Irritated Iliopsoas

Muscle of the month: Iliospoas

Psoas-majorDeep inside your abdomen, beneath your abs and beyond your viscera, lies the elusive iliopsoas.

The iliopsoas is actually a combination of two muscles, psoas major and the iliacus muscle. It spans the area of the lower back and the inside of the hip bone, and then crosses the hip joint where it inserts onto the top of the femur. Pain may occur along any area of its length but is noted as a common source of low back and hip pain.

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Take a hike, low back pain!

Muscle of the Month: Quadratus Lumborum – the hip hiker

Low back pain: we’ve all experienced it at least once in our lives. That nagging stiffness, inability to move, and dull ache can put the best of us in a bad mood, or worse, at home in bed. Low back pain can be cause by MANY factors. Muscle, joint, and fascial imbalances all tend to play a large role; one major muscle that can cause low back pain is the quadratus lumborum.

QL - Ottawa massage blogNo, it’s not a Harry Potter magic spell. The quadratus lumborum, or QL, is one of your low back muscles that is tucked very neatly between your hip and the last rib. With one on each side of the spine, the QL, especially when tight, can affect many areas of the body.

Actions: When one QL contracts: laterally flex torso, elevate hip (hip hike).  When both QLs contract: extension of low back (back bend), stabilization of ribs during forced expiration.

Common pain culprit: Sitting for extended periods of time and a hunched back; also prolonged hiking up of the hip.

As we sit, we put the QLs into a constant contraction, since our lower postural muscles (the spinal erectors) are turned off. With constant contraction, the QL begins the vicious cycle of chronic pain: decreased blood flow to muscle, then fascial adhesions, then muscle spasms. Hunching forward further exaggerates this, as it puts an imbalanced load on our postural spinal erectors and increases the need for a contracted QL to support the change in centre of gravity. Low back pain is the outcome of this over-contracted QL.

Elevated right hip

Habitual elevation or “hiking” of the hip can also cause tissue shortness on the elevated side. Daily activities such as carrying a baby can contribute to this type of imbalance.

The fix: Muscle testing to reveal the imbalance. Strengthening of postural muscles. Stretching of QL. Massage and heat for chronic dull pain.

Next time you come in with low back pain, inquire about the QL with your RMT. They can help determine if this is the affected muscle and what you can do for it.


For the love of trigger points

Your beautiful body is connected via many, many different chains and pathways. A disruption in one chain can interrupt a number of paths, and cause pain elsewhere in the body. This is seen often with trigger point referral patterns.

What is a trigger point referral pattern, you ask?

It is probably what is causing your pain. It is a precise pattern of pain elicited by an active trigger point. A trigger point is a hyperirritable palpable spot in a taut band of muscle. In other words: a knot. Referral patterns have been documented by Travell and Simons and your massage therapist know them all too well.

Many of these referral patterns span the body, away from the trigger point site. What does this mean to you? It means that your headache might be caused by your back or neck, your back pain from your glutes, or your carpel tunnel pain from your elbow, shoulder or neck!

Take a look at these common patterns.Glute Medius Trigger Point - Ottawa Massage Blog Subscapularis Trigger Point - Ottawa Massage Blog Upper Trap Trigger Point - Ottawa massage blog

An RMT can help determine where the epicentre of pain is, and provide trigger point therapy for relief. When we get muscular pain, we initially think the massage should focus on the precise area of the pain, but it is important to get other areas addressed to pin-point where the dysfunction is. For your first treatment, it is good to get a general treatment as a preliminary scan of which muscles may be causing the pain; then a few follow-up appointments can be used to focus directly on the source of pain.

Discuss trigger points with your therapist at your next massage treatment.