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Ten Exercises for a Healthy Psoas

10/5/2013

76 Comments

 
Picture
We have two psoas muscles on each side of our body: psoas major and psoas minor.  This blog is specific to our psoas major.  
This summer I took a very cool tele-class from Liz Koch, of Core Awareness.  In this 5 week series we explored the location and function of the psoas and its relationship to the nervous system and our "fight/flight/freeze" response,  to our emotional well-being and to our skeletal support.
The psoas is centrally located: emerging from the midline at thoracic level 12, attaching to every lumbar vertebra and inserting into the inner thigh at the lesser trochanter.  
The psoas allows the lower limb to move and swing a as a pendulum: multidirectional/orbital.  
As a physical therapist I see many people with SI dysfunction, hip and back pain.  In almost all cases, the psoas is the top priority to rehabilitate.   On muscle testing the psoas is usually weak, and the flexibility test is usually tight.  What I have come to understand through this tele-class, through my training as a Restorative Exercise Specialist™ and as an NKT™ practitioner, is that rather than manipulate the psoas through deep tissue work and stretching, the psoas needs to rehydrate and recover from over-exhaustion.
I have compiled my favorite top 10 ways to release, rehydrate and restore the psoas.  It is helpful to perform a release before going onto the movement sequences.  Some of these are from Liz Koch's book, "The Psoas Book" and some are from the Whole Body Alignment Program.

Releases

Constructive rest position for psoas release
Position yourself on your back as shown. You can use a pillow for your head if you notice that your chin lifts to the ceiling. Begin to focus on your breathing. Tune your awareness to your hip sockets. Imagine that the head of your femur bone is centered in the socket of your pelvis. Breathe here for 5 minutes.
Psoas release with a bolster
Postion yourself on a bolster or rolled up exercise mat as shown in the picture. You want to find a bolster that is high enough so that the back of your thighs touch the floor. When you lie on the bolster, you want to make sure that your lower ribs are flush with your abdomen. Breathe here for 2-5 minutes.
Hip flexor release with block under the pelvis
Position a yoga block, rolled up yoga mat or thick book under your sacrum. You want to make sure that the block does not go higher than your pelvis (it should not be blocking your low back). Breathe here for 2-5 minutes.

Movements

Modified Thomas Stretch
After the block release, bring one leg toward your shoulder as shown in the picture. Let the other leg go out straight and begin to lower the leg down to the floor. Make sure to keep the knee straight. Hold for 3-5 breath cycles and then repeat on other side.
Quadruped hip extension
Come on to your hands and knees (or onto your forearms as shown in the picture). Kick one leg back with a straight leg. Make sure to keep your pelvis level. Move your leg toward the floor keeping your leg straight and then extend your hip back as far as you can go without moving or rotating your pelvis. Repeat 10 times, then switch sides.
Supine straight leg raises
Lie on your back as shown. In this movement you will keep your leg straight as you lift your leg up and down 10 times, then place your leg on the floor and slide your foot toward midline and then outwards 10 times. Repeat on other side.
Picture
Bend your knees and reach your arms toward the ceiling.
Psoas stretch with arm movement
Begin to move your arms overhead as far as you can go without arching your back or lifting your ribcage, and then return to starting position. Repeat 10 times.
Knee to chest stretch with bent knee
With your knees bent, bring one knee toward your chest. Take 3-5 breath cycles and then switch sides. Repeat 3 times each side.
Single leg hip stretch with leg straight
With your opposite leg straight, bring one knee toward your chest. Take 3-5 breath cycles and then switch sides. Repeat 3 times each side.
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
76 Comments
Tim Harris
10/5/2013 04:01:31 pm

Well laid out and explained. I like the formula of "release, rehydrate, restore." This is the first time I've heard mention of the 3rd category: freeze. I refer to it that way, as well. Is that your expression? Is it a commonly held belief? In the 3rd release photo, it looked like the block could have been moved slightly buttward to encourage a little pelvic post tilt. I am nitpicking, Susan :) Great explanatory text; no typos that I could see.

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Susan
10/8/2013 03:15:09 am

Hi Tim,
Thanks for your feedback! Susan

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Yvonne
10/8/2013 09:37:08 am

Think I'd need videos to better understand some of those.

