Posts tagged ‘myofascial’

Important Muscles Involved in Lower Back Pain – Part 2 : Psoas

The Psoas muscle is one of the most commonly involved yet under treated muscle in lower back pain conditions, save to say it is probably the number 1 missing link in a lot of cases where the muscle has never been directly addressed and appropriately rehabilitated in many cases of unresolved lower back pain.  Due to the relatively deep location of the main fibres of the psoas muscle, it is seldom treated directly unless the practitioner concerned has had training in the appropriate techniques.  The muscle itself covers a very large area of the lower back and pelvic areas, significantly it attaches to the front facing side of each of the lowest set of 5 vertebrae bones of the spine, continues on to lines in the inside of the pelvis (where it is sometimes becomes known as the “iliacus” muscle) and finally attaches to the top inner part of the femur (aka tigh bone).  Due to its attachment to the front of the lower spine, tension in the psoas muscle can pull the spine forward causing an excessive forward curvature in this region (known as an excessive “lordosis”) which in turn causes the opposing muscles attached to the back facing side of the spine to become over stretched and over tensioned (muscles including the quadratus lumborum and other spinal muscles which we discussed in part 1 of this article series).

As can be seen from the above diagram set depicting the trigger point pain referral patterns for the psoas, the first illustration shows the pain pattern for the back of the body which is essentially quite straightforward as it is just a localised pattern (relative to the absolutely position of the psoas muscle itself) running parallel along either side of the lower part of the spine.   The second illustration however might be a surprise as it shows pain referral which can get set-up and experienced on the front of side of the body which in this case is a region around the inner groin and inner thigh area, so anyone experiencing pain in these areas it’s possible to attribute this to trigger points in your psoas muscle.  Proper and thorough treatment of the trigger points in the psoas muscle requires that the practitioner goes in gradually and eases in deeply moving the intestines aside in order to make contact with the psoas (and iliacus), the direction of aim is toward the spine in order to work directly on the psoas (but not ultimately to make contact with the spine).  This procedure need not be excruciatingly painful for you the client so long as your practitioner maintains a “listening sense of touch” at all times, as well as working slowly and gradually in rather than forcing their way in with battling haste and impatience.

The following video gives a nice interactive over view of the anatomy for the psoas muscle and gives a few pointers on what issues may arise as a result of the psoas muscle being overly locked in tension or on the flip side in weakness (which is generally rare):

So, here is our first video showing you a classic de facto standard stretch for the psoas muscle, note that a varation of this stretch can also be done whilst lying totally flat on the floor i.e. the leg that would have been hanging off the edge of the bench in the video example would instead be stretched out straight flat against the floor instead:

Now, here are 2 alternatives…  The first variation is a stretch that can be performed standing (instead of lying down):

The second variation is a bit more complicated to grasp, but fine once you’ve understood what you’ve got to do!  This video was for me personally a very interesting stumble upon as it’s is based upon the paradigm of myofascial stretching.  I myself perform myofoscial release work for releasing individual muscles, but have never really looked into studying myofascial stretching before and has thus whetted my appetite, so any comments welcome about this from either total new comers or those experienced in myofascial stretching already.  I tried the exercise in the video below for the first time earlier on just before writing this article and it is certainly effective yet gentle and holistic (i.e. you can feel other parts of your body gradually and subtly freeing up as well during the stretch process) all at the same time:

Remember, if you have on-going lower back pain and have never had your psoas muscle properly treated for trigger points and properly (myofascially) released by a suitably qualified massage or physical therapist, chances are that this is exactly what the missing link is.

Take care for now and see you for the part 3!

15 June, 2010 at 00:21 9 comments

Soft tissue pain: are you in the 40% group?

A study into the prevalence of significant physical aches, pain and discomfort among the general population showed that…

60% are relatively “pain free” on a day to day basis;
30% experience some kind of accute or regional / local pain;
10% suffer with some degree of widespread distributed pain everyday.

Therefore 40% of the general population experiences some kind of on-going physical pain on-going in their bodies.

Within that 40% group, between 70% – 80% of pain has been found to be soft tissue related in nature.  Soft tissue includes the muscles, tendons, ligaments and all pervading connective tissues (known as the “fascia”) of the body.

