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Iliopsoas treatment

Curious to hear the opinion of others on abdominal approaches for treatment of the iliopsoas. I've heard a number of reports of inadvertent compression on the external iliac artery during psoas treatment. Some of these apparently led to rupture of an undiagnosed aortic aneurysm. What do you think of the safety (or lack thereof) of this approach?

Whitney

Replies to This Discussion

Permalink Reply by Julia Schandelmeier on February 10, 2010 at 7:06pm

After having 3 c-sections where the small intestines are taken out and put to the side (usually on the belly and still attached), then (after pulling out the baby) all 16 feet of the small intestines were put right back in haphazardly to sort themselves out, I see the small intestines as quite forgiving and pliable.

As with Tom Myers, I teach anchoring the fingertips along the ASIS at a 45 degree angle towards the psoas then move the clients bent leg through a range of motion to access the different fibers of the psoas and keeping the fingertips stationary. I have found this very safe and effective.

Thanks for a great discussion!

Permalink Reply by Michelle Doyle, D.C., CNMT on February 10, 2010 at 7:24pm

Julia,
It seems we have a very similiar method to access the psoas. I place the client's bent leg on top of my knee to stabilize and secure their leg as I move their leg medial and lateral to access the different fibers. It's important to not rush with this procedure, since it is a very vulnerable area, but as you said very safe and effectice...if done properly.
Thanks for sharing.

Permalink Reply by Robert Downes on February 12, 2010 at 2:08pm

Also remember kinetic chain biomechanics when treating the psoas. This means we have to treat the posterior calf complex of both legs and the opposite side psoas. Consider gait. What (from a chain reaction biomechanics point of view) will cause the psoas to abnormally move in gait? What will cause the psoas to not eccentrically lengthen fully when it becomes the back leg in gait?