The psoas rolls deep

Posted on December 24, 2013

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From an upcoming, much longer, post detailing my visit to Stanford University’s Clinical Anatomy Lab, where I worked with cadavers:

Dealing only in pictures the last few years really made me lose appreciation for how deep the psoas muscle is.

Psoas

We used one cadaver where, besides the skin, everything from the anterior trunk to the posterior trunk was present. Translating this to manual therapy on the psoas, you need to deal with and or go through:

  • Skin
  • Fat below skin (which can be a lot depending on the person)
  • Fascia
  • Rectus abdominus
  • External obliques
  • Internal obliques
  • Transverse abdominus
  • Large intestine
  • Small intestine
  • Water and various fluid

To think you’re going to effectively reach this muscle with a foam roller, tennis ball, or theracane, well, good luck. To think a manual therapist can effectively get to this muscle, well, perhaps a few who are very, very skilled.

Even if they can, you can’t do so without working the abdominals. Are you sure your abdominals need the work you have to give them in order to reach the psoas?

Second, I’ve heard some talk about moving other things out of the way in order to reach the muscle. You’re still risking pressing on the organs and other critical structures, and I’m not so sure we should be doing anything dealing with moving or pushing these around. I saw one technique state, “As you press deeper, if you feel pulsing, you’re pressing on the abdominal aorta! In which case you should move your hands laterally.”

Third, this type of work on the psoas is regularly regarded as exceptionally painful. After seeing how deep it is, I think “No shit. It’s like getting punched in the stomach.”

Evolution is pretty smart. Maybe pressing on the psoas and pushing in this area is painful because the psoas needs to be “released.” Or, maybe, you know, the body is crying out to stop because it’s worried about you pressing on the abdominal aorta.

Stupid body. All worried about living and crap.

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