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If there is one muscle that I would pick for everyone to pay attention to, it’s Psoas-Iliacus (well, it’s technically two muscles, but hey) also known as your hip flexor. However, PI is probably the least known and least attended to muscle in the body. A person typically will go their entire life without even knowing it’s there, really. You can’t see it, palpate it, and unless you’ve had a health specialist show you, you wouldn’t know how to strengthen it either. In spite of all that, it’s one of the most used and abused muscles in the entire body and it is crippling us as we get older.

Here’s what you need to know about Psoas-Iliacus.

  • Part of your core: 
      • The Psoas-Iliacus is a core part of your core (lol). It is the major way your torso and legs draw close to each other. You wouldn’t be able to lift your leg off the ground without it. The abdominals are the most known part of the core and much easier to strengthen than PI. They are important, but I would argue that psoas is a larger component to well-being since it attaches to the lower spine.
  • Essential for lower back health

The top of this muscle attaches to the outer processes of the lumbar spine. The lower muscle attaches to the thigh bone and along the way fills the inner hips. Besides Psoas-Iliacus, there’s really only a couple of muscles that even attach to the lower back, but most often, I find Psoas the cause of any low-back discomfort. Even when it isn’t the major cause, it is usually a spirited contributer.

  • Gets irritated by sitting too long

The best way to ensure low back pain is a part of your life is to sit for long periods without movement. This allows the muscle to lose flexibility and bloodflow before you try to move it. I usually use the metaphor of spaghetti. Our muscles are made up of lots of long fibers. When we stop moving them, they sort of “dry out”. That’s why athletes move before competition, to get the blood flowing again.So think of when you make spaghetti. If you leave it out for about a half hour, when you go to stir it, the noodles break. Similarly with muscle fibers, just not quite as dramatically. You sitting for long periods does double duty on Psoas-Iliacus though.

Sitting puts it into a shortened position, and standing would be its long position. So by sitting and drying it out, then standing, you’re very likely to stress that muscle out. Think about how often we do that. Over the long term, this can cause serious complications and discomfort. The most intense (but not uncommon) result is PI pulling on structures, requiring surgery to correct.


How to care for Psoas

The challenge of modern life is that a lot of us are attached to our computers for eight hours a day. For the rest, try to keep moving. Muscles are made to move.

If you are chained to a desk, It’s best to keep a muscle in its lengthened position when in rest. For PI this is a reclined or standing position. A lot of people have switched to standing desks, but there are long term complications with that as well (circulatory stuff mostly). I personally use a chair to recline (feet up and everything) and use a hospital table to bring my computer to me. That’s not possible in all work environments, but if you have to choose either standing or sitting, try as much as possible to move. If that’s not really an option, make sure to take preventative measures like getting a regular massage.

Massage can also be great as a way to maintain muscle health and prevent trips to the PT or doctor. In my practice, I work on this muscle all the time. I do a type of trigger point therapy called Strain Counter Strain that is fairly effective at targeting and eliminating trouble spots in the muscle. If you’re experiencing discomfort currently head over to the Schedule page and set up your first in-home massage!


Wishing you well,


Meredith Lynch, RMP