The above a good illustration of how the psoas attaches to the spine and femur.

The above a good illustration of how the psoas attaches to the spine and femur.

  Most everybody at some point will experience low back pain.  If you're lucky its short term and very mild!  Unfortunately, this is not the case for most of us and for a small percentage of us we will experience life long, debilitating low back pain!  In almost every case it could have been prevented with a little foresight and hard work.  For those with low back pain caused by a major trauma (car crash etc.) this article may not provide much insight but it may help you understand a little more about your pain and suffering.

The crunch is a good exercise that isolates the rectus abdominals without engaging the psoas, as long as the shoulder blades remain on the floor, with trunk flexion.

The crunch is a good exercise that isolates the rectus abdominals without engaging the psoas, as long as the shoulder blades remain on the floor, with trunk flexion.

   What is the psoas!?  The psoas muscle's primary job is to perform hip flexion.  Its attachments are as follows:  the proximal attachment is at the anterior aspect of the lumbar spine, it then runs down through the pelvis and attaches to the lesser trochanter of the femur (inner thigh).  So what is hip flexion?  To put it simply, anytime your knee gets closer to you chest or head, hip flexion is occuring.  Examples include: sitting, running, walking, sit ups (not crunches) and leg raises.

As you can see here the full sit up requires hip flexion which requires psoas contraction.  So if you're doing a lot of sit ups and your back keeps hurting you might reconsider how you train the core.

As you can see here the full sit up requires hip flexion which requires psoas contraction.  So if you're doing a lot of sit ups and your back keeps hurting you might reconsider how you train the core.

    Ok, so what does this have to do with back pain?  Possibly nothing but theres just as much chance that its a direct contributor to your daily discomfort.  When you consider our lifestyles include a lot of sitting (daily commute and desk jobs) and bad posture it makes sense that the psoas can become shortened and when it becomes shortened it pulls at its attachments on either end.  How does it become shortened?  Muscle memory or habit!  I'm sure most everybody is familiar with muscle memory, but in case not:  Muscle memory: the ability to reproduce a particular movement without conscious thought, acquired as a result of frequent repetition of that movement.  So to equate that definition to our current topic, When you sit around (at your desk or in traffic) for 8-12 hours/day (30-50% of your day) the psoas becomes conditioned to remain in a contracted state.  So know when you go to lengthen it by standing, it resists and does what it can to remain in that shortened position.  When it does that the majority of the pulls goes into the lumbar spine resulting in constant lumbar spine extension.  So what does this mean?  Well for one, when you're in constant lumbar extension the posterior elements of the vertebra are compressed and two your spine is in a less than optimal weight bearing position when in extension.  The spine is designed to be its strongest in neutral, allowing for short term stability when in flexion or extension.  Prolonged hyper lordosis (exaggeration of the natural lordotic curve of the lumbar spine) can lead to permanent changes in the structure of the vertebral bodies as well as ruptured intervertebral discs (think spinal sciatica) at which point your intermittent low back pain is now chronic if not permanent.

This is good form in stretching the psoas. Note how the trunk is vertical and in a neutral position, pushing through the pelvis. 

This is good form in stretching the psoas. Note how the trunk is vertical and in a neutral position, pushing through the pelvis. 

    So how do I prevent this?  Easy, a little hard work never hurt anybody, right!?  It starts with being conscious of your posture and making sure to stay balanced.  Don't sit too long at your desk, get up and move around.  Our bodies aren't designed to sit all day, so keep moving.  Stretch the psoas.  The hurdler stretch many of us know from youth soccer is a good one.  Make sure to push through the hips and not through the chest.  If you're extending your back to get a stretch you'll feel it in the quads and miss the boat.  When done properly you should feel the stretch in the groin.  Massage can be helpful with right LMT.  Chiropractic care is a big part of it.  In most cases the psoas is just a small part of a bigger picture and proper diagnosis is necessary to formulate an effective care plan, which should include adjustments, soft tissue work and exercises designed to correct any muscle imbalances.  

This would be an incorrect stretch.  He is pushing his chest forward while extending the lumbar spine.  you will feel a stretch doing this, just not where you want!

This would be an incorrect stretch.  He is pushing his chest forward while extending the lumbar spine.  you will feel a stretch doing this, just not where you want!

   At the end of the day its up to you to do something if you're in pain.  Pushing the pain out of your pain will only result in 2 things: 1. more pain and 2.  Longer recovery period.  So I highly recommend anybody with anybody with back pain or any pain for that matter, take the initiative and let a professional get them on the right track to wellness.  We aren't getting any younger people!  As always, If you have any questions feel free to schedule a free 15 minute consult or a new patient visit form the website and I'll be happy to see what we can do together.