Issue link: https://www.massageandbodyworkdigital.com/i/530196
Each manual therapy system that includes the psoas in its repertory has its own rationales for doing so. For example, Ida Rolf placed special importance on the psoas's role in her work. "A balanced body lengthens," she said. "There is no shortening. If the 'psoas' muscle is where it belongs, the body lengthens in all movement." 13 In our Advanced Myofascial Techniques trainings, we work with the psoas as one of many possible avenues for furthering our two primary therapeutic goals, which are: 1) more options for movement, and 2) proprioceptive refinement. 14 In particular, we have observed that careful, direct work with the psoas produces beneficial effects such as: • Immediate and lasting improvements in certain clients' back or sacroiliac pain (both acute and chronic); • The already-mentioned improvements in nerve entrapment pain in the sciatic, femoral, obturator, genitofemoral distribution areas; and • Client reports of increased awareness and proprioceptive (felt) sense of length, ease, mobility, balance, or continuity through the midsection of the body in standing, walking, and running. The Psoas Technique, then, is particularly indicated in cases of back pain and nerve pain such as axial sciatica, as well as lumbar, pelvic, or hip joint mobility restrictions. And because of its unique role as a connector of the upper and lower body, as well as its high sensitivity and proprioceptive function, we often use the Psoas Technique in the closing, integrative stages of a session or series. At this stage, the goals have shifted from mobilizing or lengthening specific structures to awakening proprioceptive awareness of large (broad) relationships in the body, as well as calming, balancing, and completing a session of hands-on work. 108 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 5 PSOAS TECHNIQUE (SUPINE) With your client supine, ask her to bring her knees up (Image 3). This slackens the myofascial layers of the abdominal wall, helping the work be more comfortable and less invasive. We typically don't put a bolster under the knees, as we will ask for active movements a bolster would obstruct. As you prepare to touch your client, make sure your own approach and mindset are soft, sensitive, and unhurried. In "Working with the Mesentery" (Massage & Bodywork, March/April 2015, page 106), we described the kind of touch needed for working in the abdomen as similar to touching a soap bubble without bursting it. You'll use the same touch for working with the psoas. Begin at about the midpoint between the umbilicus and your client's side. Use a delicate, sensing touch, never pushing or pressing. Gently, with your client's breath, allow this soft touch to sink into your client's abdomen. Imagine gently sinking into a tub of water balloons (Image 4), patiently making your way to the bottom as the slippery, delicate balloons (the viscera) slide out of the way. Slowly sink posteromedially—toward the back, and slightly toward the center of the body. The safest approach is to stay at or below the level of the umbilicus. Above this level, the kidneys and their vasculature lie close to the psoas, and The Psoas Technique (supine). Use an unhurried, delicate touch to gently sink into the client's abdomen. Since one of our primary aims is refined proprioception, the pressure should be very light and sensitive. Image courtesy Advanced-Trainings.com. 3 although our touch remains so soft and sensitive that any damage or bruising is unlikely, it's a good practice to stay below (caudal to) the umbilicus, at least until you are experienced with the kind of patient, listening touch needed in the abdomen. Stay in close verbal communication with your client, checking in about comfort level, pace, etc. Encourage easy diaphragmatic breathing. Your client's exhalation will draw your hands deeper into the abdominal space. At some point, usually after at least 5–10 of these slow, relaxed breaths, you'll stop sinking, and find yourself resting against the slightly firmer posterior abdominal wall. Ask your client to make a very small movement of her leg, lifting the knee toward the ceiling. This will allow you both to feel the slight contraction of the psoas. Adjust your position if needed, and repeat, until the contraction of the psoas is clear to you both. Although this area is very sensitive, at no time should the work be painful or unpleasant. As long as the work is comfortable for your client, you can invite different slow but active movements in order to help your client feel the psoas/ leg connection in various ways. Try slowly dropping the knees from side- to-side (Image 5) or sliding the leg out along the table. Direct your client to slow down even more, and ease off on your touch if you find movements