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Susan
10/9/2013 06:32:56 am

Yvonne,
Just think about exploring the movement of your hip. Notice the boundary of hip movement and pelvic movement. You can't do any of these wrong. Susan

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C.T.aliasCAROLYN link
7/11/2017 10:10:06 pm

Video would be helpful, is there one

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Linda
7/15/2017 02:19:57 am

Irene Lugsdin
10/8/2013 12:23:38 pm

Thanks for the great summary and sequencing. Liz Koch is so inspiring. I just completed Restorative Yoga Teacher training. One of the wise instructors Swan of the The Path Yoga Centre in Vancouver BC added to the description: fight, flight, freeze and please when referencing the psoas.

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Susan
10/9/2013 06:33:32 am

Irene,
Thank you for your feedback! Susan

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Ana Matos
10/10/2013 02:01:29 am

Hi Susan,
I wonder if you can clarify some doubts I have about these exercises?
- Should the bolster that is used in the 2nd picture be used in all other exercises in the case that the ribcage is still thrusting after the initial releases?
- In the 3rd picture, should the pelvis be level to the floor or to the ribs? Is any kind of tucking allowed in this particular release?
- In the 1st "Movement" exercise, while the leg is lowered to the floor, should I be feeling a stretch? Or is it for strength -- and in this case, what muscles should be holding the leg?
- The same question for the 3rd "Movement" exercise - which muscles should be lifting the leg?
Thanks a lot for your help!
Ana

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Susan
10/10/2013 05:23:04 am

Hi Ana,
Great questions! In regard to your first question, yes, I would recommend using the bolster if you thrust your ribs.
2 question: pelvis is level to the floor: ASIS and pubic bone level.
3rd: The lowering of the leg is more of a stretch to the anterior hip and thigh. The quad is needed to keep the leg straight.
4th: The main movers to lift the leg are the psoas, illiacus and rectus femoris.

Hope this helps, Susan

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Ana
10/14/2013 07:17:34 am

Thanks Susan!
Though I'm a bit confused about the motivation for performing strengthening exercises for the psoas, I wonder if you can clarify the "theory" for me? I had understood (very simplistically, for sure) that we (chronic sitters) have a shortened psoas due to contracting it too much. So the importance of the release is clear to me. But isn't all the sitting that we are (still) doing enough as a "strengthening exercise"? Do we risk subtracting to the benefit of the release by adding the movement exercises? What am I getting wrong here? Thanks again!

Susan
10/15/2013 03:28:32 am

Ana,
These are not movements to strengthen the psoas. These are movement explorations of the hip joint to bring in "reception" to the psoas.
Sitting is a passive position. It is important to actively move the hip joint multi-directionally to bring in oxygen and blood flow to the surrounding muscles.
Susan

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Sushil Chatta
1/16/2016 10:02:03 pm

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Steve
10/10/2013 02:18:18 am

What is the rehydrate part?

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Susan
10/10/2013 05:15:34 am

Steve,
The muscles and connective tissues can rehydrate when tension in the muscles can release and the movement brings in blood flow and oxygen.

Susan

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Anne Danielle
11/4/2013 11:54:50 pm

Could you suggest some exercises for strengthening the psoas?

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Susan
11/5/2013 10:15:34 am

Anne,
The psoas gets stronger when it can return to an optimal resting length/tension position, or is not inhibiting by some other muscles in the body.
A movement to strengthen would be similar to position 6. Bring the leg out from midline about 30 degrees, rotate the hip out a little bit, then lift the leg up and down. You want to make sure the the ribcage is anchored down against the body wall(lower ribs in contact with the floor).

Hope this helps, Susan

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Brigita
12/18/2013 11:21:11 pm

Hi Susan,
I apologize for my mistake. Last time I posted my question under the wrong blog post.I suffer of SI pain and I'am very happy that I find your excersises for it. Could you please explain me the second movement.How can I extend my hip back without moving my pelvis?When I try to extend my hip back without rotating my pelvis I feel just a small hip movement. Is this enough and o.k?
Thanks for your time, Brigita from Slovenija

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Susan
12/19/2013 04:28:05 am

Hi Brigita,
Thank you for your question. That is ok that you don't have much movement. The lack of the ability to extend from the hip is generally a sign that there is tension in the front part. So this is perfect. Keep doing the releases and this will help with the tension.
Best, Susan

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Becky
1/1/2014 10:58:30 am

great article! found your blo tonight and am enjoying reading through it all. I am working on healing a diastasis recti - relatedly working on proper alignment and have a tight psoas. do you know which of these are safe to do with a diastasis recti? thank you!

