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What pain and symptoms are associated with the iliopsoas muscle?

• Low back pain
• Abdomen pain
• Groin pain
• Leg pain
• Pelvic pain

What movements does the iliopsoas muscle control?

• Picks up the thigh (when you raise your thigh toward your stomach)
• Assists in straightening the spine
• Assists in side bending

Where is the Iliopsoas muscle?

The Iliopsoas is comprised of three muscles the iliacus, psoas major, and psoas minor. The psoas major and minor attach to the lower back vertebrae come down to the inside of the hip bone to join with the iliacus which lines the inside of the hip bone. The 3 joined muscles then run through the pelvis to connect with the upper leg.

Activities that cause iliopsoas pain and symptoms:

• Strenuous running
• Climbing stairs
• Sit ups or leg ups
• Sitting for long periods

How Can Massage Therapy Relieve Pain and Symptoms Caused By The Iliopsoas Muscle?

The iliopsoas muscles lie under the intestines but are accessible for massage. Trigger points throughout the muscles need to be need to be released and the muscles soften and elongated by stretching to reduce pain and symptoms. Less common, the iliopsoas will need strengthening exercises instead of stretching. Examination and range of motion tests are needed to determine treatment.

Interesting facts about the iliopsoas:

The iliopsoas is an important postural muscle and plays a major role in human’s upright stature.

Clinical diagnoses to which this muscle symptoms may contribute: Quadratus lumborum syndrome, Sciatica, Trochanteric bursitis, Rheumatoid arthritis, Osteoarthritis, Surgical adhesions, Sprain/Strain of the low back

Other muscles that should be considered and examined in conjunction with the iliopsoas:

• Rectus Abdominis
• Abdominal Obliques
• Diaphragm
• Adductor Magnus
• Adductor Longus
• Adductor Brevis
• Pectineus
• Gracilis
• Quadratus Lumborum
• Lumber Erector Spinae Muscles

Iliacus

Origin: Superior two-thirds of the internal surface of the iliac fossa, the inner lip of the iliac crest, the ventral surface of the sacroiliac and iliolumbar ligaments, and the upper surface of the lateral part of the sacrum.
Insertion: The lesser trochanter of the femur after being joined by the tendon of psoas major. The conjoined tendon passes under the inguinal ligament to enter the thigh
Action: Flexion of thigh at hip, assists in extension of the lumbar spine
Innervation: Femoral nerve (L2, 3)

Primary Actions:

1. Flexion of thigh at the hip

• Agonists: Psoas Major
• Antagonists: Gluteus maximus, Semitendinosus, Semimembranosus, Biceps Femoris (long head), Adductor magnus (posterior)

2. Flexion of the pelvis at the hip

• Agonists: Psoas Major
• Antagonists: Gluteus maximus, Semitendinosus, Semimembranosus, Biceps Femoris (long head), Adductor magnus (posterior)

Psoas Major

Origin: Anterior surfaces of the transverse processes of T12-L5 vertebrae, the upper two thirds of the iliacus
Insertion: The lesser trochanter of the femur
Action: Flexion of thigh at hip, assists in extension of the lumbar spine
Innervation: Lumbar plexus (L2 – L4)

Primary Actions:

1. Flexion of thigh at the hip

• Agonists: Iliacus
• Antagonists: Gluteus maximus, Semitendinosus, Semimembranosus, Biceps Femoris (long head), Adductor magnus (posterior)

2. Assists with extension of the lumbar spine

• Agonists: Iliocostalis lumborum, Longissimus thoracis
• Antagonists: Rectus Abdominis

3. Lateral Flexion of the spine when acting unilaterally

• Agonists: Iliocostalis lumborum, Longissimus thoracis, Quadratus lumborum, External and Internal Oblique
• Antagonists: Same as agonists but on the opposite side.

Psoas Minor

Origin: Bodies of T12 and L1 and intervening intervertebral discs
Insertion: Fascia over the psoas major and iliacus
Action: Flexion of thigh at hip, assists in extension of the lumbar spine
Innervation: Ventral primary rami of L1
Primary Actions: Because of its position and size the psoas minor is not a prime mover.

Secondary Actions:

1. Assists with flexion of the thigh at the hip

• Agonists: Psoas Major, Iliacus
• Antagonists: Gluteus maximus, Semitendinosus, Semimembranosus, Biceps Femoris (long head), Adductor magnus (posterior)

Satellite Trigger Points: Quadratus lumborum, Rectus abdominis,  Tensor fascia latae, Gluteus maximus, Gluteus medius, Gluteus minimus, Thoracolumbar paraspinals, Piriformis

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