Thursday, March 20, 2014

The Triathlete's Nemisis

Massage Therapy for Triathletes
-The Triathlete’s Nemisis
Hello PSOAS!   Allow me to count the ways this muscle drives me crazy.   (When it’s not working properly that is)

Let’s take a look at the task of this ever so powerful hip flexor.
The job of our Psoas muscle is to bring our torso towards our thigh, bring our thigh towards our torso.  It can work bilateral or unilateral it also rotates the hip externally, and aids in side bending and stabilization of the lumbar spine.  Basically it manages every sport we do as triathletes!
Let’s dive in to this muscle shall we?
Very seldom is there a single triathlete I treat that I don’t get to go after their Psoas (grin). 
The swim:  This muscle gets worked in a lengthened position when we swim; is asked to contract when we flip turn, it’s helping with slight rotation as we breath, and it’s also helping us maintain balance in the water.  (do you every get a sore low back after a long swim session?) 
The bike:  Once we are out of the water and on to the bike, we ask this Mr. Psoas to work REALLY hard in a shortened position.  (I mean look at those watt averages) The more aggressive areo position we are in on the bike, the more we need to focus on the health of our hip flexors during our recovery and foundation training.  We spend how much time on the bike- In a race it could be 15, 25, 56, 112 miles? I’m guessing most of the triathletes reading this are more often in the 56 and 112 mile range.  That’s a ton of time working for those suckers in a shortened position.  At least you know if you’ve got hills, you’ll spend some time out of the saddle climbing, standing and lengthening that hip position slightly.  But what about those really flat fast races where you’re hunkered down in a tight aero position for the entire race?   Are your hip flexors ready for that?  Are they elongated and healthy enough to set you up for a really fantastic run?  Or are they going to hold you back? 
The run:  We begin our run and pray Psoas isn’t cranking our pelvis down and shortening our pelvic angle, pulling on our hamstrings while we are running.  (I’m sure no one reading this has ever gotten off the bike and it took them a minute or 5 to feel like they can straighten all the way into a standing position…think about it!)  Just think how much longer and more powerful our stride is when it’s just that, a full stride.  If our Psoas is allowed to lengthen, giving more extension through our hip flexors, then a fantastic phenomenon is achieved.  Happy glute muscles!  We all know…it’s all about the BUTT in the run!  If your pelvis is rotated forward, (pretend you’re running in 5 inch heels) you can’t properly engage your glutes…which really means… Oh heck, I’m not even going to get into all the issues that come from not utilizing our glutes properly, let’s just surmise, it’s not pretty.

Ok, on second thought…I am going to give you a little list.  The Psoas-  this “Triathlete Nemisis”, is time and time again know for causing low back pain, overstretched hamstrings (which most people don’t realize are actually overstretched they just keep trying to stretch them more -PLEASE STOP THAT- *breath*).  In reality the Psoas is actually doing really dirty work (and I’m not saying in a good way) pulling our pelvis into an anterior tilt pulling our low back forward causing a strong lumbar curve.   More-?.....side stitch when running, externally rotation of the hip, tight IT band, secondary tugging at the knee causing a torque at the knee.  Knee cap not tracking properly due to that external rotation of the hip; which then leads to lower issues, possible Tibial fracture, plantar fasciitis….this list goes on.  Often times, there are even neck imbalances due to a tight Psoas.  Oh man, maybe we’ll save the neck for another article.   The point of all of the above is this:
What does this look like for you, the speedy, powerful, unstoppable (until Psoas seizes) “Big Sexy” Triathlete?  
Find a therapist that’s REALLY good about evaluating your imbalances. A massage therapist that can gently loosen, stretch and elongate your Psoas muscles is a must; this work needs to be done properly.  Now, allow me to explain; this is not something that can happen in just one massage session.  Psoas work is something that needs to take place gradually, done too quickly and you’ll have a lot of rebalancing pain that’s not necessary.  As your Psoas muscle lengthens, your posterior chain needs to have time to adapt to these changes.  It’s a bit of a pulley system.    Give a little, take a little.  Now, I’m not saying that gentle work on the Psoas muscle won’t be painful.  There are times when working with clients; I can use just a couple of lbs of pressure and they feel as if I’m driving a hot poker through the abdomen to the back.  It needs to be gradual, consistent work.   
A good therapist will be able to work all along the belly of the Psoas muscle (see above diagram) from just under the rib cage, following along the spine (through the abdominal wall) to just above the inguinal ligament.  The muscle goes under the inguinal ligament, so they’ll need to pick it back up at the insertion on the femur (thigh bone).  Sometimes the point of attachment on the femur can be pretty painful.  Sometimes it can feel like a groin pull or deep-aching, throbbing or sharp pain.   The upper portion of the Psoas (just under the rib cage but very deep) when worked on can give referral pain.  Sometimes the discomfort goes straight through to the back; sometimes it transfers through the entire stomach like a burning sensation.  It can feel like a line that travels straight up and down, like a pain line from the center of the trigger point, or it can be fascial adhesions that create a tearing sensation.  When your therapist is working, you may have one side that is tighter than the other.  The left and right sides are not always equal, in fact, most often they are not.   Again, I reiterate, have this work done gradually, over several weeks of time.
Your list-  1. Have a therapist that knows how to work with the Psoas muscles.  If your therapist doesn’t, ask them if they’ll do a workshop on hips and pelvis with Psoas as a component.  Then the two of you can grow together and you don’t have to find a new therapist.  2. Have Psoas worked on regularly (I have mine loosened with EVERY session that a therapist treats me).  3.  When you’re Psoas is happy and you feel the difference, let me know!  I love hearing how much a healthy set of hip flexors changes an athlete’s life! 
Best wishes for a healthy, fast, powerful racing season!
Cindy McGuire, Licensed Massage Therapist
Owner of -Hands On Sports Massage

Article created by Cindy McGuire for “Big Sexy Racing”, February 2014