Psoas – With A Piriformis Cameo

Back by popular demand, I’m revisiting psoas, that muscle all WMTI folk came to know and love. Ah yes, psoas, a five-letter word some bodyworkers feel is a four-letter word in drag.

Let’s start with a little history. Many therapists dislike working psoas because they were taught the stupid dive-bomb technique. Forget it. It doesn’t work well, but it does succeed in annoying the client no end – if that’s your idea of a good time (anyone catch the reference?).

Psoas is continuous with the diaphragm and iliacus; I think of them as a dual (left and right) motor unit, they are so tied to each other. In this article, consider them so.

Also in the way of background, psoas is important for a number of reasons.

  1. Structurally, psoas supports and stabilizes as well as moves the anterior lumbar vertebrae.
  2. Along with the piriformis, psoas ‘locates’ the sacrum, meaning it has plenty of influence on the fluidity of the SI joints, and many of you know how I feel about those guys. (see Thomas Myers article “Poise: Psoas-Piriformis Balance” in the March/April 1998 issue of Massage Magazine).
  3. Since it is continuous with diaphragm, and diaphragm is very arguably the most emotional muscle in the body, psoas can carry plenty of emotional energy.
  4. Psoas is the deepest hip flexor, receiving the impulse to move forward first. If a person feels like he is being held back, like he can’t get ahead, the unresolved emotional energy will build in psoas (iliacus diaphragm).
  5. Hypertonicity in psoas will put pressure on any or all visceral organs, since psoas, iliacus, and diaphragm literally form a ‘bowl’ the organs sit in. This will decrease circulation in the organs, creating multiple levels of problems. (my article “Viability of the Interstitial Space” will post Wednesday this week on our website under ‘Chuck’s Articles’ and explore the issue further).

Psoas affects so much of the body structurally, emotionally, biochemically, (and so hormonally), that I feel effectively working psoas-iliacus-diaphragm and nothing else is more a full-body massage than effectively working everything else and excluding psoas-iliacus-diaphragm.

Okay, let’s get to it – how to effectively work the psoas complex, adding in piriformis.

My favorite technique for working psoas and piriformis together is:

  1. Client is supine, therapist is sitting or kneeling at the side of the table at client’s waist
  2. Client’s same-side or opposite-side leg is bent at the knee, about 90°, with the client’s arch of the foot on the bolster (I start with same-side and then experiment)
  3. Therapist’s lower-table (closest to client’s feet) fist is used to work into the piriformis area, catching all the deep rotators
  4. Simultaneously, the therapists upper-table hand can work either psoas muscle

Here, I recommend using a soft base of the palm, working the entire length of psoas from under the rib cage to the inguinal ligament on the near side, and/or pushing over psoas toward the opposite edge of the table on the far side. Note that when you use this technique on the contra-lateral psoas you are in effect ‘pulling’ on the psoas with connective tissue. This is very comfortable on a sensitive psoas. Work the entire length on that side also. (It’s easy to work cross-table into iliacus.)

Your focus is to feel a dynamic balance between psoas and piriformis. Some tips on achieving this is to feel, or even imagine, the connection between the two and focus on that connection balancing out. Remember, affecting the energy of a situation is a function of presence combined with intention. Presence primarily means keeping your attention focused, avoiding extraneous thoughts. Hold the thought of balance (a very good intention), and let your hands do their thing (“Your hands are smarter than your brain will ever be.” from The Legend Of Bagger Vance). Avoid thoughts of ‘second-guessing’ or doubting yourself; those just get in the way. If you find you have too many doubts, simply practice more (confidence is something we get for free as we become competent).

Use the same ideas for psoas work in general. Approach psoas from an angle of 30° – 60° and from the rib cage to the inguinal ligament. Soft base of the palm is my hand technique of choice, but certainly experiment. A bent near- or opposite-leg softens the area, and feel free to mobilize it. Mobilizing the rib cage or the shoulder, same side or opposite, can work: experiment and let the feel of the psoas under your hand guide you. If psoas is too sensitive to work directly, cross over. (“If it hurts to push on it, pull on it.”) Go slow, be thorough.

For a stretch, with the client supine, you can drop their lower leg off the table, push on their thigh with one hand and their rib cage with the other in opposite directions. I like to rock that back and forth, looking for motions their body responds to.

Here are two videos on psoas work:

This should be a good start.

There are lots of ways to work and stretch psoas, and you can’t have too many. Any of you with suggestions of techniques you’ve found effective please Comment. I love feedback so please do. Share, learn, and grow, always becoming more.


4 comments on “Psoas – With A Piriformis Cameo

  1. Hi there, this is a lovely blog! I’m just curious bc I was taught, I thought by several people, never to work psoas higher than the belly button, as it is too risky. Please address—thanks!

  2. i am usually good with descriptive exercise but i cannot visualize your piriformis psoas bodywork is my fist bder the buttock while my upper hand working the psoas

  3. i am usually good with descriptive exercise but i cannot visualize your piriformis psoas bodywork is my fist bder the buttock while my upper hand working the psoas
    i just receivesd a notice that tere is a duplicate comment from me whn i am only writing this inquiry

    • Hi Henry, I just embedded two videos On this blog. You have to copy & paste them on YouTube, and check them out, let me know how they help. Thanks for the comment. Chuck

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