The Iliopsoas Homework Instructions

By: Anthony DeLaCruz, LMT

The actions that can strain the Iliopsoas Complex are bending at the waist, flexing the knee as in climbing stairs or riding a bicycle and twisting motions. My suggestions for avoiding these motions are as follows. Remember, I'm not suggesting that you to abstain from these motions but to avoid them if you can.

Bending at the waist. When picking anything up, regardless of how much it does or doesn't weigh, get as close to the object as possible. Bend your knees and keep your back perpendicular to the floor. Try your best not to bend at the waist when picking up the object. Raise yourself and the object by using your legs and keeping your back perpendicular to the floor.

Pay attention to your posture throughout the day. There will be times that you find yourself bending at the waist when you really don't need to or there may be another way to approach the task at hand that doesn't involve bending at the waist. Be creative. An example would be bending over the sink when brushing your teeth or shaving your face. Do you really need to bend at the waist to complete these tasks?

Another time that we bend at the waist when it isn't necessary is when we sit down or get up from a seated position. Notice if you are scooping when you sit or when you get up from a seated position. If you are doing this stop. It is not necessary to scoop when performing either of these tasks. Sit without scooping and keep your back straight. Rise without scooping and use the strength in your legs to get up. Many people who have an Iliopsoas strain have bad knees. It is a symptom of the hip being out of balance from the Iliopsoas strain. If you do have knee pain do your best to use your legs to rise from a seated position. If you can't right now perhaps you will be able to in the future so keep trying. Please don't hurt yourself if it causes you too much pain. Please never force any movement that is uncomfortable. It is not necessary. We can do what we can do and that's fine.

Flexing the knee. Flexing the knee as in climbing stairs or going up steep hills or riding a bicycle or climbing a ladder is also a function of the Iliopsoas complex and can cause undue strain to an already compromised muscle group.

So, when you find yourself going up or down your stairway take a moment and think, "Do I have everything I need?" This will keep you from making unneeded trips up and down the stairs that can increase or aggravate your muscle strain. Also, if you are in a building and you have a choice between going up a staircase or taking an elevator or escalator, your choice should always be not to take the stairs. I know this is counter to what you have heard before concerning added exercise but when you have an Iliopsoas strain taking the staircase is not healthy for you. Take the elevator or escalator instead and save your exercise for activities that won't cause you more stress and pain.

If you enjoy bicycle riding or riding a stationary bike you would be doing yourself and your body a favor if you used a recumbent bicycle or stationary bike. These were made to save strain to the Iliopsoas Complex. If bicycle riding is your passion, fear not, later I will be giving you some ways that you may continue to enjoy activities that may be troubling to the Iliopsoas. I believe it is important that we all enjoy what life has to offer us. And I have found some ways to help us when we know we are going to perform an activity that could cause some problems for our Iliopsoas. That will come later. For now, though if you aren't a bicyclist, I wouldn't suggest taking it up. Unless it is a recumbent.

If you enjoy walking or running on a treadmill please do not put it on a grade. Leave it at 0 degrees and enjoy your walk or run. If your job involves climbing a ladder apply the same principles as when going up and down the stairs. "Do I have everything?" Decrease your trips if you can.

Twisting at the waist. When twisting at the waist take your leg with you. If you take your leg with you in the twisting motion all of the weight goes into your leg and not into your Iliopsoas Complex. If you are doing an activity that involves continued twisting, spread your legs and shift your weight from leg to leg instead of twisting. Golfers have a lot of trouble with their low back because of the bending and twisting motions of the swinging action involved. Most have Iliopsoas Complex strains and this can lead to a great deal of pain if left untreated.

Another problem that can contribute to an Iliopsoas strain is prolonged periods in one body position. Especially sitting. My rule for being in one position for a prolonged period of time is called the "45/45 rule." If you've been in one position for 45 minutes change that position for 45 seconds. For example, if you've been sitting for 45 minutes, stand for 45 seconds and then you may sit again for another 45 minutes. The only exception to the rule is when driving or riding in a car. In this case you will do well to stop every 60 minutes and get out of the car and walk around for 3 minutes. Following these rules will save you the pain associated with the Iliopsoas strain.

One last contributor to our Iliopsoas problem is how we sleep. Most folks that have an Iliopsoas strain sleep on their sides with their knees bent. The bending of the knees allows for the Iliopsoas to shorten and therefore causes less strain to the muscle involved. However, sleeping on your side contributes to displacing the hip which in turn causes more strain on the Iliopsoas Complex. Many have alleviated low back pain by merely teaching themselves to sleep on their back. At first you will need to prop your knees up while on your back. The knees should be propped up as high as the knees are bent in the side sleeping position. Once you have received enough treatment you will be able to reduce the amount of propping needed for comfort. Indeed, at some point you may not need to prop your knees at all.

