Ida Rolf recognized the importance of the psoas early in her career. One of the “cornerstone” muscles, the psoas is covered in depth in the basic Rolfing Structural Integration training as well as in workshops, the advanced training, and the Rolf Movement certification training. Having been a petroleum geologist in my previous career, I had never heard of said muscle when it was first mentioned by my Rolfer, Ed Hackerson, as he delved deeply into my abdomen. It turned out that the psoas was particularly important to my structure – more so than it is for many people – and Ed made sure to contact it numerous times in my basic series. I had been plagued with shooting pains in my lower back since injuring it while working as a grocery store clerk in high school. The situation with my low back was bad enough that I could not sleep supine with my legs out straight. This was especially so when I slept on the ground during numerous forays to study rocks while a geology student at Louisiana State University in the late 1970s. I often ended up sleeping with my knees up while still in my sleeping bag, my posture providing no end of amusement to my fellow students.

I thus feel I have a particular relationship with this most important of muscles and have always emphasized this fact during my anatomy lectures to both beginning students in Phase I classes as well as in the anatomy lead-in class for Phase III. As an anatomy instructor, I understand that unless one uses this anatomical information on a regular basis, it can be easy for the particulars of the anatomy of the psoas and surrounding structures to become a little fuzzy. Hence, when asked to write an article on the psoas for Structural Integration: The Journal of the Rolf Institute, I immediately agreed and set to work. If you feel you have a good grasp on the particulars of this muscle, please don’t feel offended when I review some of the basic anatomical facts. I will also share some of the insights I have gleaned over twenty-two years as a full-time Rolfer and fifteen years as a Rolf Institute anatomy instructor.

The Basics

As all Rolfers will agree, one cannot discuss the psoas without discussing the equally important iliacus muscle and the often-overlooked psoas minor (when present). This complex is central to the anatomical structure of the abdominal region, and its importance has been stressed in the bodywork community for many years now. With the advent of Pilates and “core training” regimens in the gym, your average client will probably have heard of the psoas, if not actually have a good grasp of its importance. We will also look at the importance of other nearby anatomical structures – namely, the quadratus lumborum and respiratory diaphragm (see Figure 1).

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Figure 1: Anterior views of the abdominal region showing the relationships of the iliopsoas, quadratus lumborum, and respiratory diaphragm (from Gorman’sThe Body Moveable).

The right and left psoas muscles are classified as fusiform (tubular-shaped) muscles and are located deep in the lower abdominal region of the human body. (Interesting tidbit for your next cocktail party:  the psoas in the cow is the tenderloin, hence the round, tubular shape of filet mignon steaks.) The superior attachments of the psoas are the transverse processes and bodies of the five lumbar vertebrae, with its most superior fibers reaching up to T12; its distal end is a cord-like attachment to the lesser trochanter of the femur.

The iliacus is classified as a triangular-shaped muscle. It has a broad, flat origin that completely fills the iliac fossa of the coxal bone; as it passes inferiorly, its fibers merge with those of the psoas at the pelvic brim to form the common tendon that attaches to the lesser trochanter. There is an underlying bursa at the pelvic brim where this common tendon passes over that minimizes wear and tear.

Since these two muscles work in tandem, I like to use the common term for this complex: the iliopsoas. The iliopsoas is considered to be the major flexor of the hip joint. When the two iliopsoas contract bilaterally, they work to flex the trunk, as when lifting the trunk from a supine position while doing a sit-up.

The third member of this complex is the psoas minor, a muscle said to be found in about 40% of the population, and, therefore, commonly overlooked. It can be more tendon than muscle, though not everyone agrees with this. It runs from the bodies of the twelfth thoracic and first lumbar vertebrae down the anterior surface of the psoas major and inserts on the iliopectineal line of the pubic bone (and thus, does not cross the hip joint). It is believed to add strength and a certain amount of rigidity to the underlying psoas major. I believe its importance lies in the fact that when the psoas major muscle becomes hypertoned, the psoas minor can add to this tightness due to its tendon-like nature. This will usually show up as a “ropiness” when palpating and/or working on the psoas major.

Along with the importance of the iliopsoas itself is the crucial relationship this muscle has with its neighbors – primarily the quadratus lumborum and the respiratory diaphragm. For me, one of the hallmarks of my advanced training in 1991 with Jan Sultan and Jeff Maitland was the emphasis they placed on working the lumbar triangle to access this vital area of the body  –the so-called “sweet spot” in Jan’s lexicon (see Figure 2).

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Figure 2: The lumbar triangle (from Gorman).

