Soften The Psoas With Thoracic Mobilizations / Bodywork, Clinical Massage Therapist Training, Education for Massage Therapists, Iliopsoas, Massage Therapy Training / By Peggy Lamb

bodywork May 12, 2023

Recently a new client came to me with a complicated pain pattern: right hip, low back, and SI joint.

Several months ago she had an ovarian cyst burst; she was in the Emergency Room for over 12 hours with 10+ pain. She was convinced she was dying – even gave all her passwords to her boyfriend. She did get her surgery and is fine now – except for the pain.

When I hear a story like that many thoughts go through my mind but the three biggies are:

  • Iliopsoas: (When our nervous system is in sympathetic arousal it  activates the psoas muscles – as it is the psoas’ job to jump into action to curl your bodies up into a ball and freeze, flee away in fear or fight to the death.)
  • Tread lightly
  • Possible neuroplastic pain (her brain/nervous system still thinks she is in danger and hasn’t regulated yet so pain is what the brain produces to keep us safe.) The body reflects our subconscious.

I knew that creating safety for her was the most important thing I could do. When I assured Lin that her body/mind is remarkably intelligent and has an enormous capacity to heal, tears came to her eyes.

My treatment plan for her initial visit was:

  • Still point holds
  • Polarity therapy
  • Gentle psoas work without direct manual therapy


How can we soften the psoas, give it messages of safety without direct manual therapy?

There are a variety of ways but here’s one I’ve been experimenting with lately and have gotten good results: : active thoracic rotations with open-book mobilizations.

You can coach your clients through these mobilizations on your table and  they can do them at home. See video below.

  1. Supine position: Test psoas length by observing which leg has trouble with full extension on your table – the back of the knee should touch the table. I do not recommend doing the Thomas test if you suspect the short length is driven by neuroplastic issues.)
  2. Coach your client through 3-5 repetitions to one side
  3. Re-test psoas length
  4. Coach your client through 3-5 repetitions going in the opposite direction
  5. Re-test psoas length
  6. Which direction had more impact?
  7. I recommend doing them to both sides so both psoas muscles get the benefits


Let’s unpack the relationship of the psoas to thoracic mobility

A short, activated psoas rotates the thoracic spine in the opposite direction via the attachment at T12.  For example if the right side is shortened, the thoracic spine is generally rotated to the left.

By doing these open-book mobilizations the psoas (especially the superior fibers) get a gentle lengthening and softening which in turn allows for more of a rest and repair state of the nervous system.

Let me know your thoughts!




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