So far, I've been giving your things to avoid doing. But you may ask, "How can I be proactive in my treatment process?" "Are there things I can do to help relieve my pain? Homework?" Well the answer is yes.

The very first thing you can do is see me. I will release the muscles involved in your particular case. My work is very specific and I release very specific muscles to help with your particular problem. Once I release the muscles the problem becomes how do we keep them released? The muscle has memory and it will want to return to the position it was previously in so muscle memory becomes our nemesis. The idea is to keep the muscle lengthened and relaxed. Here are a few steps in helping to keep the muscle in the state of release and to combat muscle memory therefore shortening the time it will take to get you to a normal state.

First is the opening of the body from the neck, chest and abdomen. Remember we are opening these areas not stretching them although what we are doing appears to be stretching, we are not putting our body in a state of stretch. We are concentrating on relaxing the muscle not forcing a stretch on the muscle which will only make the muscle tighter. In a standing position let your head relax backwards, open your arms and open your chest then lean back and open your abdomen. The important thing to remember here is to stop where your body stops and hold. If you go beyond where your body stops you are then in a state of stretch and you don't want to go that far. Once you find where your body stops hold that position for a count of 15. Concentrate on relaxing your neck, chest and abdomen. Once you've reached 15 you may stand straight again and relax. This exercise may be repeated up to 3 times in one session and that will be about as good as it gets at that particular time. However, you may repeat this exercise as often as you like throughout your day. The nice thing about this exercise is that it can be performed anywhere.

The most important tool that I encourage everyone to purchase is an exercise ball. These are the large balls that one sees in most health clubs and gyms. If you don't already have one, I would suggest purchasing one with a pump included. This way if you travel you may deflate the ball and take it with you. The ball should be inflated so that it is firm. Then you simply lay on the ball face up and relax on the ball for 3 minutes. If you find it difficult to balance on the ball at first then place the ball close to the wall and place your hand on the wall to help with balance. Make sure your head is back and relaxed, the chest and abdomen are opened. If 3 minutes is too difficult to do at once then break it up into 3 one-minute intervals but make sure you complete 3 minutes per session.

For the first 30 days you want to use the ball 3 times a day. I suggest when you first awaken, when you get home from work and just before bed. After 30 days you may reduce to once a day. Please make this a routine every morning whether you feel stiff or not do it every day. Continued use of the ball will help reduce the amount of Iliopsoas treatments you will need in the future. Once the Iliopsoas has been strained most of us will need to receive continued maintenance treatments in the future to keep the strain from happening again. How often you will need to be seen is dependent on how well you follow these instructions and your activity level. I have many clients that only receive maintenance treatments 3-4 times a year and are pain free.

Another use for the ball is when we know we are going to do something that may cause a lot of stress to the Iliopsoas region. Perhaps we are a bicyclist, or a golfer. Perhaps gardening or landscaping brings us joy. And of course, there is the dreaded housework. Going to the gym and working out or participating in a class can also bring added stress to the Iliopsoas. No worries my friends. Use your ball. Lay on your ball 3 minutes before and 3 minutes after the activity. Remember keeping the muscle lengthened and relaxed will help keep it in a healthy state. Utilizing the ball and doing the standing opening exercise described earlier will allow you to continue to do the activities you enjoy or need to do and maintain the lengthened release that you received at your treatment session. The use of the ball in this way is in addition to the 3 times a day for the first 30 days and once a day after the 30-day period.

Something else that helps us maintain our treatment release is yoga. Yoga is all about balancing the opposing muscles. When we are in a state of strain and pain our opposing muscles are not in a balanced state. Balance must be maintained side to side, front and back and top and bottom. Yoga helps to facilitate this balance and helps to keep the muscles in a healthy state. One that practices yoga will need much fewer maintenance treatments.

The last proactive activity that I will suggest to you is probably the most remarkable. That would be swimming or doing some sort of activity in the water. I have many clients that simply walk in the water. Others do water aerobics. However, if you know how to swim, I would highly encourage you to do so. Remember this is a therapeutic swim. You are not in competition so take it easy. Swimming lengthens the muscle. It strengthens and tones. Swimming involves a no impact aerobic workout. Just moving in the water for 20 minutes can bring you remarkable results. I have one client who went from seeing me every week for 2 years to seeing me once a year for a maintenance treatment simply by getting in the water and swimming 3 times for 20 minutes weekly. Water is very healing for the muscles and joints and no I don't mean sitting in a hot tub. You must be moving your entire body submerged in water.

Ok so there it is! My suggestions for maintaining a healthy Iliopsoas. If you have any questions please feel free to call me. Good luck!