Video: Myofascial release for iliacus and psoas

Here’s how I work with the hip flexors. While I show some variations for clients who prefer more direct contact, my usual approach for iliacus and psoas is one of broad contact and slow sinking.

My reasoning:

First, these muscles are rarely touched, and so it doesn’t take a lot of stimulus for them to reduce their tone and sensitivity. I find that simply making contact and waiting can produce fairly pronounced softening in a short period of time. It’s like they’re waiting for a chance to take a break.

Second, these can be sensitive areas, and it’s worth keeping the human in mind as you approach them. Attempts to dig into psoas can be anxiety provoking for some people, and even the best work can be counteracted if the contact is perceived as threatening. Why not start with what’s friendliest to the client’s nervous system and see what results you get?

A quick story, shared with permission: I just started seeing a new client about a month ago, and her hip and low back were constantly causing her trouble. Sleep was difficult, sitting at work was difficult, and a lot of her favorite activities had to be set aside to prevent a painful snapping sensation along the front of her hip. Medical imaging had revealed arthritis and a bone spur in the region.

I explained that, while I couldn’t change the joint itself, there was a lot we could do with the nearby muscles. It might be the case that her nervous system was keeping that hip on lockdown, and between massage and some movement and stretching on her part, we could convince it to ease that high-tension situation.

And so, I got to convincing. We started with some long slow sinking like in the video, followed by movement — gentle jostling, and exploring her comfortable range of motion. After the area softened up a bit and became less touch sensitive, I slowly moved the leg out and down, approaching that hanging position. She started feeling some uncomfortable pull, so we did some more movement and contact of TFL and iliacus, until she was able to tolerate her leg in that abducted and extended position. More gentle contact and jostling. We proceeded in that fashion in both supine and prone position, I gave her a stretch she could do in her office chair (I’ll post that as a reel on Instagram soon), and she went on her way.

Reader, I am pleased to report that her hip pain was mostly resolved when I saw her again two weeks later. I don’t always have big obvious outcomes like that, but like I said, sometimes some muscles are just waiting for an excuse to chill out. We kept on the path we were on: More movement and contact with those hip flexors, and more playing with her range of motion as we did so.

My takeaway from this particular case: You don’t necessarily need to dig to get results, and you don’t even need a specific protocol. By using your hands to have a conversation with the client’s body, you might find that it’s ready and willing to give up longstanding patterns of guarding and sensitivity.

Let me know what you think, and please feel free to tell us about your own approaches to this area in the comments!

Comments? Stories? Tell me stuff.