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You may not have even heard of the psoas muscle, but you’d be surprised how much you use it throughout the day, especially during workouts. The psoas is a long, spindly tissue that runs from your lower spine to your pelvis, and is part of the hip flexor group.
“Any time you lift your knee, your psoas muscle will contract. Whether you’re going up and down stairs, walking, or running, that strength is coming from the psoas,” says Elizabeth Matzkin, M.D., an assistant professor of orthopedic surgery at Harvard Medical School.
Exercises that make the psoas more susceptible to injury include running, snatches, and squats. In addition, going from completely stationary to an intense workout could also do more harm than good. “This is because your hip flexor and psoas muscles become shortened and tight from sitting. If you don’t warm up properly and stretch before working out you’re more likely to become injured,” says Matzkin.
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“If the psoas is tight or strained you will feel it in you hip or lower back,” says Matzkin. You’ll want to pay close attention to these areas if you think your hip flexor is injured. “You will feel discomfort in the front of your hip and your hip crease. You may also experience hip impingement and lower-back pain,” says physical therapist David Reavy, founder of React Physical Therapy in Chicago.
What may begin as a minor ache could easily snowball into a more serious setback, says Reavy. Left untreated, an injury like a psoas sprain or strain can lead to herniated disks, facet-joint syndrome, chronic poor posture, and lower-back or neck pain. “If your psoas hurts and you’re not using it the right way, you may start to overcompensate with other muscle groups and throw off your lower back, hamstrings, and glutes,” says Matzkin. This can put you on the sidelines for much longer than expected.
The first line of treatments include rest, ice, anti-inflammatory, and stretching followed by strengthening, notes Matzkin. One good rehab move is a hip flexor/psoas release using a lacrosse ball, adds Reavy. (See illustration, right.) “If there is a muscle strain along the hip, be careful to put the ball above or below the area of injury, but not on the point itself,” he says.
1.5-6: Months of recovery time you should estimate, depending on the severity of the psoas injury and
the sport you’re trying to get back to.
Focus on stretching as part of recovery, says Matzkin, so you can start to heal a sore psoas. (See four good options, right.) Avoid running hills when first returning to physical activity, since they can aggravate the injury more than flat surfaces. Matzkin also suggests getting up and walking around for even just a few minutes every hour to help avoid shortening/tightening of the psoas when sitting for extended periods of time. Finally, “make a conscious effort to stand with good posture to allow your posterior chain to work properly,” says Reavy.
Taking a few minutes to properly stretch before and after exercise can help reduce your recovery time. “Yoga itself is very good for stretching out the hips, especially King Cobra,” says David Reavy. “We recommend releasing, stretching, and activating your posterior chain and abdominals before any workout and in the morning to start your day.”
Stand with feet shoulder-width apart. Slightly bend right leg, keeping knee over heel. Bring left foot back and behind the right leg, turning torso to the right and leaning into right glute. Hold 30 seconds; switch sides and repeat.
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Get into a half-kneeling position, right leg forward with knee bent 90 degrees and left foot on floor behind you. Push hips forward, keeping back straight. You’ll feel the stretch along the front of your left thigh and hip. Hold 30 seconds; switch sides and repeat.
Lie facedown with palms turned out slightly, arms slightly wider than shoulder distance. Slide left knee up to left side, keeping right leg extended and turned in slightly. Push shoulders off the floor until arms are straight, pressing shoulder blades down and back. Keep hips on the floor and elbows close to your sides. Squeeze your glutes and look up, twisting gently toward left. Continue for 30 seconds; switch sides.
￼Lie facedown with a lacrosse ball (or a tennis ball) placed just inside your left hip bone. Lean a comfortable amount of weight onto the ball and bend left knee about 90 degrees, keeping right leg extended. Move the left leg gently from side to side. Continue for 30 seconds to two minutes, then switch sides.