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Susan
1/9/2014 07:54:57 am

Becky,
All of these are safe to do for DR. Susan

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Rachel
1/9/2014 06:23:38 am

I think my left psoas may be stuck in contraction because of pain on that entire side. Don't think any other muscle could cause so much dysfunction. If I commit to doing these everyday, how long do you think before I notice an improvement?

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Susan
1/9/2014 07:58:43 am

Rachel,
It is hard to say without evaluating you and seeing what is going on. A general rule to have tissue changes is 30-40 days. Hope that helps! The psoas release with the bolster (2nd pic) is the most helpful for decreasing tension.

Susan

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Rachel
3/21/2014 10:24:19 am

Have you thought of making a video of you doing these (all of them) and selling it? I'd buy it!! :) Sometimes it's just nice to do this stuff with a video and someone reminding you why you are doing it.

Susan
3/21/2014 10:41:33 am

Rachel,
I have thought of it and have made a couple videos so far, I am calling it my "Feel Good" Series. One is on the back and the other is on the feet. I haven't posted them yet. It is so good to know that you would be interested in something like this. I can definitely do this series.... it is one of my favorites!
Thank you for your feedback! Susan

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Jeanette
10/2/2016 06:55:39 pm

I'd buy one also.

Julian
3/11/2014 03:31:55 pm

Susan,
regarding on knee's isssues (like patella tracking e.g.)
do you recomnend releasing/stretching exercises or strenghtening exercises?
And what about in a lower crossed syndrome (Janda's aprouch) ?
thanks.

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Susan
3/21/2014 09:31:53 am

Julian,
Sorry for the delayed response. Without evaluating you, it is difficult to say what needs stretching or strengthening for patellar tracking or even with the lower cross syndrome. It would be good to connect with someone in your area to address your specific needs.
Susan

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kanupriya link
3/17/2014 08:59:23 pm

Good blog...visit our site for yoga training http://zerogravitygym.com/

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Rachel
3/21/2014 10:18:05 am

A massage therapist told me that type A personality types can't get a release from these gentle approaches. I am a type A and do have a hard time getting a complete release. Do you think there's any bit of truth to his statement?

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Susan
3/22/2014 12:59:31 am

Rachel,
There is truth to that statement. Have you tried a meditation practice, or a moving meditation? Something like that may be helpful for you.
Susan

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Breathe Exercise link
3/30/2014 09:23:16 pm

nice information thanks for sharing this

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Ellen
4/9/2014 04:44:18 am

This is great info! I did these for the first time yesterday and can't wait to do every day for at least 30 days! I also have some specific questions!
1) In the 3rd Movement when the leg goes twd and away from midline, does the foot stay pointed up or can/should the leg turn out when moving out?
2) In the last 2 pictures does the knee go twd the midline, as in aiming for the heart (you wrote twd the chest) which is different from the 1st Movement where the knee went twd the shoulder?
3) In the last picture should the straight leg foot point up?
Thanks!

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colleen
4/25/2014 11:26:28 am

I have suffered for 4 years with extreme pain in thigh knee and lower back I do have degenerative disk probs and osteo arthritis , been told I need hip replacement already had both knees replaced, Not convinced the pain is all from my hip . no one ever spoke of the Psoas muscle and its implications, read of this muscle and applied your and other positions and I am able to lift my right leg where I have not been able to for 4 years following a 4 month course of statin drugs. I am amazed at the relief I have gained This is HONESTLY the TRUTH I have ceased all medication and feel better for it. I cannot tell you the excruciating pain I was in, Funny thing I learned of the Psoas on a quiz programme . I didn't know the answer to what part of the body it controlled. looked it up and then was so amazed I continued to research and eventually learned how to relieve my own Pain with NO DRUGS I believe statin drugs started my problems with the psoas muscle as the onset was at the same time as I was prescribed these awful drugs within 3 months my muscles all became painful and my legs wouldn't work .. thank you so much

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Susan
4/25/2014 12:13:41 pm

Colleen,
Thank you so much for sharing. It is so empowering when you are able to get yourself out of pain!
Susan

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June Necchi
7/15/2017 02:37:23 pm

Hi Colleen. I developed a dysfunctional IS joint after taking statins..

