Category Archives: Spine

PSOAS Plus

“Your psoas is tight”

“I have a pain here (pointing to the anatomical muscular attachment place of the psoas on the inner thigh) and I think it is my psoas”

“I am told my psoas is my problem”

Have you said, been told or heard someone express these statements in one form or another? As a movement professional, I have heard and been told, even about my own body by other professionals, these very thoughts about the psoas.

For those who are not body professionals, the psoas is a complex, very long muscle that runs from the base of the ribs (12th rib) and 12th vertebrae of the thorax and runs along the spine merging with all sorts of other connective tissue (other muscles, fascia, bone and more). According to the muscle anatomy books, the psoas attaches to a bony protuberance on the inner upper thigh bone called the lesser trochanter. The body professionals, who are very committed to learning and discovering how the body thrives, moves and heals, have different opinions of the actual function of the psoas in terms of posture and movement.

How do you know your psoas is tight? Many answers would be my hip flexors are tight. Yes, the ability to extend your hip may be limited. Is it only the psoas restricting the movement? Are you purely moving the hip joint (normal pure hip extension is 10°-15°) or is your range including the movement of the pelvis and spine creating a larger range? Your hip flexors include all of the muscles that are on the anterior (front and inner sides of the hip).

See the illustration to save me from typing the names of many muscles! What you may not be aware of is that the fascial connections and relationships of the front of the hip allow for good range of hip extension.

Is the psoas a hip flexor in active straight leg raise?

It is possible that fascial restrictions are limiting the range of motion, causing discomfort or torque of the spine and pelvis. An example would be a restriction of the fascia of the scapula that merges into the ribcage and pulls on the opposite side pelvis. This will spiral the body in a direction where extension of the hip and spine can be restricted.

In a recent training, Madeline Black’s Immersive Body Training, I was demonstrating and teaching the details and techniques for working the “psoas”. We cannot talk about or work with the psoas without addressing other structures. The psoas does not perform alone nor does it affect our posture and movements alone. We decided to say “Psoas Plus”  rather than “psoas” to be inclusive of all that is in the neighborhood of the psoas and how other structures influence movement.

Another reference that is made to a tight psoas is the pelvis position and spine while standing. Most people are told that an anterior pelvis (when the top of the pelvis from the front is tipped forward which increases hip flexion) is an indication of a tight psoas. The reasoning is the notion that the psoas influences the spine. There is no objective data determining actual skeletal position or where the curve is coming from. Someone may have very tight back muscles (erectors) without the support of the abdominals in the front and around the waist (myofascial core ring) and tight hip flexors (see illustration again) that pull the pelvis forward. If this person lies down on their back, the spine would be extended off the table, and the pelvis in an anterior tilt. Saying this is a psoas issue is simply inaccurate.

What is the function and dysfunction of the psoas? As is cited by Gibbons, Comerford and Emerson, the function of the psoas is lumbar stability and the initial action of drawing the head of the femur into the socket prior to hip flexion.
Stability Function of the Psoas Major by Gibbons, Comerford and Emerson

I think of the psoas as a lumbar spine stabilizer and femoral head spinner (the micro-movement initiator of hip flexion), and a hip stabilizer. One indication of a non-functioning psoas is when someone expresses a pinching pain when performing hip flexion. The head of the femur is not sitting well in the socket and the psoas is not able to draw the head into the socket. Teaching the clients or yourself how to engage the psoas prior to moving the leg is a necessary exercise to begin retraining the psoas.

When we do movements that are called psoas releases or stretches, remember you are actually moving the whole system –  the spine, intrinsic muscles of the spine, and again all that is living in the neighborhood. These movements and stretches do feel good and have benefits of improving body movement. And there are so many ways to move and change the tensions so that we have a supple spine.

You can learn more about how to work with the Psoas Plus by attending my Psoas as a Core Muscle workshop at Pilates on Tour in London, Pilates on Tour London
or Pre-conference Pilates on Tour in New Orleans Pilates on Tour New Orleans Pre-Conference Spine by Design
or attending one of the Madeline Black Immersive Body Trainings. http://www.madelineblack.com/workshops/

Below is a video where I am working the Psoas Plus by engaging the leg through hamstring activity, at the same time reaching the same side leg by pressing into the wall, and moving the spine into flexion using the opposite leg so that the spine can move toward the floor creating an active lengthening of the Psoas Plus! I will be posting more Psoas Plus movements in my Member Blog. http://www.madelineblack.com/memberships/

Illustration of the psoas is from “Centered” by Madeline Black, permission by Handspring Publishers

Upper Thorax: Vertebromanubrial Region

Check out my new workshop over at Fusion Pilates.

Upper Thorax: Vertebromanubrial Region
I will guide you through the intricate relationship of the 1st- 2nd ribs, sternum with the cervical spine, shoulder mechanics and overall posture. Discover the power the upper ribs have when moving the head and arms. Also this area is one of great discomfort for many people. I’ll teach exercises on the Pilates apparatus and mat that specifically address mobility and stability of this region. See how a new perspective of the upper ribs changes your cueing that translates easily into your client’s body.

This workshop is approximately 1.2 hours long and you have 30 days of access when you purchase. Go to FusionPilates.edu for details.

New study doing side plank reduced spinal curve in scoliosis Flawed or Benefit?

A study released in 2014 suggests treating scoliosis with a side plank has been all the buzz of the yoga community, reported in the Wall Street Journal and in the current March issue of the IDEA fitness magazine. The lead study author is Dr. Loren Fishman of Manhattan Physical Medicine and Rehabilitation and professor at Columbia Medical School in NY. The study was published September 2014 in Global Advances in Health and Medicine. Read the study for yourself: Global Adv Health Med. 2014;3(5):16-21.

This study is so flawed that it amazes me that it has gotten so much press. There was no control group, relied on self -reporting, too small a group and including adolescence age participants. Never the less, there is a positive side of this study and that is stability work changed some of the spines who participated in the study. And the medical community is turning toward movement and training as treatment for Scoliosis.

click to enlarge
click to enlarge

For movement educators/trainers, scoliosis is a spinal condition that is complex to train. Understanding how the spine moves and adapts to gravity is important when working with this population. It is not as simple as a “C” curve or “S” curve. This makes it sound as if there is one curve or two. A “C” curve is actually three or four if considering the whole spine. The training idea of a weak side and strong side is old information. The spine is a whole 3 dimensional structure with many forces playing on it from the fascia, muscles, ligaments, arms, legs and organs to name a few. We have to consider and challenge the whole spine.

Working with the three-dimensional motion of the spine may be the key to bringing the spine closer to center or it can become the downfall of increasing the curvature. When one area of the spine, the lumbar for example, is moving into a side bend then the entire spine adapts. Using the 3D model, there are coupled movements of rotation and either flexion or extension. All of which, we as movement educators and trainers need to take into consideration.

The Pilates apparatus and specifically cued movements are extremely effective to improving the life of a person with scoliosis. I offer a workshop educating the trainer/ teachers on the 3 dimensional aspects of the spine in relation to scoliosis and how to work with the spine in a simple and safe way. There are two opportunities this year. Coming up fast is a two day workshop at Studio 26 in NYC March 28-29, and a one day workshop at Pilates Chicago May 17th.