Figure 3, from Carmine Clemente’s Anatomy: A Regional Atlas of the Human Body,  is one of my most cherished images of human anatomy showing the relationship between the psoas, quadratus lumborum, and the anterior thoracolumbar fascia (as opposed to the posterior thoracolumbar fascia, or the aponuerosis of the latissimus dorsi). This anterior section of the thoracolumbar fascia is composed of three layers of connective tissue, one from each of the three abdominal muscles wrapping around from the front of the body. This fascial layer forms a “wall” between the psoas/quadratus lumborum complex and the sacrospinalis group of muscles (the erector spinae and transversospinalis muscles) of the spinal column. In accessing this anterior thoracolumbar fascia, we have a profound effect on the psoas and quadratus lumborum as well as the respiratory diaphragm (and of course, the deep abdominal fascia covering these structures).

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Figure 3: Transverse section through the lower abdominal region showing the relationship of the various myofascial components of this area (modified from Clemente).

In referring back to Figure 1, we can see the important anatomical relationship between the psoas major, the quadratus lumborum, and the respiratory diaphragm. The posterior inferior edge of the diaphragm forms two small arches – the medial and lateral arcuate lines. The upper end of the quadratus lumborum slips beneath the lateral arcuate line on its way to its superior attachment on the twelfth rib, while the psoas major slides under the medial arcuate line. The entire complex is covered in a layer of fascia and is intimately related to the anterior thoracolumbar fascia previously mentioned. The importance of the quadratus lumborum cannot be stressed too highly. It not only works as the “hip hiker” in raising one of the coxal bones, but it can also be viewed as a muscle of respiration. When the respiratory diaphragm contracts during inhalation, the quadratus lumborum contracts isometrically to stabilize the twelfth rib – one of the attachment sites of the posterior edge of the diaphragm. Again, working the area of the lumbar triangle in a sidelying position will allow a small amount of work (especially when done with hip-hiking movements and/or deep breaths by the client) to have far-reaching and profound effects on this core area of the human structure. Additionally, contacting the deep fascial layers via the lumbar triangle will also feed the work down into the pelvic bowl. So, even doing “superficial” work in the lumbar triangle early in the Ten Series, we will be preparing the area of the deep pelvic bowl for later work in sessions four, five, and six.

Another important anatomical consideration of the iliopsoas complex is the presence of the lumbosacral plexus of autonomic nerves. These nerves control the sympathetic response of the organs of the abdominal region and are embedded in the fascia lying over the psoas/quadratus lumborum muscles. Overwork in this area can cause a sympathetic (“fight or flight”) response. This was shown to me in a most dramatic fashion on two separate occasions early in my Rolfing career. On both occasions, it was the instructor who triggered this response; and in both cases, it involved hyperventilating and uncontrolled shaking by the model/client. Breathing into paper bags and some craniosacral work relieved the response, and in the “post mortem” (ahem—I know, a bad choice of words) both instructors admitted that they had gotten a little carried away and overworked the psoas. It was a great learning experience for us students, and I vowed that I would always err on the side of doing too little, as opposed to doing too much, when it came to the psoas.

In looking back on my teaching career, it is interesting to note that there have been changes in how we Rolfers approach working on the psoas. I was taught to carefully sink down through the abdomen, gently pushing the intestines out of the way until I came to the psoas. I had seen the psoas worked with the client supine, knees either up or flat on the table, and have used both approaches in my practice. A number of years ago while teaching a Phase III lead-in class, I went to palpate the psoas in this fashion and there was an audible gasp from the class: “We were told in Phase II to never work the psoas like that – you could puncture the intestines if you are not extremely careful.” Acquiescing to the students’ concerns, I showed them how to access the distal end of the iliopsoas muscle just lateral to the femoral artery, as well as the edge of the iliacus muscle just behind the anterior superior iliac spine (ASIS). The following year, teaching another Phase III lead-in class, I asked the students how they were taught to access the psoas in their respective Phase II classes, and to a person, they said they were shown to carefully sink down through the abdomen. So, I’m not sure where that little “blip” in approaching the psoas had come from, but it seemed to fade within a year of surfacing.

Internal vs. External Considerations

Being an acolyte of Sultan’s internal/external typology, I have two distinctly different ideas with regards to addressing the iliopsoas. Any undue bilateral psoas tension will cause the lumbar vertebrae to be compressed, thereby exacerbating any ill effects of lumbar compression. Unilateral hypertonicity will cause compression as well as rotation. In externals, with their typical flat or posterior-tilting pelvises, I believe that the psoas major lies centered in the mid-coronal plane with a decidedly erect orientation slightly posterior to the bodies of the lumbar vertebrae. In internals, with their typical anterior-tilting pelvises, the psoas major will lie forward of the mid-coronal plane and more anterior to the lumbar bodies. Any undue bilateral tension in the internal configuration can accentuate the anterior tilt while unilateral tension will cause rotation as well. In general (and I do mean in general), I have found that externals tend toward hypertoned psoas major muscles more so than internals. This makes sense if you believe that externals tend to be more “core bound” than internals – and what could be more “core,” muscularly, than the psoas muscles? One final observation: if I do encounter hypertonicity in the two iliaci muscles, almost invariably the tighter of the two muscles is the one on the left. Now this is not some scientific study I have done, just something I have noticed over the years and food for thought.

