Ease Stomach and Back Pain by Focusing on the Psoas Muscle
The Psoas Muscle The One Muscle to Rule Them All
What if i told you that you can improve gut health, decrease back pain, and improve performance by focusing on one muscle? Well you can, and that muscle is the psoas.
Your psoas muscles are the main muscular connection between your torso and lower body. Their major function is to help flex your hip joint by bringing your leg up and in toward your torso. They also help strengthen your lower spine, which lends support to your posture.
Your psoas muscles are long — up to 16 inches. They extend from each side of your lower spine through your hips and connect to your upper thigh bone, called the femur. You use them every day when you: stand, walk, run, jump, dance, and maintain an upright posture. Essential at all times (1) .
The first time my massage therapist worked on my psoas it was weird and it HURT. The next day my body felt like a cooked noodle. The day after that I was performing like a superhero, just in time to set a new personal record in my upcoming meet. Previous to this massage session I had no idea what the psoas was, I just knew that my hips and back were tight. Fast forward 5 years to being diagnosed with ulcerative colitis and now my hips and back are tight again due to inflammation. Not only that, but I was suffering from bloating stagnation, and an upset stomach. I was able to find relief after practicing some of the psoas release techniques I learned and that left me with one burning question: can the same techniques used during my athletic career to improving my performance be used now to help ease my stomach distress?
How treating your colon as an injury can help provide GI relief
Following massage therapy, “improvement in psoas tension and tenderness on palpation was observed for all participants after an average of 5 treatments (range 2–12). Complete resolution of all symptoms of abdominal pain, reflux, vomiting, nausea, and bowel upset was seen in 88/96 (92%) participants at the time of treatment completion without side effects.” (2)
The psoas is the one secret you probably didn't know about that improves gut health, decreases back pain, and improves overall performance. There are so many proposed benefits stemming from proper care that I got lost in the research trying to unlock all the secrets of the psoas. One downside is that there are not many quality resources that tell you exactly how the psoas impacts health.
I’d argue the psoas is the most important and underrated muscle in the body. The psoas is used for almost everything including stability, sitting, standing, walking, running, and jumping. As an athlete, you’re taught that power, speed, and agility come from the hips and back, or more accurately, the psoas. Think about how all the major lifts (squats, deadlifts, lunges) have to do with with the hip and back region. Now think about the stiffness and soreness associated with those regions after a long hike, big game, heavy-weight session, or simply sitting/standing in one place for too long. Okay, I think I can stop convincing you how important the psoas is. Now let’s get into what can we do to improve it.
Despite the proposed benefits lacking research, we can draw some interesting conclusions by focusing on treating the person wholistically rather than defining a person by their symptoms. In this article, we are specifically interested in what the psoas is and how the psoas relates to gut health, back pain, and overall athletic performance. So unfasten your seat beat and get ready to stretch your mind and body (because sitting sucks and is bad for your psoas).
What the Gut? Linking the Psoas and Gut Health
There is an association with psoas trauma, stiffness, and shortness linked to IBD and gastric upset. (3, 4)
Psoas Gut Health
Cycles of inflammation and healing following flare-ups lead to scar tissue that narrows the intestine. One of the signs of poor gut health in patients with IBD is the rigidity of the colon following a flare-up. “One main cause of colon strictures is inflammatory bowel diseases (IBDs) like Crohn's disease and ulcerative colitis. A cycle of inflammation and healing leads to scar tissue that narrows the intestine.” (5 ) There is also an association with psoas trauma, stiffness, and shortness linked to IBD and gastric upset ( 6, 7 ). This presents a challenge of how to heal that scar tissue and return the colon to its flexible and pliable state.
As an athlete who has dealt with numerous injuries and scar tissue, I’m intimately familiar with the recovery process. But how does that translate to the much more sensitive area of the psoas and colon? Given that the colon and psoas are in direct proximity to each other, I have to believe it’s at least possible to rid the area of scar tissue and restore general playability. While I think it’s obvious more research is needed from the field, at the very least we can conclude that taking better care of your psoas won't lead to worse gut health, and is worth trying to improve gut health.
I’ve got to add some disclaimers here if you are in serious pain, as always, PLEASE contact your doctor. I don’t care what kind of acronyms follow someone’s name, don’t only listen to random YouTubers. The psoas muscle can react to disease or inflammation occurring in the closer related visceral organs leading to psoas spasms with benign conditions: colitis, hiatal hernia, dysbiosis, leaky gut syndrome, or irritable bowel syndrome. (8)
So let’s make sure we’re dealing with psoas tightness, not an underlying disease.
