How to release the psoas muscle (hip flexor) to improve posture

by Kitti Lepp MSc. (Rehab) 

Now more than ever, we’re sitting more and becoming more sedentary. Whether it’s school, work, or just our more inactive lifestyles, this increases our risk for poor posture. What is becoming more well known is that poor posture can lead to issues, such as back and neck pain. One of the most significant contributing factors comes from having tight psoas muscle(s) (also known as a hip flexor). By releasing your psoas muscle, you can help alleviate pain, improve wellbeing and attain better posture. What’s fantastic is that you can do this at home (without any equipment!). At the end of this article, you’ll be thinking why you hadn’t thought of following these simple tips earlier.


About the psoas muscle


The psoas muscle is sometimes known as the psoas major (more formally) or hip flexor (more casually) for some people. Due to the location of this muscle near the hip and lower back, it can contribute to poor posture and ultimately pain within these regions.

  • Psoas major origin – Transverse process and lateral surfaces of T12-L5
  • Psoas major insertion – Lesser trochanter of the hip
  • Psoas major function – Predominantly trunk and hip flexion trunk. Contributes less hip external rotation and lateral trunk rotation

The table uses medical jargon to explain the psoas muscle location. It essentially means that it starts around the low back spine and runs along into the inner part of our thighs. So, what does the psoas muscle do? Great question! Simply put, it performs hip flexion, which means that it brings the hip closer to our torso. Examples of these movements include kicking a ball or running. However, it is also involved in the rotation of the hip and torso to a lesser extent.

The psoas muscle plays a crucial role in preventing low back pain as it determines the position of the hips and the lumbar region, consequently affecting the entire posture. We have also observed that the psoas major is linked to physical impairments, such as hip or knee rotation, misalignment of the spine, and a shifted center of gravity.

Although hip flexors typically refer to a group of muscles that moves the hip joint forward, most people will often describe the psoas major when referring to it. This article will be interchanging the terms “psoas” and “hip flexor” to help reduce repetition and expand our outreach to the readers in need. 


What causes tight hip flexor muscles such as the psoas major?


Tight hip flexors generally occur through repetitive movements or long positions. Sometimes it occurs if we run for long periods. Or it can even happen when we are sleeping in a fetal position in bed. Whatever the case, it can lead to numerous (and even debilitating) health problems, such as nagging low back or psoas muscle pain.

Unfortunately, it is well known that a significant number of people above 25 years of age suffer from low back pain. Low back pain often comes randomly, is complex, and is contributed by over 30 causes. However, on a positive note, 80% of the cases are not related to spinal damage but intertwining factors, including depression, stress, anxiety, and low self-esteem.

So you may be thinking – how do these factors translate into tight hip flexors? One thing to understand is that Our nervous system (e.g., spinal cord and brain) responds to stress, depression, and low self-esteem in many ways, including the contraction of the muscles around the torso. One of these muscles is the hip flexors which include the psoas major.


Tight hip flexor symptoms


The consequences of contracted or tight hip flexors can affect the whole body. It can cause irregular arching in your spine and lead to closed positioning of the shoulders, thoracic kyphosis (slumping of the upper back), lumbar lordosis (flattening of the lower back), and sometimes is present during scoliosis. Persisting contractions can lead to many problems, including low back pain, neck aches, and even constipation.

The chronic contraction of the psoas muscle causes the shortening of the muscle itself, leading to a limitation in the hip movements. Excessive pulling of the muscles leads to changes in the body, such as strong tension in the entire lumbar area and excessive knee rotation. Asymmetries in our body can appear as the muscles progressively get shorter and contracted (particularly if the problem is just one side). Compensation along the whole body (e.g., spine, neck, head, etc.) can affect our walking gait. Less commonly, it can even develop into conditions, such as hip flexor tendonitis or popping (also known as ‘snapping hip syndrome‘).

Not only do tight hip flexors affect our muscular and skeletal system, but misalignment of our legs and torso also reduces the space for our internal organs, which can impair their ability to function efficiently. A common symptom is dysfunctional breathing which can physically manifest as short and rapid patterns of breathing. 


Diagnosis and treatment


Psoas issues can often mask themselves as other conditions, such as groin and low back pain. Therefore, getting a diagnosis from a medical professional such as a GP, physiotherapist or osteopath is recommended. Further examinations might be required in some cases, but otherwise, hip flexor problems can be determined through a thorough physical assessment.

A straightforward strategy to unlock your hip flexors is by regularly performing specialized exercises to improve flexibility and mobility. Activities that involve hip flexor strengthening are also vital for long-term success. At Osteopath Malta, we have a list of psoas exercises specifically designed for your injury recovery. Simply by following the 15-20 minute exercise program below, you can help significantly relax the psoas muscle.

1. Hip to knee stretch

The first position to try is the one shown in the picture above. While you do it, make sure that your lower back is completely pressed against the floor. Once your pelvis is stabilized, extend your leg, and the psoas muscle will be lengthened accordingly. Keep this position for 2-3 minutes and try it with both legs.


2. Kneeling Psoas Stretch

The second exercise is a bit more difficult to execute as you will need to keep your shoulders open and your torso correctly aligned (without arching your back).

During the exercises it is important to reduce any tension to the minimum: relax jaw, shoulders, the upper part of the back, belly, pelvic zone, and hip articulations. Take long and deep breaths.  To loosen hip flexors further, try squeezing your pelvis forward.


3. Overhead kneeling psoas stretch

If you cannot execute the second position without arching the spine, you can try a simpler exercise. Breathe in deeply and extend your arms above your head without changing the orientation of both hips and spinal column. Breathe in while you extend your arms, and lower them down while breathing out. Repeat the action 3-4 times.


4. Face down hip flexor stretch

To complete the session, put your hands down and make them slide towards your feet. Keep the position as shown in the picture above for 1 minute.


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