Massage therapists who have had specalist (usually extended) training in remedial massage and soft tissue manipuation techniques are particuarly well placed to provide effective assistance in the addressing or easing of soft tissue pain.  Suitably qualified therapists will usually advertise their skills by using any one of the following modality descriptions in order to differentiate themselves from those who are just offering non-remedial general relaxation massage or spa type treatments: remedial massage, remedial bodywork, sports massage, soft tissue manipulation, soft tissue therapy, myofascial release, fascial bodywork, structural bodywork, structural integration, Rolfing, neuromuscular therapy, neuromuscular technique, neuromusuclar massage, deep tissue massage, trigger point therapy, medical massage and clinical massage.  Also related are the modalities of visceral manipulation, craniosacral therapy and physical therapy.

This type of therapy involes various types of postural, visual and functional assessment procedures which help the therapist identify the issue.  The work is often concentrated on a particular area with precision focus for an extended amount of time involving interactive feedback with the client, whilst other areas of the body which may seem unrelated to the presenting issue can also be worked on in the same session or in future sessions.  Finally the client is given useful exercises to do in-between visits in order to maintain, supplement and enhance the effectiveness of the work done durinig each session.

The video below is aimed at therapists but still will be very much of interest to a lay person such as maybe yourself who may be looking for a proven alternative or complementary approach to relieving their soft tissue related pain, it expalins the physiological mechanism of pain and how remedial massage modalities can help:

Over the next few days, I’ll be publishing a series of articles defining some of the soft tissue modalities and techniques (mentioned above) that I use in my own clinical massage clinic here in Exeter (UK) and how in practical terms they have worked successfully on real world clients.

12 February, 2010 at 00:30 Leave a comment

Destination New Zealand and Peter Grunwald’s Eyebody Retreat

I’ll be traveling to the airport tomorrow morning catching a flight bound for New Zealand.  Flight time is going to be nearly 24 hours including a 2 hour stop over in Los Angeles for crew change (and refuel?).

The purpose of this trip will be to attend Peter Grunwald’s 3 week long Eyebody workshop.  The Eyebody method is a totally natural system of eye sight improvement, it incorporates ideas from Alexander Technique and Bates Method eye exercises plus a unique and holistic concept of eye, body and mind awareness that has been discovered by Peter which he used over a period of 18 months to completely let go of wearing glasses to correct an eye condition which he had for over 27 years without any kind of surgical intervention whatsoever.  I’ve already spent a day with Peter in a group workshop sampling some of the ideas and techniques when he attended The Mind, Body, Spirit Festival in London earlier on this year so know that spending 3 weeks practicing daily and ingraining the learnings into habit is going to be worthwhile.  As a famous personal development saying goes, when we are adults it’s not so much about learning new things but UNLEARNING the subconscious habits we have picked up along with way (especially in our first 7 years of childhood), and this is the nature of the process I’m expecting to go through.

Being a massage therapist and bodyworker I sometimes get involved with structural and postural alignment work with my clients and it’s also been something I’ve been exploring myself on myself through modalities such as indirect and direct myofascial release, cranoisacral therapy and visceral manipulation as well as body awareness through qigong, but this is the first time I’ll have comprehensively experienced first hand Alexander Technique.  All very interesting stuff which feeds back and around into the loop as I get to experience and benefit from and also which I can pass on and benefit the people whom I also work with.

I believe there will be 7 others on this workshop retreat, all with vastly different eye conditions no doubt, so I will report back what unfolds for those interested in the applicability of this approach to their specific circumstances.  Save to say that perhaps the key theoretical cornerstone to this Eyebody work is that the physical structural integrity of the eye and the optic nerve only accounts for 10% of our perception of sight, the other 90% in other words comes from the processing or our currently installed software which “filters” and gives us our “perception” of sight to give a computer type of analogy.

More information can be found at: www.eyebody.com

The first week of the workshop will be held residential on site amongst the natural beauty and surroundings of The Mana Retreat Centre in Coromandel (on the coastal location about 2.5 hours drive from Auckland).  From what I’ve gleaned from the videos that I’ve found of this place on YouTube, it’s going to be just like mana to a nature lover such as myself:

The remaining 2 weeks of the workshop will be held in Auckland.

I’ll hopefully be providing regular updates to this blog whilst I’m out there if logistics allow, otherwise I’ll make sure that a written debrief and photos are made available on my return.

Wishing everyone a happy, healthy and prosperous 2010.

Henry. xx

28 December, 2009 at 20:12 2 comments


Henry Tang – Therapeutic & Advanced Clinical Massage Practitioner (Crows Nest, Sydney, Australia)

Click image above to visit Spaces of Possibilities Wellness Centre, Crows Nest, Sydney, Australia.

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