Accessing the Psoas Major

Lower Back Pain? Think Psoas Major

Image showing psoas muscle anatomy

Pronounced with a silent ‘p’, the psoas major (let’s just call it the psoas), is the only muscle in the body that connects the upper body to the lower body. This often comes as quite a surprise statement to people – but it’s true as it attaches the lumbar vertebrae to the inside of the femur, having passed through the entire inguinal/ hip region. It’s important and hefty role is flexion and extension of the hips – think walking, climbing stairs, sitting down and standing up.


There’s much more to it than that, of course – as it becomes one with the iliacus muscle and is more generally known as the iliopsoas, and it should be treated in unison with the piriformis (and others). But the point here is about accessing this primary hip flexor.

Those who sit for long times at computers, who drive, or in lotus-position meditation will find their psoas muscles shortening. If no hip-stretches or exercises (with external hip rotation) are done to counter this, a chronic back-stooping pose may be the result, accompanied by lower back and neck pain as muscles in those areas try to compensate.

It’s a deep muscle in a vulnerable, tender spot – it can hold much emotion. Chances are good that even regular massage clients may never have had this worked on – it’s an area of caution for some. There’s no doubt it can be a painful and quite alarming experience having your psoas worked on for the first time. However, the physical and emotional benefits are substantial, so perseverance is key.


But before the first touch in that region, a conversation is necessary. The massage therapist should explain the muscle, what is does, why it might need attention, and then the process of working into it, the pain-scale, how to breathe into and ‘accept’ the discomfort, and how to communicate during the process. Trust, good skills with soft, warm fingers and ‘permission’ from the body and the client’s mind are all needed for the massage therapist to be able to gain access to the psoas.

Without creating discomfort, the massage therapist will gently press down and create movement (massage) the skin and fascia just below and to the side of the navel and toward the hip bone.  Patient gentle, continuous soft pressure and massage will eventually allow access to the psoas with the finger tips.

Massage of the psoas itself depends on what the therapist finds in there, the overall goal of the session, and also goals with on-going treatment – but that’s all beyond the intention of this post.

Massage of the the psoas Major, (along with the piriformis and others) is an important ‘maintenance’ consideration for regular clients.  It it is one of the body’s ‘primary’ skeletal muscles with important jobs – it’s worth persevering with the sensitivity of reaching it as the benefits – and the feeling of such work – are immense.

Be Well,

Hamish and Rochelle