Menu
The iliacus and psoas muscles are an often-missed cause of lower back, groin and front of thigh pain. Knowing how to release psoas trigger points can be a highly effective way to get mobile and pain-free again.
This article will cover:
The iliopsoas muscle is a big strong thick band of muscle. It’s used in any kind of movement to do with walking, running, and standing. The iliopsoas muscle is composed of two muscles: the psoas and the iliacus.
While all the other lower back muscles connect to the back of the lumbar spine, the psoas attaches to the front, making it a very deep muscle. It then runs through a gap in the pelvis and attaches to the femur – your thigh bone.
It’s a huge muscle joining the pelvis, lumbar spine, and femur with large tendons. It’s also one of those muscles (like the trapezius,) that have two mobile attachments, making it vulnerable to trigger points and overuse.
The iliacus runs around the inside of the iliac bone of the pelvis. This is a broad, fan-shaped muscle that attaches to the inner surface of the pelvis, then join with the psoas and attaches into the femur.
It’s also a huge muscle, sitting in the cup of the pelvis. Triggers in this muscle are not as deep as the psoas, but you do need to hook your fingers round and press onto the inside of the pelvic bone (see the pictures for more detail.)
These muscles join up an insert into the femur (thigh bone.) Together, they are called the iliopsoas.
When the iliopsoas contracts, it flexes the leg or pulls the femur upwards at the hip. It is a very important hip flexor, used to bring your leg forward. There’s only one other muscle that flexes the hip joint and that’s the rectus femoris, which is a lot weaker.
Every time you walk, run, jog or jump, you’re using the iliopsoas to do so. The psoas is also used for posture, to keep you steady as you stand.
Movements that set off trigger points can be when you strain the muscle by lifting your leg against a weight or accidentally doing the splits. Once you have active trigger points, any movement that involves lifting your leg can turn on pain in the muscle. Triggers in this muscle can also make your leg feel weak.
Trigger points in the psoas are often secondary to other muscles. As it’s an important posture muscle, it’s often involved with other muscles which may be causing lower back pain, abdominal and buttock pain.
These trigger points can be very tender. They can cause pain in the back, groin, front of the thigh and abdomen.
Psoas trigger points are often missed – particularly as a cause of back pain. There are two reasons for this. The first is that the psoas is reached from the front – not the back – so it’s overlooked for someone with back pain.
The second reason is that it’s such a deep muscle. You have to press very deeply into the abdomen to get there – pretty much down to your spine, but from the front.
The only way to get to the triggers is to make sure all the muscles between the psoas and your skin are relaxed. You need to lie on your back and be very relaxed. Make your tummy as soft as you can, and take your hand or a trigger point tool and push down into the abdomen, to the side of the rectus abdominus (your six-pack.)
You have to push deep inside your belly to reach the trigger points. It can be an uncomfortable operation, however, it can get you fast pain relief.
It’s a good idea to use breathing to stay relaxed during the treatment, as the trigger points are often very tender.
You have to go through a whole lot of other structures before you get to the psoas. Depending on exactly where you press, this may include: the bowels, sigmoid colon, middle of the bladder. On the other side of your body, there’s the appendix, and in women, there’s the ovaries and fallopian tubes.
All these structures can be painful when pressed on, and you need to make sure you’re really getting down to the psoas. I
It’s important to rule out these organs as a source of pain before going on to treat the psoas. That said, you can get psoas trigger points as a reaction to organ pain. Or trigger points can be a potent cause of lower back, groin, abdomen and front of thigh pain on their own.
The iliacus muscle is easier to reach. You search for trigger points by hooking your fingers inside the iliac crest. Because this is an area which doesn’t normally get any kind of massage, trigger points, if active, are often extremely tender.
When you treat the trigger points, spend time pressing on the area to make sure you’re right on the point. Signs that you are on the trigger include: a sudden increase of local pain, or the pain referral pattern becoming active.
Once you find the spot, press in more deeply, gradually increasing the force while staying below the pain threshold. Use the ischemic pressure principle to turn off the trigger point.
Then, stretch the psoas muscle by extending your hip. Lie on your side, put a heat pack on the muscle, and leave your leg hanging over the side. Let it drop down to create a stretch.
The psoas is a big strong muscle. However, it’s so deep and hidden away it’s difficult to diagnose and treat.
If you have triggers in the psoas, sometimes just lifting your leg off the ground can cause intense pain.
If you want to get more information on how to release psoas triggers, here’s where to get started with a Free Trigger Point Manual >>>
Alternately, the Lower Back, Buttock and Pelvis Trigger Point Course gives full video instructions for treating all the major muscles in the body, including the psoas.