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Debbie
8/1/2017 05:54:18 am

I am having issues with my psoas lately & suspect statins. I was on them for 20 yrs & they finally realized they were the cause of my asthma. Went off last year & SURPRISE! No asthma. Went back on a month ago at the urging of my doctors & now having horrible issues with my psoas. I'm going off them again to see if that's the cause.

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5/14/2014 11:00:11 am

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Natalie
7/20/2014 02:26:50 am

I have some pretty severe psoas problems at one point it was so weak I put my hip and lower back out 4 years ago. Before that I didn't know I had a psoas. It took several chiropractor treatments to get me back to the activity I had been at previous and lots of strengthening exercises. I have scoliosis and spinal stenosis in my lower lumbar. L4- L5 and S1 joints. It seems no matter the exercises I do my psoas has never quite recovered. When I am on my feet for a long time or doing labour it seems almost like it wants to give out and cause deep pelvic pain. It is only my right hip affected. The first Movement after doing the release poses seemed to have helped like nothing I have done before.

Are these the right kind of exercises for me and my psoas issue?

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Bobbi Hennessey
10/29/2014 10:07:06 am

I have found these exercises very helpful - I sit at a desk all day and my back gets tight and these exercises help loosen the muscles.
Do you sell DVDs of these exercises? I l live on the east coast and so travel is not an option but I'd love to purchase some DVDs so I can do these exercises more easily - I don't have a tablet.
I thought perhaps new things in the fall might include the sale of some DVDs.

Thank you for your time

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Tori Eldridge link
12/11/2014 02:55:54 am

Great exercises Susan! Hope you can offer me some guidance.
When I lay on my back with my legs suspended and bent, my right knee is about an inch higher and my left hip presses against the floor. When I place my feet on the floor my husband can see that my current norm (where my knees point) is several inches to the right of center. When he moves my knees to center, I can then feel equal pressure of both hips on the floor.
My question: When I do movement exercises 4 & 5 (moving arms with knees bent and feet on floor), should I engage my muscles to keep my knees pointing up in true center, or should I allow them to relax into their accustomed mis-aligned center?
My goal is to correct my alignment so I can stop ongoing pain, weakness in my back, and compounding problems as I get older. Any suggestions will be much appreciated.
PS: I'm 52 years old and a former Broadway dancer and 5th degree martial artist.

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Susan
12/11/2014 03:28:44 am

Tori,
Thank you for question. I would say as you do movements 4&5 keep your knees in line with your hip sockets and don't let your leg drift outward. I hope that you enjoy this sequence!

Susan

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Paige Maximovitch
1/9/2015 02:40:29 am

Susan:

Your site was recommended to me by my doctor to find exercises to strengthen my back. Also, can you believe we played softball together in high school?! I went my Nancy then. Very small world! Thanks for the information:)

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Susan
1/9/2015 03:18:02 am

Paige,
Nancy with red hair? That is so crazy.... do you live in Utah? Who is your doctor? I would love to thank them for referring you to my site. I hope this sequence is helpful for you.

Susan

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sue
1/26/2015 04:12:37 pm

Hi Susan, I was in your guest class at Nancy's studio this morning and I LOVED the class and exercises you did...do you have those in a book or handout format? I tried to review them in my mind as I left and throughout the day, but I can't recall all of them. Some i recognize from my regular classes with Nancy. I felt really great after your psoas class...all day!!! Thank you and I hope you can come visit us again!!! =:0)

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Susan
1/27/2015 01:39:25 am

Hi Sue,
I am so glad that you enjoyed the class! Here is a blog where I demonstrate using the balls at the back. We also rocked the knees side to side, which is not shown in the blog. The crossed leg rotation movement comes from a Feldenkrais lesson that I really love.... We only did a portion of it.
Thank you for your feedback, Susan
http://www.alignintegrationandmovement.com/blog/thoracic-mobility

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Stefan Brann
6/16/2015 06:16:29 am

Hello
I am a recipient of 3 artificial hip joints in the past 2 yrs.
I had my right done in March of 2014 with a failure resulting in a revision in Nov 2014.
I have had numerous complications since Nov. as well as extreme pain at times.
My Dr is now telling me the source of most of my pain is psoas syndrome due to multiple surgeries.
Prior to my surgeries I was a runner and basketball ref, so needless to say this is becoming very frustrating.
Any advice would be greatly appreciated.

