Pilates and the Psoas Muscle A Deeper Look Michele Buller February 28 th 2017 2014, Visalia, California
Abstract This case study took a deeper look at the importance, function and care of the psoas muscles, their role in integration with other muscles, and the mind-body connection. Staying true to the essence of the original Pilates method of Contrology, the BASI Block system shaped the workout instruction. Although the focus was the psoas muscles, whole body integration was given proper attention. Exercises were chosen that allowed the psoas to engage in both stabilization and activation. The outcome desired was muscular balance, coordination, and relief from pain and dysfunction. Maintaining the health and function of these muscles is imperative to quality of movement, enhanced muscle function and integration, while promoting energy in the body. 1
Table of Contents Abstract..1 Table of Contents.2 Anatomical description and pictures 3 Introduction...4 Case Study 5 Conditioning Program 6-7 Program Selection and Desired Results.8 Conclusion..9 Bibliography 10 2
Anatomical description and pictures The psoas (SO-az) muscles are located deep within the abdominal wall and pelvis. These muscles one on each side of the body originate from the bottom of the ribcage and five vertebrae of the lumbar spine to the sacrum. Then cross the hip joint, join the iliacus muscles (becoming the iliopsoas), and end the attachment at the iliofemoral joint of the femur. There are major and minor parts of these muscles. The major connects the femur to the spine and the minor connects the pelvis to the spine. These muscles are aided by the abdominal muscles, the latisimus dorsi, and the erector spinae to stabilize the spine. As the psoas joins the iliacus, they work with the rectus femoris, sartorius, pectineus, and the tensor fasciae latae to flex the thigh. 3
Introduction The psoas muscles are a major element of the core the muscles in Pilates we refer to as the Powerhouse. The functions of the psoas are to stabilize and maintain the natural curve of the lumbar spine, assist in lateral flexion of the lumbar spine, flex the thigh at the hip joint, stabilize the pelvis, and move the pelvis to the spine. It is more commonly referred to as the [group] iliopsoas, as it joins the iliacus. The psoas (located on both sides of the body) are also the only muscles that cross more than one joint and joins the upper body with the lower body (connecting the spine to the legs). Furthermore, it has an intimate relationship with the ribcage and nerve innervations and its proximity to the diaphragm is important to the breath. The psoas is often thought of as just a hip flexor muscle, flexing the thigh at the hip joint (iliopsoas). However, since its attachment points run from the bottom rib and lower spine, crossing the hip, and attaching to the thigh bone, dysfunction of this muscle can cause low back pain, stiffness, and deviations in body movement patterns. Due to its deep location and complicated network of joint attachments and nerves, when these muscles misbehave it can cause limitations in the spine, hips, pelvis, or knee. Likewise, stress on the nerves can cause dysfunction and undesirable effect on the abdominals, pelvic floor, deep hip rotators, and thigh muscles. Moreover, there are many muscles that act on the pelvic-lumbo complex and need also be considered. The human body is dynamic and layered with muscles. When all muscles work synergistically and function within their design, the body can flow with precision and movement economy while maintaining balance. 4
Case Study Client: Michele Buller Age: 53 Gender: Female Limitations: Cervical spine Reasons for the conditioning program: Chronic lower back pain. Client presents with lumbar hyperlordosis. Assessments conclude pain is largely due to tight/dysfunctional psoas and back extensor muscles and weakness in the hamstring muscles and abdominals. Level: Intermediate Past medical evaluations: Physical Therapist and Chiropractor confirm the condition. Recommendations: Stretching and Pilates. Goals: To strengthen and improve the function of the abdominal muscles, stretch the hip flexors and low back extensors. Improve synergy between muscles, improve overall strength, coordination, and balance within the body and mind. For my case study, I chose myself. Years of being a low back pain sufferer, typical stretching routines offered minimal or temporary relief. The objective was to un-lock my own back and hips to improve movement patterns, synergy, and reduce pain. In so doing, I hoped to achieve a greater understanding of these muscles and how they function, in order to help others with this same condition. 5
Conditioning Program: BASI Block System Warm up: Roll down, roll up, spine twist supine, double leg stretch, single leg stretch, criss cross REFORMER Foot Work: Parallel heels/toes, V-position toes, open V-position heels/toes, calf raises, prances, prehensile, single leg heel/toes Abdominal Work: Hundred, coordination Hip Work: Frog, circles, down/up, openings Spinal Articulation: Bottom lift and bottom lift with extensions, semi-circle Stretches: Standing lunge Full Body Integration: Elephant, up stretch 2, long stretch. Arm Work: Arms Kneeling Series; Chest expansion, circles up/down, triceps, biceps. (Kneeling Series was chosen to engage abdominal support while keeping the hips in neutral/extension) Leg Work: (Chair) Standing leg press, backward step down Lateral Flexion/Rotation: (Chair) Side stretch Back Extension: (Chair) Swan basic 6
Apparatus workouts were followed by mat stretches for the lower back, hamstrings, and the hips in all three planes; flexion, extension, and rotation. The roll down Spine twist supine Figure 4 stretch (supine) Cat stretch Bird dog (prone; hands and knees) Rest position (prone) Mat exercises also included: Front support Back support 7
Program Selection and Desired Results Program selection was determined on the following factors; the brain-body connection, the function of the muscles, and the limitations or deviations of the muscles. There is a relationship between the psoas and the brain through the Somatic Nervous System (SNS). This can send a signal through the SNS for the body to form a fetal position. Therefore, much of the focus of strengthening the abdominals was spent in a lengthened position and limited exercises that require hip flexion. Work also included spinal extension (anti-flexion) to offset the brain-body connection of forward flexion that often happens with dysfunction of these muscles. Likewise, working to balance the muscles closely related to, or that act on the pelvis, were included. Due to the deep location of the psoas muscles, [at the solar plexus] breath was also an important focus. Attention was given to both activation and stabilization of these muscles. 8
Conclusion The desired results were better function and less pain. It took time, effort and coordination in re-teaching synergistic muscle movement to the affected area. Maintaining flow of the exercises, utilizing the importance of the breath, and maintaining mind-body connection helped the process. The results were less pain, freedom of movement in the hip joints and back muscles. Fewer Chiropractor visits became necessary and adjustments held better. Less pain and economy of movement were achieved, as well as, more overall energy in the body. 9
Bibliography Books Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, 2000-2013. Bowman, Katy. Move Your DNA: Restore Your Health Through Natural Movement. First Printing, 2014. Staugaard-Jones, Jo Ann. The Vital Psoas Muscle: Connecting Physical, Emotional, and Spiritual Well-Being. Lotus Publishing, 2012. Isacowitz, Rael, Clippinger, Karen. Pilates Anatomy. Human Kinetics, 2011. Franklin, Eric. Pelvic Power. Princeton Book Company, 2002,2003. 10