Causes and symptoms (9 , 10 , 11)
Symptoms of a damaged (scar tissue) colon stricture may include if you:
Are nauseated or feel sick to your stomach
Throw up
Are constipated
Have diarrhea
Notice swelling
Lose your appetite
Feel tired
Other symptoms include:
Lower back pain
Pain in your pelvis
Pain radiating down to your knee
Difficulty walking — including limping or shuffling
Difficulty maintaining a fully upright position
Causes
Repetitive jumping — for example, jumping rope and long jump activities
Long, frequent periods of sitting — which cause the muscle to shorten and tense up — followed by physical activity
Complications from surgery
Sports with a lot of jumping are the most likely to cause a psoas muscle injury, overuse or trauma.
How to Care for the Psoas
“Typical treatment includes physical therapy focused on stretching and strengthening the spine and hip joints alongside the psoas muscle. One study found 100% of dancers responded to conservative management. Exercise programs that the patient can do at home with a focus on hip rotation have demonstrated effectiveness in reducing pain and improving activity for patients in pain.” (12)
As we learn how to stretch and release your psoas muscle in order to improve gut health and get rid of back pain, avoid quick progression while trying psoas release techniques. You can’t instantly “hack” your way to an improved psoas. Applying swift pressure to the psoas can do damage to the colon. One of my favorite massage therapists taught me not only do you apply slow and steady pressure to the psoas while doing manual manipulations but also to aim for a slow and steady release of tension on the muscle. You need to work with care and patience, not urgency.
Understanding that a damaged or inflamed psoas muscle is an area with scar tissue, and then treating that area as an area of injury, can provide great relief and repair to the psoas/colon region. Scar tissue sounds bad but is absolutely necessary as a part of the body’s repair process. Scar tissue brings in collagen and new cells to repair the area of injury, however, scar tissue forms new muscle fibers that are tightly coiled with limited blood flow. Our goal in helping scar tissue with its repair job is 5-fold: (1) allowing time for rest so scar tissue can do its job (2) encouraging fresh blood flow in the area to bring in oxygen and nutrients (3) uncoiling the tight nature of the new muscle fibers. (4) lengthening the psoas muscle (5) strengthening the psoas.
“Scar tissue can be thought of as a physical structure made of collagen that is wound up tight and coiled in on itself like a rubber band….scar tissue does not have blood flow” (13)
Allow scar tissue to do its thing with rest and recovery
This is the easiest step of the five. Yes active recovery is our main focus, but you need to rest when dealing with any injury, especially internal ones. Accelerating too quickly in the rehab process following injury does not allow your body time to lay down that beneficial scar tissue and actually creates more injury, prolonging your rehab time. Even something as simple as stretching can cause unformed scar tissue to bind even tighter making its coiled nature even harder to uncoil in the future. Rest is productive.
(2) Blood Flow with Mobility
Mobility is the effort of bringing in fresh blood flow to begin repairing an injury. The psoas muscle is intertwined with the hips and back, which happen to be jointed. We can think of a joint as a ball and socket relationship. The best way to create blood flow in these ball and socket regions is with circular motions.
Hip and back circles
(3) Massage
After we have established good blood flow and the area is nice and warm, we want to work on releasing some of the tension in our psoas and breaking up any scar tissue that may be in this region. As a reminder, this is a slow and steady process that could take weeks, months, or even years.
Manual manipulation
Pso-rite
Hyperice ball
(4) Stretching
Following self-massage is stretching the psoas muscle itself. This follows self-massage because if you do not break up scar tissue as it has been laid down, then you’re only going to make it tighter and more difficult to break apart later. Think of it as a rope in a knot and you try to stretch the rope to maximum length without first getting rid of the knot.
Psoas stretches
P90 warrior pose
Leg up on bench knew down
Pigeon pose
(5) Strengthen
Once we have established good blow flow and the area is warm and pliable we can begin to finally re-strengthen the psoas
Planks
Hanging leg raises
6 inches/V-ups
References
https://www.webmd.com/back-pain/what-is-psoas-major-function
https://www.webmd.com/ibd-crohns-disease/crohns-disease/colon-stricture-overview
https://www.webmd.com/ibd-crohns-disease/crohns-disease/colon-stricture-overview
https://www.webmd.com/back-pain/what-is-psoas-major-function
13. https://www.sciencedirect.com/topics/medicine-and-dentistry/scar-tissue