The psoas muscle is a deep hip flexor located within the abdominal cavity, connecting the lower lumbar spine to the top of the femur. When dysfunctional, this long, ribbon-shaped muscle can cause persistent pain in the lower back, hip, or groin, limiting daily activities like standing or walking. This article provides specific stretches and exercises for both immediate relief and long-term management of psoas pain, though it is not a substitute for professional medical advice.
Identifying the Psoas and Common Pain Triggers
The psoas major muscle works closely with the iliacus muscle, together forming the iliopsoas, which serves as the primary engine for hip flexion, such as when you lift your knee toward your chest. It is also responsible for stabilizing the lumbar spine and helping to maintain proper posture. This deep connection to the spine means that dysfunction can refer pain to the lower back, the front of the hip, and sometimes the groin.
Psoas pain generally arises from two main mechanisms: chronic shortening and acute strain. Prolonged periods of sitting keeps the psoas in a shortened position, causing it to become tight and weak over time. This chronic tightness can pull on the lumbar vertebrae, contributing to lower back pain and postural imbalances. Acute strain results from sudden, intense activities that involve forceful hip flexion, such as running, high kicking, or sudden rotational movements. This overuse can lead to inflammation or small tears in the muscle fibers, resulting in sharp pain and muscle spasm.
Strategies for Immediate Pain Reduction
When acute psoas pain flares up, the immediate priority is to reduce tension and inflammation using passive interventions. A proper resting position can offer immediate relief by taking pressure off the irritated muscle. Lying on your back with your knees bent and a pillow placed under them is a gentle way to keep the psoas slightly shortened and relaxed.
If the pain is sharp and new, indicating acute inflammation or strain, applying a cold pack for 10 to 15 minutes can help numb the area and reduce swelling. For pain that feels more like a dull ache or deep muscle tightness, the application of moist heat can help relax the muscle and increase blood flow to the area. Activity modification requires temporary rest from activities that aggravate the pain. Avoid any motion that requires forceful hip flexion or deep hip extension. Once the sharp pain subsides, gentle, intentional movement can begin as tolerated.
Targeted Psoas Release Through Stretching
Addressing chronic psoas tightness requires targeted stretching to restore the muscle’s full length. The half-kneeling hip flexor stretch is one of the most direct ways to lengthen the psoas. Begin in a lunge position with one knee on the floor and the other foot flat in front of you, ensuring both knees are bent at approximately a 90-degree angle.
The proper form for this stretch is crucial for isolating the psoas and protecting the lower back. Actively engage the gluteal muscles of the kneeling leg, and gently tuck the tailbone forward to tilt the pelvis backward. This posterior pelvic tilt prevents the lower back from arching, which would otherwise take the stretch away from the psoas. Once the pelvis is stabilized, slowly shift your body weight forward until a comfortable tension is felt in the front of the hip and upper thigh of the kneeling leg. Hold this position for 20 to 30 seconds, breathing deeply and avoiding any bouncing motion. Repeat this stretch two to three times on each side to ensure balanced flexibility. A variation called the supine psoas stretch is performed lying on your back near the edge of a bed or bench. Hug one knee to your chest while allowing the other leg to hang freely off the edge, which uses gravity to gently encourage hip extension.
Preventing Recurrence Through Core Stability
While stretching addresses muscle tightness, lasting relief and pain prevention depend on strengthening the adjacent stabilizing muscles. A weak core, particularly the deep abdominal muscles and the glutes, forces the psoas to work harder as a stabilizer, leading to chronic overuse and stiffness. Strengthening these surrounding areas helps offload the psoas, allowing it to perform its primary function without strain.
The glute bridge is an excellent exercise that strengthens the glutes and hamstrings without demanding excessive hip flexion. Lie on your back with your knees bent and feet flat on the floor, then squeeze your glutes to lift your hips until your body forms a straight line from your shoulders to your knees. This movement also gently stretches the psoas as the hip extends.
Another effective exercise is the Dead Bug, which promotes deep abdominal stability. Start by lying on your back with your arms extended toward the ceiling and your hips and knees bent to 90 degrees, forming a tabletop position. Slowly lower one leg and the opposite arm toward the floor, keeping your lower back pressed firmly against the ground to ensure the core is engaged, then return to the start and alternate sides.
The Bird-Dog exercise is performed on all fours and focuses on spinal and core control while coordinating movement across the body. Extend one arm straight forward and the opposite leg straight back, maintaining a flat back and level hips. These strengthening exercises should be performed in a controlled, slow manner, focusing on quality of movement over quantity of repetitions, aiming for three sets of 10 to 15 repetitions each.