Lower Back Pain and the Iliopsoas (PDF)

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Low Back Pain and The Iliopsoas Laura Staton, OTR/L, C-IAYT, APD Yoga Bones A Comprehensive Guide to Managing Pain and Orthopedic Injuries Through Yoga Yoga Alliance CE Workshop 4/05/21 [email protected] laurastaton.com IG: luluotyoga FB: Lulu OT + Yoga !1 The Iliopsoas muscle is a deep core muscle and considered a muscle of the posterior abdominal wall. It is comprised of the psoas major (and minor) and the iliacus. Together these muscles are the chief flexors of the thigh. They also help to maintain erect posture of the hip joint. !2 The psoas major is approximately 16” and starts at the base of the ribcage attaching to the five lumbar vertebrae on the transverse process and vertebral bodies. It then travels through the pelvis, merges with the iliacus, and attaches to the lesser trochanter !3of the inner thigh. The Iliacus Muscle lies in the iliac fossa, attaches to the sides of the sacrum and anterior sacroiliac ligaments, and merges with the psoas to attach to the lesser trochanter of the inner thigh. !4 The Psoas Major: With the origin fixed the lower portion flexes the thigh towards the trunk. With the insertion fixed the trunk flexes towards the thigh. The upper portion of the psoas bilaterally extends the spine and unilaterally flexes the trunk. The psoas major acts to extend and laterally flex the lumbar spine. The Iliacus: mainly flexes the thigh and stabilizes the hip joint. It is active with walking and does not flex or extend the lumbar spine. The iliacus has some involvement in abduction and lateral rotation of the femur. Because of the differing origins of each muscle the psoas acts more on the spine and the iliacus acts more on the pelvis. !5 The Connection to Lower Back Pain: • Bilateral shortness of the iliopsoas muscle increases lumbar lordosis. • Unilateral shortness (i.e scoliosis, leg length discrepancy) can cause rotation and tilting of the pelvis. • Weakness of the iliopsoas muscle decreases functional movements such as walking, stair climbing, getting out of bed, and getting up from a chair. • Weakness can also be a factor in a posterior pelvic tilt (i.e wheelchairs) • Because the psoas lies on the spine, injury to the spine (i.e. herniation) or psoas muscle, can cause a protective reflex spasm of the Iliopsoas. What repetitive movements cause shortness and weakness? sitting sitting sitting! !6 Poses From Yoga Bones 1a. Supta Tadasana (stretching the psoas) 1b. Find your psoas (feel your psoas) 2. Pavanmuktasana & Supta Padangusthasana (stretch) 3. Lunge with chair bent and straight legs (stretch) 4. Supported Setu-Bandhasana (stretch) 5. Thigh Presses (strengthen) 6. Leg Circles (strengthen 7. Ardha Navasana (strengthen 8. Vrksasana (stretch & strengthen) 9. Standing Marichyasana (stretch & strengthen) 10. Standing Tadasana (stretch & strengthen) !7.

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Iliopsoas Tendonitis/Bursitis Exercises
ILIOPSOAS TENDONITIS / BURSITIS What is the Iliopsoas and Bursa? The iliopsoas is a muscle that runs from your lower back through the pelvis to attach to a small bump (the lesser trochanter) on the top portion of the thighbone near your groin. This muscle has the important job of helping to bend the hip—it helps you to lift your leg when going up and down stairs or to start getting out of a car. A fluid-filled sac (bursa) helps to protect and allow the tendon to glide during these movements. The iliopsoas tendon can become inflamed or overworked during repetitive activities. The tendon can also become irritated after hip replacement surgery. Signs and Symptoms Iliopsoas issues may feel like “a pulled groin muscle”. The main symptom is usually a catch during certain movements such as when trying to put on socks or rising from a seated position. You may find yourself leading with your other leg when going up the stairs to avoid lifting the painful leg. The pain may extend from the groin to the inside of the thigh area. Snapping or clicking within the front of the hip can also be experienced. Do not worry this is not your hip trying to pop out of socket but it is usually the iliopsoas tendon rubbing over the hip joint or pelvis. Treatment Conservative treatment in the form of stretching and strengthening usually helps with the majority of patients with iliopsoas bursitis. This issue is the result of soft tissue inflammation, therefore rest, ice, anti- inflammatory medications, physical therapy exercises, and/or injections are effective treatment options.
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Department of Human Anatomy. Medical University of Białystok Beata Klim Gluteal region It lies posterior to the pelvis between the level of the iliac crests and the inferior borders of the gluteus maximus muscles. The intergluteal (natal) cleft separates the buttocks from each other. The gluteal sulcus demarcates the inferior boundary of the buttock and the superior boundary of the thigh. Gluteal region The gluteal muscles (maximus, medius and minimus) form the bulk of the buttock. Pelvic girdle- muscles The anterior compartment: Psoas major Psoas minor Iliacus They are called - Iliopsoas Iliopsoas Proximal attachments: Psoas major- sides of T12-L5 vertebrae & discs between them; transverse processes of all lumbar vertebrae Psoas minor- sides of T12-L1 & intervertebral disc Iliacus- iliac crest, iliac fossa, ala of sacrum & anterior sacroiliac ligaments Iliopsoas Distal attachments: Psoas major- lesser trochanter of femur Psoas minor- pectineal line, iliopectineal eminence via iliopectineal arch Iliacus- tendon of psoas major, lesser trochanter, and femur distal to it Iliopsoas Innervation: Psoas major- ventral rami of lumbar nerves L1, L2, L3 Psoas minor- ventral rami of lumbar nerves L1, L2 Iliacus- femoral nerve L2, L3 Iliopsoas Main action: It is the chief flexor of the thigh, and when the thigh is fixed, it flexes the trunk on the hip. It is also a postural muscle that is active during standing by preventing hyperextension of the hip joint. The gluteal muscles The gluteal muscles consist of: Three large glutei (maximus, medius & minimus), which are mainly extensors and abductors of the thigh. A deeper group of smaller muscles (piriformis, obturator internus, obturator externus, gemelli and quadratus femoris), which are covered by the inferior part of the gluteus maximus.
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Back of Thigh
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