Low back pain – Psoas Paradox

“Spending much time Sitting – This is for you” 

Psoas is a major muscle in the human body, the attachment of this muscle is from the lumbar spine (low back) to the long bone of the thigh (femur).

The primary function of Psoas is to bend the hip forward (hip flexion) and when this muscle is tight, owing to its attachment in the lumbar spine, it pulls it forward resulting in increased stress at the low back causing pain.

But why?

Because, when we sit for prolonged periods of time, the hip flexors are in a shortened position and they tend to develop a certain tightness what we call an “adaptive shortening”. When we stand up, as shown in the picture above this tight muscles tends to pull the spine forward causing increased stress in the low back causing pain.  

While the pain is in the low back, the actual causative factor is in the front (the tight Psoas muscles). This is often observed in people whose job involves a lot of time sitting – office staff, receptionists, computer professionals, truck/cab drivers to name a few.s

What do we do about it?

One of the simple but most effective things to do is to just get up and move. There is absolutely no posture better than the “next posture”. By getting up and moving around for a bit, we break the tendency to develop this tightness. 

We typically recommend to get up and move every 20-30 mins. For some, you may also benefit with getting a tall office desk (also called standing desk) so that you don’t end up too much time sitting.

Are there any exercises?

Yes, yes and yes, the focus here would be to stretch the tight hip flexors and strengthen the lumbar core and hip extensors. However, I must mention here, that in many instances there never is just one cause and that one magic solution. 

If you have low back pain, we would be able to identify and address the contributing factors for your pain and dysfunction only after a proper assessment.

If you or anyone you know has low back pain, consult a physiotherapist, give us a call or email us. We will set up an appointment to complete an assessment and start your treatment.

While we are limited in terms of providing “in-person” visits to only those that are in “urgent” or “emergency” situations. We are still available via “telehealth” to assess and provide tangible treatment solutions to enable you to “Get well and Move well”

References:

Richard M Bachrach, Jeanette Micelotta & Carolyn Winuk (2007) The Relationship of Low Back Pain to PSOAS Insufficiency, Journal of Orthopaedic Medicine, 29:3, 98-104, DOI: 10.1080/1355297X.2007.11736333

Wendy Aspinall (1993) Clinical Implications of Iliopsoas Dysfunction, Journal of Manual & Manipulative Therapy, 1:2, 41-46, DOI: 10.1179/jmt.1993.1.2.41

Alf Nachemson (1968) The Possible Importance of the Psoas Muscle for Stabilization of the Lumbar Spine, Acta Orthopaedica Scandinavica, 39:1-3, 47-57, DOI: 10.3109/17453676808989438

Ben M. Stutchfield & Simon Coleman (2006) The relationships between hamstring flexibility, lumbar flexion, and low back pain in rowers, European Journal of Sport Science, 6:4, 255-260, DOI: 10.1080/17461390601012678

David G. Simons & Janet G. Travell (1983) Myofascial origins of low back pain, Postgraduate Medicine, 73:2, 99-108, DOI: 10.1080/00325481.1983.11697758

Image credit: Retrieved from: https://www.avogel.co.uk/health/muscles-joints/muscle-pain/psoas-muscle/. Retrieved on Mar 25, 2019


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