Common Issues: The Psoas

Summary of Key Issues

  1. Constantly flexed hips—as in excessive sitting—shortens hips flexors, pulling the pelvis forward and causing low back compression and lordosis plus knee issues.
  2. The psoas muscles may cause the same issues based on their imbalance with more-flexible hamstrings.
  3. In contrast, a weak psoas in conjunction with tight hamstrings can flatten lumbar curve.
  4. Tension in the psoas muscles can be asymmetrical leading to additional issues due to the body’s compensation.
  5. A tight psoas affects breathing and triggers the stress response, leading to a cascade of negative effects.
  6. If out of balance, it “can be a significant contributor to low back and pelvic pain.” (Julie Gudmestad)

Expert Readings

The Wide-Ranging Impact of the Psoas Muscle

Gaining a functional psoas is vital for recovering from symptoms and conditions such as:

  • Lower back pain
  • Sciatica
  • Excessive menstrual cramping
  • Hip socket tension
  • Groin pain
  • Scoliosis
  • Knee, neck, and ankle tension
  • Bladder disturbances
  • Digestive upsets

Liz Koch

Issues from Constantly Flexed Hips

If the hip is constantly kept in a flexed position—like sitting—for hours every day, day after day, the hip flexors will shorten and shrink, limiting your ability to fully extend (straighten) the hip. If the iliopsoas and other hip flexors are tight, they pull down and forward on the pelvis, which tilts the pelvis forward and compresses the lower back. Picture a man standing with the front of his pelvis tilting forward and his tailbone lifting. To stand upright, he has to overarch his lower back… It’s so important to make hip flexor stretches part of your daily practice, especially after a long day of sitting. – Julie Gudmestad

Chronic Contraction & Asymmetrical Issues

Chronic contraction of the psoas, whether from stress or repetitive activity, limits range of movement in the hip sockets, with the frequent result of strain in the lumbar spine and the knees. When tension in the psoas is asymmetrical, that is, one side is more contracted than the other, the resulting tilt of the pelvis effectively shortens one leg relative to the other, and causes compensation up the spine into the neck as the head tries to stay level. Tension also shortens the trunk and reduces room for the viscera, so the organs don’t work as efficiently. On top of that, when the pelvis, spine, and legs are misaligned, the weight of the torso is no longer carried easily through the bones, stability is compromised, and the psoas ends up trying to stabilize the pelvis rather than moving freely in its hip-flexing function. – Sandra Anderson

Muscular Imbalance with Hamstrings

Most yoga practitioners work long and hard to improve their hamstring flexibility but spend much less time stretching their hip flexors. Eventually, the hamstrings lengthen significantly, while the hip flexors improve only slightly. The result: The relatively tighter hip flexors tip the pelvis forward because the relatively longer hamstrings no longer exert an equal counterpull on the sitting bones of the pelvis. If the hip flexors are tight, the resulting anterior pelvic tilt and lumbar hyperextension will cause problems in many yoga poses, including standing poses like Virabhadrasana II (Warrior Pose II) and Trikonasana (Triangle Pose), in which the primary leg action is opening to the sides instead of flexing forward or extending back. – Julie Gudmestad

Tight Psoas Signals Danger & Depletes Bodily Systems

A tight psoas not only creates structural problems, it constricts the organs, puts pressure on nerves, interferes with the movement of fluids, and impairs diaphragmatic breathing. In fact, “The psoas is so intimately involved in such basic physical and emotional reactions, that a chronically tightened psoas continually signals your body that you’re in danger, eventually exhausting the adrenal glands and depleting the immune system.” – Danielle Prohom Olson

Weak Psoas Contributes to Flattened Lumbar

A weak and overstretched psoas can contribute to a common postural problem in which the pelvis is pushed forward of the chest and knees. This misalignment is characterized by tight hamstrings pulling down on the sitting bones, a vertical sacrum (instead of its usual gentle forward tilt), and a flattened lumbar spine. Without its normal curve, the low back is weakened and vulnerable to injury, especially at the intervertebral discs. – Julie Gudmestad

Psoas May Try to Externally Rotate Hip

The psoas may try to externally rotate the hip in poses where we don’t want external rotation, such as backbends or forward bends. – Julie Gudmestad

Anatomical View: Nearby Nerves

This image shows some of the major nerves near the psoas that control organs.