floor, passing from the thoracic diaphragm to the floor of the mouth. Like many structures in the human body, the diaphragm muscle has more than one function, and has links throughout the body, and provides the network necessary for breathing (Bordoni & Zanier, 2013). When the sympathetic branch of the autonomic nervous system is in fight, freeze or flight mode. Blood moves from the internal organs to the extremities, breath is shallow and restricted, organ function decreases and muscle tissue becomes hypertonic or restricted in alert to this real or perceived danger. Another matter to consider is the connection between the respiratory and pelvic diaphragms. During normal respiration, or in the event of coughing or any other physiologic diaphragmatic alteration, a symmetric change in the pelvic floor can be observed (Bordoni & Zanier, 2013). The psoas forms a diagonal muscular shelf supporting the abdominal organs, viscera, and nerve ganglia. When supple, dynamic, and in harmony with diaphragmatic breathing, with every walking step the psoas acts like a hydraulic pump increasing circulation and connection to the organs. But when structurally misused the psoas can become exhausted leading to muscle tension, lack of vitality, and reduced flexibility (Koch, 2004).
From the Tao Te Ching and the words of Lao Tzu, “Human beings are soft and supple when alive, stiff and straight when dead. The myriad creatures, the grasses and the trees are soft and fragile when alive, dry and withered when dead. Therefore it is said: the rigid person is a disciple of death; the soft and supple and delicate are lovers of life. An army that is inflexible will not conquer; a tree that is inflexible will snap. The unyielding and might shall be brought low; the soft supple, and delicate will be set above.” It is clear that working with habitual holding and stress patterns is the key to unwinding and healing a chronically flexed, dry or stiff and overstretched psoas muscle. Prevention includes stretching and releasing holding patterns through yoga, somatic meditation, limiting sitting, and working with the nervous system and emotions. Sensing through subtle movements and awareness rather than invasive techniques that aggravate the sensitive region that is highly innervated with nerves and in close proximity to the kidneys, ovaries, and lower intestines.
Enhanced proprioceptive awareness of the psoas is in itself therapeutic, through gentle intensity of experience and connection to movement in novel ways there is often something deeply satisfying about receiving skillful psoas work (Luchau, 2015). The power of both professional support through acupuncture, massage, and internal exploration could create a lasting and powerful transformation in a chronically contracted psoas, stress patterns, and postural dysfunction. Thus, awakening greater communication between the heart and kidney and the upper, middle and lower jiaos’ to insure the free flow of Qi and harmony of yin and yang. So that shen and jing can awaken a deeper sense of vitality, ease of movement, and freedom from pain.
Bordoni, B. & Zanier, E., 2013, Anatomic connections of the diaphragm: influence of respiration on the body system. Multidiscipline health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731110/
Burke, N, 2015, How childhood trauma affects health across a lifetime. TED Talks. https://www.youtube.com/watch?v=95ovIJ3dsNk
Jarrett, L. S, 2006, The Clinical Practice of Chinese Medicine. Stockbridge, MA. Spirit Path press.
Judith, A, 1999, Wheels of Life, the classic guide to the chakra system. Llewellyn Publications, Woodbury MN.
Keleman, S.,1985, Emotional Anatomy, Center Press, Berkeley California.
Koch, L., 2004, The Psoas Muscle, Issue 72, p30-31. 2p. http://web.a.ebscohost.com
Levine, P. A. 2008, Healing Trauma, a pioneering Program for restoring the wisdom for your body. Colorado, Sounds True, Inc.
Long, R., 2006, The Key Muscles of Yoga, Bandha Yoga Publications, China.
Luchau, T., 2015, Working with the Psoas, Massage & Bodywork, Vol. 30 Issue 4, p106-109. 4p. http://web.a.ebscohost.com
Maciocia, G,. 2017, The Heart Channel, connection with Uterus, Santa Barbara, USA. http://www.giovanni-maciocia.com/articles/heart.html