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The Hidden Root Of Pain The Iliopsoas Muscle The iliopsoas muscle is referred to as a «hidden prankster» in Myofacscial Pain and Dysfunktion:The Triggerpoint Manual by Janet Travell and David Simons. They couldn`t find a more fitting label for this complex muscle. The iliopsoas has numerous keyfunctions in the body,often become painful and can also be responsible for variety of postural distortions and compensations. 2 muscle in one m psoas and m iliacus The psoas major muscle attaches along the lumbar spine and intervertebral discs and than descends obliquely to attach at the lesser trochanter of the femur. The m iliacus attatches to the upper two tirds of the ilica fossa than descends to join the the psoas major tendon, with some of its fibres attaching direct to the femur near the lesser trochanter. Keyfunktions of the iliopsoas The primary function of both the m psoas and iliacus is hip flexion, known as the flexion of the tight. In other words, these muscles lift the knee to take a step in walking. When you ascend stairs, the iliopsoas must lift the knee higher and therefore must work harder. Both muscles can assist in thigh function (raising the leg away from the boddy) and to some extent external tight rotation as well. Due to this attatchment along the spine, the psoas plays a major role in maintaining upright posture.It can assist in extending the lumbar spine and when excessivly short, can contribute to excessive lumbar lordosis. During sitting and standing, the psoas remains active. The iliacus may or may not be active during sitting and is often active during standing. Iliopsoas syndrome One very commen problem is that they can both shorten over time, specially in those who sit for long periods of time. Prolonged sitting in which the muscles are in shortened state for extended periods of time can lead to the muscles getting used to this posion and adapt to this. Once in adapted state, muscles have trouble in returning in their normal resting length. This is a basic characteristic of muscle function. The Cross-Bridge Theory which attempts to explain the contractile action of muscle tissue assert that,once contracted, a muscle cannot lengthen on its own. The contractile muscle must be streched back to their original resting length by an outside force, before the muscle is able to actively contract and relax again. In some cases you can relax this muscles with streching exercises wich has to be done religously day in and day out. But in some cases the fibres of the muscles become adhered together and stuck. In this cases you need manual therapy techniques. Consequences of Chronic Muscular Contraction If a muscle can return not to its normal resting length, it then resides in a state of chronic contraction. Numerous undesirable consequences can result: • • • • • A chronically contracted muscle can become ischemic(low in blood flow) An ischemic muscle is often a painful muscle. A chronically contracted muscle can develop trigger points which refer pain (or sensations -thermal,tingling,numbness,aching) either radiating out from the muscle or felt in other parts of the body. A chronical contracted muscle can distort the movment of the joint it crosses. For example, a chronically tight iliacus could reduce movement in the front of the hip. A chronically contracted muscle can cause other compensations or distortions in the body. If a chronically tight iliacus reduces movement in one hip, then the other hip or the spine or other parts of the body will be called up to compensate or to change their normal pattern of movement. Achronically contracted muscle may be responsible for entrapment of nerves, another cause of pain. In case of the iliopsoas, entrapment of following nerves is possible: the femoral nerve, the lateral femoral cutaneus nerve, the femoral branch of the geniofermoral nerves, the iliohhypogastric nerve and ilioinguinal nerve. Or we call it simply ischias pain. Potential Regions of Pain • • • • • • • • Lower abdomen Buttocks Hip Lower back Down the leg Groin SI joint Across the top of the hipbone