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*Burlington Runner’s Club newsletter submission THE PSOAS MUSCLE EXPLAINED The psoas muscle (pronounced “so-az”)…… commonly talked about in running circles, the psoas muscle has developed a bad name! And perhaps rightly so, as the root cause of many lower extremity injuries is due to excessive tightness of the psoas. The psoas muscle is our main hip flexor and is responsible for bringing the knee forward and up during a running (or walking) stride. The psoas attaches to the front side of the lumbar spine, deep within the abdomen, and runs across the front of the hip joint, also attaching to the top of the femur. Many runners experience injuries to the lower body, often due to overuse. These injuries are frequently attributed to muscular weakness or dysfunction of the gluteus muscles (buttocks). In many cases, however, the psoas muscle is the root cause of the problem and the glutes are a symptom. Without addressing the original cause of the injury, the runner will continue to experience pain and/or weakness. So how are these muscles related? The psoas and glutes are opposing muscles; that is, their functions are opposite. The psoas flexes the hip and brings the knee forward, while the glutes are responsible for extending the hip and bringing the leg backward. In this way, the psoas and glutes act to stabilize the sacroiliac and hip joints. Muscular stability of the pelvis is primarily maintained by the psoas, gluteus maximus (buttocks), and gluteus medius (on the upper outside of the hip), and problems arise when these relationships are not balanced. Muscular stability is crucially important when preventing and managing injuries. There are three areas that comprise “pillar stability” (Verstegen and Williams, 2005): pelvis, spine, and the shoulder girdle. It is these areas from which all movement is produced and controlled. As we sit at our desk, in our cars, and on our computers, the psoas muscle becomes excessively tightened and shortened. As described by Dr. Vladimir Janda, a neurologist and physiatrist renowned for his anatomical research, the excessively tight psoas not only restricts movement of the hip, but also lengthens and inhibits the glutes via reciprocal inhibition, a neurological mechanism. This mechanism, first reported in 1907 by Charles Scott Sherrington, is quite simple: when one muscle contracts, its opposing muscle must relax. So, when the psoas contracts or is excessively tight and shortened, the gluteus maximus (the opposing muscle) is neurologically forced to weaken by this inhibitory reflex. And voila! A pelvic muscular instability develops! The weakened glutes then do not provide the necessary stability and control of the pelvis and leg, thereby overloading the smaller muscles of the lower body. Working beyond their capabilities, these smaller muscles can become injured and the overtaxed muscles tighten as a protective effect due to the overloading. These compensations often rear their ugly heads as injuries in hamstrings, quadriceps, piriformis muscles, calves, and lower backs. This is evidenced in most runners by the excessive tightness, restricted range of motion, and excessive tenderness to pressure. What to do, what to do? Keeping the psoas lengthened is crucial- and this is not an easy task in our sitting-dominant society. Avoid prolonged sitting and take frequent walk/stretching breaks while at work. Stretch out your psoas muscle via a lunge stretch, whereby you focus on opening up the front of your hip. Yoga is also a great way for runners to cross-train, improve flexibility, and strengthen pelvic stability. For many runners, stretching is not enough and manual therapy is also indicated- Active Release Techniques (ART®) or deep-tissue massage can help to keep the psoas loosened. Strengthening of the glute muscles is also significant, and this can be achieved via exercises that engage in the correct sequence and movement patterns of glute firing, such as glute kickbacks and single-leg extensions. Lateral movement exercises (side to side) can be incorporated to maximize recovery and optimize function by assisting the glutes in their hip stability role. In summary, by avoiding psoas tightness, the glutes are able to function properly, thereby preventing overload on the smaller muscles of the lower extremity and decreasing the risk of injury! Now go stretch your psoas! -Dr. Ashley Worobec