Iliopsoas is often called the joker because it can cause pain in the lower back as well as the stomach and down the front of the leg, patients usually can only give vague descriptions of the pain. Iliopsoas is made up of two muscles, psoas and iliacus and runs from lateral borders of T12 to L5 and the transverse processes of the lumbar vertibrae to merge with the tendon of the iliacus and attaches to the lesser trochanter of the femur. Iliopsoas causes pain patterns such as lower back pain, pain in the front of the thigh, pseudo-appendicitis pain as well as the following problems difficulty in getting up from a seated position, inability to do a sit-up, loss of full extension of the hip, abnormal gaiting, difficulty in climbing stairs, scoliosis and Lewit (1999) reported iliacus spasm may result from lesions of the L5-S1 segment producing pseudo-gynocological symptoms. Iliopsoas cannot be accessed from the back and can only be accessed easily from the femoral triangle. Vladimir Janda (1983) developed a human movements test that will show a well trained remedial massage therapist (RMT) if the pain patterns are coming from the iliopsoas. Practitioners will often be caught out by the joker and treat several muscles before they even think of the psoas because the pain patterns mimic so many other muscle and health problems. The patient is often far from convinced that the practitioner knows what he/she is doing because the pain is coming from an area a long way from the source of the problem. When the practitioner fixes the problem and removes the pain they will be very grateful and you will have won a patient because you can safely bet they have been to quite a few other practitioners that truly didn’t have a clue what the problem was.
See John Bobbin Massage…
Iliopsoas will prove to be a huge challenge for anyone lacking advanced study in neuromuscular techniques.
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