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Terra
11/16/2015 09:41:35 am

I have a question about the psoas release on the block under the sacrum. Is it more of an iliacus release than the entire psoas, or is it as beneficial as the shoulder bolster psoas release? We're having some questions about that in an alignment group I'm in! Thanks!

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Susan
11/16/2015 11:54:07 am

Yes, the block release addresses the illiacus! Susan

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Lara
11/30/2015 05:27:31 pm

Thank you so much for these, Susan. My psoas on my left side are so weak that I often have trouble lifting my leg when I walk, which causes me to limp. Will these help to strengthen the muscles eventually? Thanks. -Lara

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Susan
12/2/2015 07:28:37 am

Lara,
I would suggest that you go see a good movement specialist whether that be a PT, chiro or bodyworker. It could be simple and these exercises could help, but you may need someone really looking at how you move! Susan

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Ed
12/31/2015 06:17:04 pm

I have had a recent hip replacement. Do these movements need to be modified in that case?

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Susan
1/1/2016 09:30:39 am

Ed,
If you know your hip precautions you can modify any exercise to avoid hip flexion greater than 90 degrees and crossing leg. There are 3 exercises in this sequence that bring one leg toward your chest, so don't do those. All of the other movements are great! Enjoy!
Susan

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Amy Cordry
1/11/2016 03:09:43 pm

I have had intense hip/lower back pain for years. Physical therapy, acupuncture, massage therapy even yoga did little to relieve it. I have been doing these movements now for 14 days and have experienced so much relief. I can even feel the difference when I practice my yoga!
Thanks so much for such a simple solution. Glad I found you.

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Susan
1/11/2016 03:35:47 pm

Amy,

Thank you so much for sharing! This is so great to hear! Cheers, Susan

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Gretchen
3/8/2016 05:43:29 pm

Hi Susan,
I am 14 months post partum and very physically active. I've recently discovered I have diastasis recti and have read exercises for the pelvic floor and psoas should help to heal this condition. Are there any other exercises you'd highly recommend ?

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Susan
3/8/2016 07:31:14 pm

Yes, buy the book Diastasis Recti, by Katy Bowman

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Sree
6/6/2016 03:34:23 am

Hi Susan
I am diagnosed with right psoas abscess.And undergoing treatment for that.Can I do these exercises after my treatment is completed?are there any other exercises you'd recommend?!

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Susan
6/6/2016 07:31:55 am

Sree,

I don't know what your surgery entails. You will have to ask your doctor if these exercises would be appropriate for you.

Thanks for reading, Susan

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Kiara
7/5/2016 08:18:40 am

Hi. I'm finding these exercises great for my hips! I have anterior pelvic tilt and one hip sits higher than the other. I can feel theses muscles slowly strengthening so thank you so much for sharing! Questions: how many times a day/week should i be doing this and does the body eventually reach a more or less self-sustaining state (obviously within reason) or is constant work needed to keep up improvements once things feel they have levelled out? Thanks!

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Susan
7/5/2016 10:36:05 am

Hi Kiara,

I am so happy to hear that you enjoy these exercises! I recommend doing the release positions daily and the movements daily to every other day. In my opinion, the body always needs some kind of maintenance to recover from daily living. Have fun with these!

Susan

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scott t
10/18/2016 12:23:27 pm

HI Susan,
I have had two bouts of surgery on L5S1 and now having more trouble. 1st OP at 17 2nd at 31 now this at 36 all with the intense sciatica symptoms. I have been told I have a straight lumbar spine which applies a lot of load to that area causing the impingement. will these exercises help strengthen the psoas and assist in gaining the necessary curvature to take pressure off L5S1 disc.
any help appreciated..... Scott

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Susan
10/19/2016 08:06:30 am

Hi Scott, Without looking at your body and giving you a thorough assessment, it would be difficult (and irresponsible) for me to give you any input whether these would be good for you. Some of them may be challenging. Try doing the release positions on the block and on the bolster and see how your body responds. Take these to a current practitioner and see what they say. Best Susan

