What do low back pain, knee problems, poor pelvic alignment, hip popping, and weak glute muscles have in common? Besides the fact that all of these things suck and they are common complaints in my clinic. . . read on.

The iliopsoas (the p is silent) muscles run from the lumbar vertebrae (lower back) and interior of the ilium (hip/pelvis bones) to the inside of the femur (thigh bone). There are actually two muscles that make up this group: the psoas major (origin at T12-L5 vertebrae) and the iliacus (origin at iliac fossa of ilium). They are generally considered together, and they generally act together and insert together at the lesser trochanter of the femur. Phew. Ok. Why should you care about these little dudes?

Mirror muscles, they are not. Because they’re located deep to other structures, it’s not easy to see and feel them, so many people aren’t even aware that they’re there until something goes awry. But they are critically important to function and performance. The iliopsoas mucles are major hip flexors, pulling the thigh up to the abdomen, and stabilizers of the trunk and pelvis. They get major action with movements like running and cycling, or the constant external rotation of things like ballet, but they can also get weak and tight from sitting in a chair for long periods of time. Think about where those muscles go and what your position is doing to them. Sitting followed by hard training? That sounds like a perfect storm. No wonder they are often troublemakers!

What happens when things aren’t right in iliopsoas land? Sometimes it’s hip-specific problems like:

• snapping hip syndrome, thought to be related to iliopsoas tendinitis or tendinosis
• Iliopsoas bursitis, painful inflammation of the cuishioning fluid sacs
• iliopsoas syndrome- pain and stiffness that can travel to the abdomen, butt, groin, lower back, hip, and thigh

But the trouble can also be more insidious. Continue reading →