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Case Study: Unravelling A Tight Psoas Mystery

by Liz Koch(more info)

listed in bodywork, originally published in issue 160 - July 2009

As a somatic educator and recognized 'authority' on the psoas muscle, I receive many enquires regarding the psoas.  People write long and complicated stories in an effort to explain their situation. Each story is compelling; however, I contend that if one understands the psoas as messenger of the central nervous system, it is possible to unravel the complexity of symptoms and support a person's active recovery.  Here is one story I've edited for clarity, but the content is retained:

"I am currently suffering from a problem linked to the psoas and would like your opinion.  In 2006, while exercising in a gym I injured myself.  I admit I didn't stretch before working out, used a variety of machines, and am not fit as I currently work at an office job (originally I trained as a professional dancer).  I ended up with all my weight on the right side of my body, unable to walk properly. Since the injury, I've sought out a variety of therapeutic modalities of which nothing has helped until I started working with a physiotherapist, who also trained as a Pilates instructor. I have been exercising every day and gradually, just recently, I managed to get my weight over the left side and walk better. I felt the right psoas release (?) the day I managed to get my weight-distributed evenly. 

"However, a couple of days after this 'breakthrough', my menstrual cycle began and everything just packed in. My pelvis didn't function properly, and I had to bend at the knees while walking. By day two my pelvis stiffened and one side of my back and head. I think the psoas upsets the gynaecological functions.  My doctor took blood tests to eliminate any other problems and a scan of my lower back (lumber spine), sacroiliac and hip. I hope there is not a serious problem, and that it is a question of a very tight psoas on my left side, which is being inhibited by the weak gluteus structure.

"I find it very difficult because I have been very emotional and frightened and no one understands. I have always been a rather 'emotional', 'uptight' person, especially around my period. I am very interested in the holistic approach to healing and was very interested to read your articles on the psoas, as you are so right how it has a great psychological effect on the body – or is it that our psychological traumas have an effect on the muscle? I have to say that since my dance training many years ago, I have become rather unfit (I am not fat or overweight), but my core strength is very poor and I have weak abdominals. I have been a bit 'directionless' in my life and I do believe that if you have a strong core you have a stronger mind. If you have any suggestions or comments I would be very pleased to hear from you."

Unravelling the Mystery

June's story beautifully demonstrates the bio-intelligence of her organism.  It is not simply a matter of one muscle, or one dysfunction, but a divergence of many aspects of June expressing her dilemma.  In other words, I do not separate out emotional expression from thoughts, from actions, from symptoms.  They are all aspects of a disruption in her core integrity and her 2006 injury is but a catalysis for life's journey towards self.

Although June was a professional dancer, I don't assume she was functional.  Many dancers struggle with injuries they endure in their attempt to stay competitive. Plus, dancers notoriously have tight upper psoas muscles. Her gym experience and career choice are also important clues: working on machines that do not adapt to the user's dysfunctions, with dry, unresponsive tissue (being unfit), is a sure recipe for injury. 

I am guessing that June tore or disrupted her SI joint (sacral-iliac ligaments) when she felt her weight shift to one leg. Because gravity passes through the spine, distributing weight through both legs via the pelvic basin, the pelvis is a vital keystone for good alignment. Having an office job usually implies sitting in chairs for long periods of time.  As most office chairs do not support the pelvic basin (i.e. sitting up on one's sits bones) but encourages rounding of the sacrum and forward thrusting the head, it is a pretty sure bet that June's sacral ligaments and the integrity of her pelvis were already compromised before a pulling motion at the gym tore ligament fibres. 

If one is not able to bear weight, the psoas takes over for damaged ligaments. Doing so, the psoas helps avoid spinal neurological damage, but loses its supple, dynamic expression.  The psoas is the filet mignon, juicy tissue that dries and shrinks when immobilized.  It is no wonder that a well-trained physiotherapist could help June embark on core integrity and get results. Focusing on the midline is a necessary step back to health.  However, ultimately, the SI joints need to heal by supporting healthy functioning with good ergonomics and proprioceptive awareness.

June is right that the iliopsoas (psoas and iliacus complex) affects reproductive organs.  Nerves embed through the psoas muscle to the uterus, and the iliacus shapes the pelvic basin. Shaped like a fan, a tight iliacus will shorten the space between the navel and the hip (remember her mentioning that her gluteus muscles are weak). So abdominal toning must also engage full relaxation in both iliacus muscles.  Although Pilates can be taught from a place of control or awareness, it is worth noting that June's appreciation of Pilates remind her of a time when she felt inner control.  What June may not realize is that a tight core is not a coherent core. 

Most important is June's great question regarding feelings of fear and dysfunction, and which comes first, a tight psoas or fear? The instinct to curl and return to foetal is a primal survival response.  June has trauma in her system and she is beginning to realize that muscular control cannot make it go away.  What June can do is work with her bio-intelligence.  By resting on her side in foetal June can intentionally begin to go inside and reconnect with the fears of the past.

