Ah, the psoas muscle. Most of us who train frequently are familiar with the psoas muscle, short for iliopsoas, and commonly referred to as the “hip flexor.”
“My hip flexors are tight.” “My hip flexors hurt.” “All this sitting has got my hip flexors fired up.” “My hip flexors are pinching.” You name it and I’ve heard it. We’re familiar, for the most part, with what hip flexors are. However, a lot of us are completely lost on what to do to help them.
Stretching your psoas can help some in a lot of cases, and it feels good, but you may feel doomed to a daily routine of psoas stretching without making any progress. You may feel like you’re just maintaining, but that your hip flexors will never change. They are just simply always tight.
I’m going to get down to the nitty-gritty and explain when and why stretching your psoas is not helping.
NOTE: STRETCHING YOUR PSOAS IS IN MOST CASES A GOOD THING TO DO. THIS CONTENT IS FOR THOSE WHO AREN’T GETTING THE RESULTS THEY NEED FROM SIMPLY STRETCHING THEIR HIP FLEXORS.
WHEN and WHY Stretching Your Psoas is Not Enough
× You Have Psoas tendonitis or tendinopathy. If you have inflammation, microtrauma, and pain in the tendon (the rope-like portion of the muscle that’s made of more fibrous connective tissue) constantly stretching your psoas is not going to fix it. In fact, it has a better chance of delaying your recovery and continuing to irritate it.
× You Have a Psoas Strain. When you strain your psoas you have a small tear in the muscle. Tear is a scary word, but if it’s strained it’s a small tear. A complete tear would be considered a rupture and these are much rarer. If you’ve strained your psoas and you are stretching it, hoping this will fix your problem you’ve got it wrong. Stretching a strained muscle is going to subject the muscle to more tension than is desirable during recovery.
× You Sit Almost All Day at Work. If you sit almost all of your day at work, stretching your psoas for 5-10 isn’t enough. You cant “unwind” all the shortening in your hip flexors with a few minutes. I’m not saying it’s pointless, because I do feel it will give you some relief, but it’s just not going to get the job done.
× Your Psoas Muscle is Not Actually the Problem. If you haven’t been evaluated and diagnosed you may be guessing it’s the hip flexor, and it may be another issue. There are a number of issues that can cause pain in the same area as your hip flexor, like:
- Cam-type, Pincer-type, and Mixed-type hip impingement
- Hip labrum tears
- Osteoarthritis of the hip
- Groin strains
- Hip bursitis
- Hip dysplasia
- Referred lower back pain
Even experienced clinicians misdiagnosis hip pain, so don’t feel bad if you feel like you did. The point is that if you’re not improving you should probably get a professional opinion on your hip.
If you’re trying to nail down if your psoas is a pain producer or weak, see this content with videos where I cover psoas strength testing, psoas release techniques, and psoas exercises –> How to Release a Tight Psoas Muscle
× You Aren’t Creating Strength in Opposing Muscles. One of the biggest reasons why stretching your hip flexors isn’t enough is because you’re neglecting your opposing muscles. The opposing muscles of the psoas are the gluteal muscles and hamstring muscles. They pull your hip in the opposite direction. If you’re not doing activation and strengthening exercises to create an oppositional force, your hip flexor muscles will always dominate. The oppositional muscles are notoriously weak but if you work on them they will fight the good fight for you.
Take a look at all the muscles in this area, in addition to the iliopsoas. The front of the hip is also sensitive because of the femoral artery, vein, nerve, and inguinal ligament. There are a lot of structures that can be involved in hip tightness and/or discomfort, especially if stretching your psoas isn’t relieving.
× You Don’t Exercise and are Inactive. I promise I’m not trying to slam you if this is you, but it’s the truth. You have to exercise to maintain your physical frame and mind. Deconditioning is a real thing, and over the long run, a psoas issue is small in compared to the other problems that can arise from deconditioning. You don’t have to do CrossFit (although I recommend it and it can change your life) but you need to move.
As a side note – If you’re interested in CrossFit, make sure you find a gym with good exercise instruction. All CrossFit gyms are not created equal and may have different areas of focus. I work out here –> Black Bolt CrossFit
× You’re Stretching the Psoas Wrong. Believe it or not, it’s common to have patients in my office that think they are stretching the psoas when they’re actually stretching the gluteal muscles. An equal amount of people are close to the correct stretch but are leaning back and involving their back instead of shifting their hips forward. Make sure you know what you’re doing before you write it off.
× You Arent Spending Time on Mobility for the Other Supporting Muscles. Your body works in synergy and isolating your psoas for stretching while neglecting other supporting muscles will not yield results. Creating a comprehensive mobility plan to address other hip, back, and leg muscles is necessary. The human body is balanced and complex, we need synergy to function right.
× You’re Not Avoiding Aggravating Factors. If you keep aggravating your injury, whether it’s the psoas or something else, your chances of making a full recovery are slim to none. As much as we want to “work through” things and be “tough,” we have to recognize when it’s hurting more than helping. There’s no amount of psoas stretching that will help if you are repetitively injuring the area.
What Can You Do Besides Stretching for Psoas Pain Relief?
If you think one of these reasons may apply to you, don’t be alarmed. All of these reasons are things you can change. This isn’t a mea culpa on stretching the psoas, I promise. Stretching is part of the rehab strategy most of the time, but the rehab process is usually more complicated than simply stretching.
If you’re experiencing nagging hip discomfort or injury that’s not resolving with stretching, consider reaching out to our chiropractors or another provider who can provide treatments for psoas pain relief and a psoas pain rehab strategy. These issues can almost always be resolved conservatively and without invasive or surgical procedures.
If you’re looking for more information on how a chiropractor can help with general hip mobility, I have some content on that here –> Chiropractor for Hip Mobility
Dr. Jason Williams DC is a chiropractic physician practicing at AccessHealth Chiropractic in Cary, NC. He treats neuromusculoskeletal pain and injuries using chiropractic manipulation, dry needling, acupuncture, rehab exercise strategies, and other supportive therapies. Primary areas of focus include back pain, neck pain, muscular pain, extremity pain, and orthopedic injuries. Dr. Williams is experienced in treating athletes, especially those in the CrossFit, Brazilian Jiu-Jitsu, Muay Thai, and MMA community.
If you’re interested in whether he or another AccessHealth provider can help you, navigate to our contact page or follow this link to request an appointment.