Psoas Muscle: A Key to Chronic Pain Relief?

“Where is the psoas muscle?” is a question a surprising number of students ask even after studying with me for years. How can it be that hard to remember where a muscle is? Or maybe the question is why is it so hard to remember where a muscle is?

The psoas is a mysterious muscle. For some reason—and I don’t really know why—it is off the radar of too many doctors and healthcare practitioners. And I’m not sure why, since I think the psoas is the most important muscle in the body. I believe it is also the answer to many chronic pain issues that traditional methods fail to heal.

Chronic Pain: What Part Might the Psoas Muscles Play?

This post is for people who have spent a lot of time seeking those traditional methods. You have been to multiple doctors, repeated rounds of physical therapy, and maybe even undergone batteries of tests only to be told that nothing is wrong. And that can make you feel crazy.

The pain is real, but the x-rays and MRIs show that your spine looks okay, your hips are fine, and nothing seems to be off. But here’s the thing: a tight psoas muscle causing you to live in a state of chronic pain won’t show up on tests. If health practitioners don’t have an understanding of what problems a tight psoas can cause, there is absolutely no reason why you would find relief.

In order to heal, you have to step outside the box and look at things with a new approach. And knowing where the psoas muscle is key to your healing journey.

When I say the psoas is a muscle of pain and trauma—and this might be a stretch for some—I am suggesting that unprocessed energy that our bodies can’t handle at a given moment can end up being stored in the psoas muscle.

Bear with me because I know that is a bit out there. Let me explain.

What is the Psoas?

Before I get there, here’s some more detail about the psoas. The name psoas is of Greek origin, meaning “muscle of the loin.” Here is how to pronounce psoas: so-az, the P is silent.

The psoas is one of only three muscles that connect the legs to the spine. It connects the legs to the anterior lumbar spine. The other two, the gluteus maximus and piriformis muscles, connect the legs to the spine at the back of the body. The psoas major muscle connects at six points along the spine and the leg.

The simple answer to where the psoas muscle is: it’s deep in the core. It attaches to the back of the body at the base of the ribcage, along the anterior side of the lumbar vertebrae, and at the front of the body on the back half of the femur or leg bone.

Among the unique characteristics of the psoas is that it changes direction, which not many muscles do. It moves forward from the bottom of the spine to cross the front of the pelvis. Then it moves back to attach to the back of the leg. That’s how and where the psoas connects.

What Does the Psoas Muscle Do?

It is the body’s main hip flexor, which is important both physically and emotionally. A flexor muscle brings two body parts closer together. In the case of the psoas, that means lifting the foot up to take a step.

The hips must flex with each step we take, and if done well, each step is initiated by the psoas. The psoas also plays a role in situps, initiating the movement before the abdominal muscles take over.

But the question of where is the psoas muscle located doesn’t get near the importance of this muscle. That’s because sometimes flexion can be related to the body’s fear response. When we experience fear, our natural response is often to fold inward—i.e., to go into flexion—to protect ourselves.

Pain, Trauma and the Psoas

Traumatic events or unprocessed energy from traumatic events live in the body. This, of course, includes the psoas muscle.

Here’s how it works. Human beings are survivors. We are born to survive and to adapt in order to survive. Survival requires safety or the feeling of safety. But life is full of intense experiences, both large and small, that can get the best of us.

We can lose hold of that safety for many different reasons. It could be that you live geographically in a place of conflicts—such as a war zone, a dangerous neighborhood, or an emotionally or physically violent household. It could be a car accident, a mugging, or a near-death experience. The list goes on.

When we no longer feel safe for whatever reason, the balance of our nervous system is thrown off, and the body begins to compensate in order to get by. For example, compensation for injury often takes the form of a limp.

But trauma and its aftermath can manifest in different ways, including pain that doctors fail to diagnose. That’s where the psoas muscle, in all its mystery and majesty, comes in.

Trauma Lives in the Body

I know this might seem a little woo-woo. And I know a lot of people might not think they fall into the category of someone suffering from trauma. I also know that a number of people will read this and feel heard for the first time in a long, painful journey.

Life is messy and complicated. It is not meant to be easy. We will all experience trauma in our lives. But the good news is that in response to trauma, we develop a support system to fend off the slings and arrows that life sends our way.

But some people are more sensitive than others, and their nervous systems can’t cope as well. There are some events that simply can’t be processed as they are happening. If the mind can’t handle something in real-time, it has the ability to lock the event somewhere out of reach.

The trauma that’s out of reach to the mind is still in the body because that energy has to go somewhere. I believe that the psoas muscle is one of the places where trauma can take up residence.

What Does a Tight Psoas Look Like?

Everyone has one psoas muscle that is tighter than the other. Even if you don’t have psoas problems, we all have a dominant side, and those muscles are often stronger and/or tighter than the other.
A tight psoas that leads to pain tends to be much tighter and often, but not always, pulls the body into a pattern resembling the picture above. Do you see yourself in that picture?

Where it gets interesting is that psoas pain symptoms can take a number of different forms. And psoas pain can manifest in different places.

Before we cover the symptoms of a tight psoas muscle, we should discuss exactly what pain is. Because pain isn’t a thing. Pain is just a reaction in the body telling you that something is wrong. When you get into a car accident or trip and sprain your ankle, pain can be especially useful because as it diminishes, you know you are healing.

On the other hand, pain can also be a warning sign telling you to beware because trouble is brewing. Think of a runner who develops hip pain over the course of months. Mild soreness after a run that goes unattended can lead to chronic pain. By failing to pay attention to the warning signs until it is too late, it is not uncommon to end up with a serious injury. All too many people don’t pay attention to those warning signs before it is too late.

Symptoms of a Tight Psoas

• Low back pain
• Hip pain
• Groin pain
• Wrapping pain from the groin to the low back
• High buttock pain
• Waking up to urinate multiple times a night
• Extreme menstrual cramps

Because of the psoas muscles’ deep connection to the spine and core, if you have an ankle injury that no one can diagnose or help you heal correctly, it’s worth taking a look at this amazing muscle.