Foetal - curled on side
Foetal – curled on side

Softening, listening, breathing and just simply be present in the moment nourishes coherency in her nervous system.  Constructive rest is another great position for eliciting inner coherency because it works with gravity to release upper and lower psoas tension.  June can begin to feel the supportive rebound through all the diaphragms of her body; foot, pelvis, breath, roof of the mouth and skull – thus letting go of deeply held core tension.  Resting on her back with knees up and feet planted on the floor provides an instinctual being position that allows gravity to release her psoas and balance her pelvis.

Constructive rest
Constructive rest

Muscular coordination results not from control, but neurological maturity. Returning to the core and a responsive psoas offers not only a muscular-skeletal alignment but also an emotional-spiritual alignment.  Coherency is quite simple.  One is either safe or not safe – in the earth's gravitational flow, or not.  June can now begin organizing from a relaxed core, from the inside out; to stand on her own two feet to face the challenges of today.


  1. Danielle said..

    I'm so glad I found this article. I, too, have a tight/weak psoas which has rendered me inactive because of the pain. Because of it have experienced abdominal pain and bloating along with bowel issues. Recently, I've been having feelings of lethargy, unhappiness, and anxiousness. I thought I was crazy but after reading this I made a connection. When my body is functioning properly so is my mind and emotions. I plan on visiting my chiropractor very soon so I can regain my vitality.

  2. Joni said..

    I've had lower back on the right side for two years. it began three months after I hit a tree with left shoulder while skiing. I had significant damage to the shoulder, four broken ribs and superspinatas muscle and nerve damage. I've seen numerous doctors and a chiropractor but nothing helped. Finally saw a neuromuscular massage therapist and he thought the psoas could be the culprit. Since I discovered the constructive rest a few days ago, things are feeling much better. I still have much work to do but I want to be I am do the correct work. Joni

  3. Rachel said..

    Something hard to come by is info telling us why our psoas keeps getting so tight. If it's a stabilizer, maybe it's getting so tight on some of us because other muscles are not doing there job? I am wondering what muscles on me are not doing their job. I've exercised my glutes to death but it didn't turn off my psoas. Constructive rest is extrememly boring for me. I keep trying though! Could a tight psoas be a proprioception problem?

  4. barb said..

    I lost my mom 6 months ago and entered into extreme anxiety and fight or flight. I lost my Dad 3 years ago. It was mostly emotional but then it became physical. My nervous system became physically over reactive, so have been physically shaking a lot and over-reacting to the tiniest thing. My lower back became very very tight and had to stop taking walks. Gradually the fear calmed down a bit and I got less shaky as I did a lot of talking to my inner child and assuring her she was safe in the world. My back stayed bad however. I could be on my feet for maybe 10 min max - more if i wore a back belt. 2 weeks ago I sold my childhood home and panic came back big time! Worse, my lower back has become so tight it hurts all the time, and middle back too. My diaphragm is shoved up into my ribs and is stuck there making it difficult to breathe - panic makes it worse. I can only stand for just over one minute now, and then my whole torso muscles start shaking and contracting and hurting and my nervous system freaks out. My chiropractor says its the diaphragm not being able to do its job of stabilizing, and my psoas is so so tight that its pulling on the lower back. Psoas and diaphragm work together? My upper stomach muscles are like concrete and make it difficult to sit, let alone stand and make breathing difficult. He says the superficial muscles are trying to stabilize me, but I'm on the couch all the time now. I realize this is emotionally based, but I can't be on the couch forever. Do you see a way out for me? I do creative rest position all the time as it helps with the S curve. I have searching on the internet and have not found anyone else with this issue. Thank you.

  5. Michael said..

    I can relate to your suffering, although mine is not nearly as bad as yours sounds to be. I also have a lot of muscle tension, especially in the abdomen, lower back, pelvis and hips, and I think that anxiety, a hyperactive nervous system and tight psoas muscles would be a logical explanation for these symptoms. Sadly, I can't tell you how to make the symptoms completely disappear, but here's something I have found helpful: Mindfulness meditation and yoga have helped me release some of my muscles and they have also helped me decreased my stress level, so that I am now much less reactive to petty, little things than I used to be a few months ago. So I would suggest reading a book called 'Full Catastrophe Living' by Jon Kabat-Zinn. It takes you through a mindfulness-based stress reduction program, which contains some very useful exercises such as the 'body scan meditation' and a gentle yoga sequence that you can do mostly lying on your back.

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About Liz Koch

Liz Koch is an international somatic educator, and creator of Core Awareness ( focusing on awareness for developing human potential. With 30 years experience working with and specializing in the iliopsoas, she is recognized in the somatic, bodywork and fitness professions as an authority on the core muscle. Liz is a nationally and internationally published writer and the author of The Psoas Book, Unraveling Scoliosis CD, Core Awareness; Enhancing Yoga, Pilates, Exercise & Dance, and her new release Psoas & Back Pain CD. Approved by the USA National Certification Board for Therapeutic Massage & Bodywork (NCBTMB), as a continuing education provider, Liz Koch is a member of the International Movement Educators Assoc. (IMA).  She may be contacted via

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