As a follow up to my post on Muscle Testing of the Psoas Muscle, here is a video blog from a friend and collegue Patrick Ward. Patrick’s video demonstrates how to do a soft tissue treatment of the psoas and the iliacus.
I find these muscles to be grossly overlooked in their role in low back pain. Two recent clients are good examples. One had experienced long term chronic back pain, over 40 years. The other had experienced six months of pain that took her out of her normal life activities.
Both had sought medical treaments from a variety of health care providers. Both had participated in multiple physical therapy sessions. Both had been seen by other massage therapists. They had one other thing in common; neither had received any soft tissue treatment of the psoas or iliacus muscles. In my practice, I find this to be true of 90% of the clients I see with low back pain.
If you are a client, find a therapist that can do this work. If you are a therapist become confident in how to do this work. Your clients will thank you.
Below is a video from Patrick Ward’s blog. He has lots of great infromation there. Check it out. http://optimumsportsperformance.com/blog/
In addition to the treatment of the muscles, there is another key structure that is important to recognize. The iliac fascia is a substantial fascial layer that separates the iliacus from the rest of the pelvic contents. This fascia tends to get bound down to the iliacus.
Brielfly, here is a treatment strategy. The client is supine, the hip flexed, and the foot resting on the table. Therapist holds gentle pressure contacting the iliacus on the inside of the ilium. Hold this pressure to pin the tissues and have the client slide their foot down the table as if they were going to push it off the end of the table.
As their hip and knee straighten the client’s sense of stretch will increase. This will help to release any adhesions in the iliac fascia.
Caution: medial to this work is the femoral artery. If you feel a pulse when palpating the iliacus simply reposition by moving more laterally.
Don Miller, MA, LMT
September 2011
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