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Rosaleen mitchell link
2/4/2017 02:32:58 pm

Susan I have suffered with right hip knee and ankle pain for almost two years and most days walk with a cane. My PMD said I have OA and that's how it is some days you can hardly walk and other days you are better. I consulted an orthopedic doc who did a thorough evaluation and agreed I had OA but not bad enough to need joint replacement. He recommended I see a Rheumatologist who thought I had gouty arthritis but I knew I didn't have that....I'm a retired RN.... everyone wanted to medicate me and say that is life. Last Sundday after walking around Botanical Gardens using cane I came home with such a thirst to know what could be wrong with me. I was beginning to feel everyone thought it was all in my head. Well Sunday I googled what could be causing my hip knee and ankle pain and your site popped up with the psoas release and movements. Well I performed them then and there and everyday since (7) and from first day I started to improve. No more cane and no terrible pain down my leg. I believe I was missed dx although I believe I do have OA my real problem all along was a tight shortened psoas. No more pain from right side of pubic bone up towards hip . Thank you thank you thank you. I feel like I have been cured and want to shout it from highest mountain. I appreciate you sharing your expertise on line so people like me can benefit from it.

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Susan
2/4/2017 07:54:35 pm

Rosaleen,

WOW! Thank you so much for sharing your success, and kudos to you for making the change and doing the exercises!

You deserve this! Susan

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Francie Green
2/15/2017 06:47:46 am

Susan, the psoas release, I feel like my issue is the psoas is tight and pulling up on the pelvis and that is causing posterior pelvic tilt. Is this yoga flow and release good for this issue as I feel it is promoting the PPT.....thanks for your help!

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Susan
2/15/2017 09:29:48 am

Francie,
Yes, this is excellent for releasing the psoas!

Susan

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Melena
3/16/2017 05:38:03 am

Hi Susan, thank you for publishing this comprehensive information on your blog. Do you have any adaptations for an obese individual? Thanks for any further information you can provide.

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Susan
3/16/2017 12:16:47 pm

Hi Melena,
Yes, thank you for your question. You may need to use the rolled up yoga mat place under the hips for the block release which is the 3rd exercise shown above. Also, you may have a harder time holding at the knee when you bring your leg toward your chest. Take a yoga strap and buckle it, put it behind your leg just above the knee and then pull the leg toward your chest while holding the strap.
I think everything else should be fine. Did you have a specific move that was hard to do?
Susan

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Jean
6/15/2017 04:52:11 pm

A great set of exercises; my husband and I have been doing them every second or third night before bed. Work a treat... its the sitting that seems to really upset the soas muscles.

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Connie
6/25/2017 08:36:23 pm

After 2 hip replacements, I find I have some low back pain and painful groin(s) when I walk a short distance. I read that a tight psoas can cause these symptoms and I want to be able to walk more to manage my weight. Will any of these exercise positions need to be avoided due to the hip replacements?

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Susan
6/26/2017 02:00:57 pm

Hi Connie,
You don't need to avoid any of them, but you may want to modify the ones that bring your knee to your chest. Be aware of your hip precautions and don't go beyond 90 degrees.

Best, Susan

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Krishna Brown
7/26/2017 06:27:10 pm

Hi Susan
I have osteoarthritis in my right and left hips and I also have lower back pain,will these release exercise help with my pain.

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Flo
10/11/2017 10:14:28 pm

Will this help with scoliosis? I also have some lordosis. Essentially my left leg is shortened and my left shoulder is lower. Right now I have pain on the inside of the top of my right pelvis. Wondering if THAT can be psoas-related. Thank you!

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Cesca
11/15/2017 03:59:09 am

Hello. I wonder if you could help? I have been struggling with lower back pain and lower back injuries for five or six years. I've just had my fifth baby so know I need to strengthen my core. I don't carry any extra weight, I drink water all day long and I eat well. I have a significant anterior tilt and now scoliosis, and I stumbled across this page today because after weeks of researching I've figured it may all be connected with my psoas. Last week I had a deep tissue massage to release the psoas (pain!) and I've started stretches, but now wonder if that was all too soon? Thank you for your time.

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Steven
2/19/2018 05:55:06 pm

Thank you - good tips :D ~ and modestly done too.

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