Running from your lower back to your hip flexors, the psoas is a muscle many runners might not realize could be the cause of common running-related injuries. Instead of letting this lesser known core muscle hurt your performance and potentially sideline you completely, learn how to identify common symptoms of psoas injuries along with possible treatments.
WHAT IS THE PSOAS?
The psoas is a pair of muscles that run from each side of the lumbar spine and extend through the groin before inserting on the femur. Because this muscle runs from back to front and lies deep in the belly, it can be difficult to stretch and pinpoint it as a cause of injury.
The primary job of the psoas muscle is to stabilize the spine during movement — and, along with the iliacus muscle, helps to flex the hip. For runners, this muscle contracts and lengthens thousands of times during a run. The contraction of this muscle occurs when you lift the knee, then it lengthens as your leg swings behind the body.
As well as being responsible for leg swing, it is also vitally important to posture. Working with a variety of core muscles, if there is an injury, it forces the other muscles to work harder to stabilize the spine and can lead to a decrease in performance.
SYMPTOMS OF PSOAS INJURIES IN RUNNERS
While some lower back pain can be caused by a tight or weak psoas muscle, most often psoas injuries present as hip, groin or gluteal pain. Sharp pain in the hip and pelvis area, a clenching, pulling or sore sensation in the upper leg or groin and the inability to lift the leg are all common symptoms.
With psoas injuries, pain is most noticeable when walking or running uphill or stairs, when a more exaggerated knee lift is required. Runners who rely too much on the hip flexor to lift the knee and move the foot forward during their stride, instead of using the hamstrings to lift the foot toward the butt, may also be more susceptible to this injury.
Sitting for long periods of time before exercise is also a common trademark of individuals with psoas-related injuries. Along with poor posture, sitting shortens the psoas muscle. When asked to activate and lengthen suddenly during a run, injuries often occur.
HOW TO TREAT PSOAS-RELATED INJURIES
Like any other injury, consult a medical professional to get the correct diagnosis, then eliminate any activities that cause aggravation. If you can run without discomfort but hills cause a flare up, stick to flat terrain until you’ve given the injury enough time to calm down and can begin a stretching and strengthening routine.
In more severe cases, you may need to take time away from running completely, and cross train with activities like cycling or swimming as long as you are pain-free. If pain isn’t the issue, but chronic tightness doesn’t seem to be going away, you’ll need to focus a lot of your energy toward lengthening the muscle.
To get the muscle to relax so stretching is useful, massage release techniques to lessen tension are a good place to start. If a weekly massage isn’t realistic, you can also try a massage tool called the Pso-Rite or a Pilates ball. While massage balls and foam rollers can’t target the psoas effectively, because of the location and depth of the muscle, the Pso-Rite is supposed to reach the deeper tissue of the psoas muscle.
Once the muscle is released and more relaxed, here are a few stretches you can use to lengthen the psoas:
- Kneeling lunge: With one foot forward and a knee on the ground (on the same side of the hip you’re attempting to stretch), lean forward on the front leg. Raise both your arms overhead as you come forward, keeping your back as straight as possible. Hold the stretch for 30–40 seconds for 3–4 repetitions. Complete on the opposite side if necessary.
- Warrior 1 pose: Similar to a standing lunge, this yoga pose can be done in a doorway to stretch the psoas. With the front foot forward through the doorway, place the opposite hip right up against the door jam. This leg should be extended behind you in the lunge position. Raise both arms overhead and focus on reaching tall through the hands and aligning the pelvis, belly button and sternum with the frame of the door. Since a tight psoas tilts the pelvis anteriorly, focus on a posterior pelvic tilt (rocking your hips back) to stretch. Hold for 30–40 seconds and complete 3–4 repetitions.
- Hamstring stretch: A tight psoas is almost always accompanied by tight hamstrings, so it’s a good idea to focus on this muscle group as well. Lying on your back, use a bed sheet or a towel and wrap it around the foot of the leg you’re going to stretch. Pull the foot with the sheet up to 90 degrees (or as close as you can get), keeping the leg as straight as possible and avoid bending the knee. This position is better than other hamstring stretches for the psoas because the hip flexors can relax and avoid contraction. Hold for 30–40 seconds and complete 3–4 repetitions.
After you’ve had sufficient rest and have lengthened the psoas, you can resume your regular activities. It’s also a good idea to complete strengthening exercises to prevent injuries from reoccurring. Yoga poses like bridges and boat are great for strengthening. Or, try this strengthening move to specifically target the psoas:
- Sitting on a weight bench or low box with your knees bent, alternate raising one knee above 90 degrees or above the level of your hip. Keep your back straight, your abs tight and concentrate on using your hips to raise your leg. If you have to lean forward or backward to raise your leg, you’re doing it incorrectly. Hold for 5–10 seconds before placing your foot back on the floor. Repeat with the opposite leg. Complete 5–10 repetitions on each side.