Working with the Iliopsoas

My “standard” approach to accessing the iliacus and psoas muscles is the one I learned in basic training – the client lying supine, knees up, feet flat on the table. I usually start with both iliaci just behind the ASIS and have the client rock his pelvis very slightly. While still contacting both iliaci, I then have him slide one leg down onto the table, then the other. I pick one side and have him slightly raise his knee while still working that iliacus behind the ASIS. The work can be done with hands, or gently with an elbow. After doing the same on the other side, I move to the psoas with the client’s legs still down. Once I have contacted the psoas on that particular side, I have the client slightly raise that knee. A couple of these movements will finish the work here. If I feel that the psoas needs more work, I will work something else to give both psoas muscles a chance to integrate and settle down. Then I may go back and briefly touch in on them again later that session, or make a note to do some more work here later on in the series. With both internal and external types, I have found that the hallmark of a well-toned and integrated psoas is that it is hard to find and contact, even with the client’s leg laid out flat.

Obviously, I have tried different approaches to the psoas including standing and seated work, but I find that this basic approach will suffice for almost all of my clients. While this may seem a bit conservative, I have found that I have never “overcooked” a client and have had nothing even approaching a sympathetic response. (The two instances of instructors overworking the psoas, mentioned earlier, involved seated work in one case and standing work in the other.) I also believe that I have not underworked the psoas in this approach. While not eliciting a sympathetic response, I have encountered numerous emotional releases from clients while working this area. (One time, at the beginning of my career, I merely touched the two iliaci and my client had a dramatic emotional release – naturally, that was enough work in that area for that session).

The Iliopsoas and Rolf Movement Integration

During my training in Rolf Movement Integration, I was impressed with the amount of time and energy devoted to the iliopsoas and its effect on the free and easy movement one looks for in walking. In my basic training, I was shown Dr. Rolf’s “bell clapper” exercise and have used it repeatedly throughout my career. For those of you who may never have heard of this technique, it is performed as follows:

‘Place a small footstool (a large phone book will work as well) near a wall, leaving a space between the stool and the wall. Have the client stand perpendicular to a wall, with the foot further from the wall on the stool and the closer side of her body supported against the wall; in this position, the leg closest to the wall will hang freely, ready to swing. Ask the client to gently swing her leg forward and backward, as if it were a bell clapper – the psoas/leg is the clapper and the respiratory diaphragm is the bell. I place my fingers in the lumbar region and gently coax this area to lengthen when the leg swings forward. For most clients, in doing this action the lumbar region either contracts slightly or stays neutral. By using my fingers to promote lengthening here, I believe that I can alleviate any unnecessary contraction of the lumbar region while the psoas is doing its job. This intervention promotes the functional integration of the legs, pelvis, and lower back while walking.’

Also part of my movement training with the iliopsoas was a discussion of the difference between the swaggering gait of John Wayne and his severely restricted psoas/pelvis and the smooth gait of Mikhail Baryshnikov whose legs seem to float and reach out from his pelvis. I like to say that John Wayne walked “around” his pelvis while Baryshnikov walks “through” his pelvis. In the John Wayne style of walking you do not see the torsional movement across the two sacroiliac joints that you do see in the Baryshnikov-style of walking. We can look at these styles of walking as two ends of a continuum, with the goal for our clients being to have the John Wayne style more closely approximate the Baryshnikov style. In order to accomplish this goal, I employ a lot of iliopsoas integration, especially in sessions eight through ten of the ten-session series. This integration includes, but is not limited to, the “bell clapper,” classic Rolf Movement “heel drags” with the client supine, and the visualization of the connection from the lower limbs up into the lower trunk and beyond while doing bench work. Needless to say, when the iliopsoas is healthy and working properly, it shows up immediately in the client’s gait.

Conclusions

Every Rolfer will have his or her own style of working with the iliopsoas. That, to me, is one of the beauties of the ten-session series and all subsequent advanced and movement work – there is plenty of room for variation and creativity depending on the client’s needs. Dr. Rolf realized the importance of the psoas at a time when very few people even knew it existed. It is a “cornerstone” muscle in the integration of the human structure, and the more educated and comfortable one is in working with this crucial complex, the better the work of Dr. Rolf will be integrated by our clients and subsequently move out into the world.

References

. Clemente, Carmine, Anatomy: A Regional Atlas of the Human Body, fifth edition. Baltimore, MD: Lippincott, Williams & Wilkins, 2007.

. Gorman, David, The Body Moveable. Ontario: Ampersand Press, 2002.

. Netter, Frank, Atlas of Human Anatomy, fourth edition. Philadelphia, PA: Saunders-Elsevier, 2006.

John Schewe was certified as a Rolfer in 1987 and completed his Advanced Training in 1991. He began teaching anatomy and physiology, and structural kinesiology, for the Rolf Institute in 1996. He is a Phase I class coordinator and is currently the Chair of the Life Sciences Group at the RISI.