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October 9, 2007

Today's Special: Psoas

It was another one of those days where I felt that every case that walked through the door would benefit from the same treatment. In this case it was the psoas muscle.

A new client presented with low back pain. They said they wake up feeling like they are 140 years old. From my own experience, I can relate to their pain. I coached them about techniques for decompressing their back upon arising in the morning. I also worked the gluteal muscles, especially at the sacral attachments and around the sciatic nerve. All areas were very tender. I followed this with sacral decompression which made my client question what I was doing. Their experience of massage involved the use of a lot of oil so I explained that given what their body presented me, I was doing more bodywork than massage. I finished the massage by working in their psoas muscle on the most affected side. Though they came out of my practice room moving as though they were stiff, they said they could tell that the work was doing something. Sometimes, we must work through a lot of discomfort to get relief from chronic pain.

My client with chronic quadratus lumborum pain came in again. After only four days, their QL muscle had a knot like a rock. I had done some reading concerning innervation of the muscle looking for a visceral connection along the same nerve trunk only to find that the lumbar muscle is innervated by T-12 through L-3. Visceral involvement could be anything from a bladder infection to diverticulosis to gall bladder trouble. However, during my reading I happened across several mentions of the psoas muscle. I made a mental note to check on the health of the muscle and found it to be the most contracted psoas I had ever palpated. Releasing it gave the client immediate relief which I hope will be lasting.

Another client presented with chronic sacroiliac pain. I have attempted to release the fibrous connective tissue in the joint with gentle posterior traction of the ilium with anterior pressure on the lumbar muscles on the painful side. This usually corrects SI joint dysfunction, but not on this client. Taking a cue from my previous client, I decided it could not hurt to check the health of the psoas muscle. Sure enough, on the affected side, this client's psoas was tight. In fact, once I palpated the muscle deep in the abdomen, the client reported a familiar sensation--this muscle would go into spasm several times a day! We were on to something, so I worked the muscle. The client reported having an easier time getting off the table. I showed the client how to stretch the psoas with a modified lunge. Again, as in the earlier case, I hope this has lasting results for the client.

tags: massage massagetherapy wellness massage therapy bodywork health

Posted by linda at October 9, 2007 7:52 AM