Back Pain - could it be your iliopsoas?

Marathon Training Schedule advice…

The most persistent pain you may have if your are training for a marathon (half marathon) is back pain. It may be a result of the "pounding the pavement" hard surfaces or the extra running workload coupled with a desk type job (or drivers job) that requires long sitting hours.

There is a muscle group called iliopsoas that runs in front of the spine in your lower back that attaches to the femur (thigh bone) that helps with hip flexion (raising your knee whilst running) but in the sitting position if you don't have a good sitting posture it is also contracting to keep you from falling backwards.

As a massage practitioner the number one symptom for someone that had iliopsoas problems is the patient described a "struggle to stand up straight after sitting or driving". 

Other symptoms include:

Relief of pain is often experienced by sitting down.

Worse for doing situps.

Worsened by externally rotating the hip (i.e. making the knee cap look outward) when the hip joint is fully extended.

In patients with siatic nerve pain, lying flat on one's back with the legs out straight causes the trigger point tightened iliopsoas to compress the lumbar vertebrae together, with the result that the nerve roots of the siatic nerve are compressed too.

When lying flat on one's back, doing a straight leg raise reveals weakness on the affected side.

As with any trigger point, when a knowledgeable therapist applies pressure to the trigger point "knot" in the muscle, the pain is severe: "If the iliopsoas muscle is in spasm the patient will jump off the table. Believe me, it's that painful".

In patients with siatic nerve pain due to nerve root compression, lying flat on one's back with legs out straight stretches that trigger point tightened iliopsoas. The result is that the iliopsoas compresses the lumbar vertebrae together, and the the nerve roots of the siatic nerve are compressed at the same time.

The best advice I can give you to overcome this problem is seek out a good massage practitioner or Phsyiotherapists and ask for a "Psoas release"……I do have to warn you it is a painful procedure (the practitioner will "strip" their fingers through the psoas by going deep into your lower abdomen…. the best news is that the relief can be immediate!

As an ongoing remedy you can stretch the iliopsoas like this (moving in the direction of the arrow whilst kneeling in this position.