Psoas – The “Hidden Prankster”

My final term at the Center for Neurosomatic Studies began week before last.  We’ve only had 2 weeks of school and already we’ve covered tons of interesting stuff in Advanced Technique class.  I finally know the official protocols for the diaphragm, illiacus, superficial paraspinals, quadratus lumborum, deep spinal rotators, deep costal muscles, and, wait for it….THE PSOAS, aka, the “Hidden Prankster” according to Janet Travell who literally wrote the book on trigger points.

All of these muscles can be implicated in the number one reason people miss work – BACK PAIN.  But the psoas is in a world of its own.  Because of its placement in the the body, it can contribute to almost every distortion imaginable.

The psoas lies on the anterior surface  (the front) of the transverse processes (the horizontal parts of the vertebrae) and bodies of lumbar vertebrae and attaches to the lesser trochanter of the femur (a little bump of bone on the inside of your thigh).  It’s basically this huge strap of muscle that runs deep along your lumbar spine, behind all your guts (aka viscera) that connects your torso to your legs.  When you sit all day, it gets shorter, and shorter and shorter and ramps up its pranksteriness to a 10.

Because of its length, placement, and connections in the body, it can contribute to spinal flexion, extension, and rotation; hip flexion, extension and tilt; torso tilt, and pain in the abdomen and back.  It also shares attachments with the diaphragm, so it can contribute to breathing dysfunctions, which can lead to to a whole host of other ailments like anxiety, depression, head forward posture, neck pain, etc.

It’s a tricky muscle to treat effectively, however, because it is deeeeeep within the body.  We learned a technique to kind of swim down through the viscera to the back of the abdomen.  As you can imagine, this is not a FUN muscle to have treated.  But it can make a world of difference!!

If you can’t find a neurosomatic therapist, or if you don’t want to fly to Florida and visit me, there are lots of exercises you can do to help stretch out the psoas.  Katy Bowman, my favorite biomechanist, describes an easy psoas stretch here, and Jill Miller shares a creative way to use Yoga Tune Up® balls to get into this area here.

All this is to say, I’m so glad I finally learned the official protocol for this little prankster!

 

The Agony of Learning

Well, about 5 weeks ago I started Student Clinic, which means for 4 hours every week I have the opportunity to practice what I have been learning for the past 8 months.  This has been a very…overwhelming, humbling, joyful, agonizing, educational, fun, scary, awesome, horrible experience.  I have found that I am MUCH more comfortable reading about providing therapy than I am actually DOING therapy.  Where the rubber meets the road is WAY outside of my comfort zone.

There is SO much to process in a 60-minute neurosomatic therapy session:  you need to be PRESENT with the patient, you need to connect with them, make them feel safe, make them feel like they are in good hands (when you really doubt that you have good hands at this stage), you need to converse with them while taking 84 measurements (some of which take a degree of palpation skill I do not yet possess), you need to register what they are saying while also figuring out, if my finger in her right earhole (aka external auditory meatus) is higher than my finger in her left earhole, does that mean her left side is higher or her right side??, and then remember that for at least 10 seconds while you mark it on the posturology chart.

Then, you survive taking all the measurements, and then the really hard part comes – analyzing what is going on in that beautiful, complicated, multidimensional, fluid/solid mass of bones, soft tissue, emotions, and thoughts.  So you look at the chart, form a semblance of a plan and get started.  Then the clinic supervisor comes over and challenges your assessment, based on his years of experience in comparison to your 6 months of experience.  So you adjust, all the while trying to maintain an air of confidence in front of your patient patient (yes, that’s intentional).

And then you look down at the body on the table and realize you forgot all the techniques you’ve been learning.  Then the real panic sets in.  You question your ability to function as a coherent human being, much less a competent neurosomatic therapist.  Your brain hurts from this strain of trying to juggle so many requirements. Your thumbs hurt because you are too focused on everything else to focus on good body mechanics. Plus your thumbs are double jointed which adds an even more interesting challenge to performing deep tissue/trigger point work.

BUT, while that whole process continues to happen with each successive Student Clinic, each time it gets slightly less awkward and slightly more fun.  Especially when the patient gets up and says,”Wow – my sinuses are so much clearer!”  “My neck feels so much better!  I have so much more range of motion!”  “My head feels lighter.”  “The pain in my chest I’ve had for 8 years is GONE!”  And you’re like, “Holy shit.  This DOES work!  I CAN help people.  I am not a failure!”  And that part is super awesome.

So, the gist of this whole long rant is that learning a new skill (manual therapy) that is worlds apart from the skills you currently posses (business analysis/project management) is PAINFUL!!  Especially if you are a perfectionist with helpful undercurrent of anxiety.  Oh man.  It is SO hard.  But no growth comes from living in your comfort zone.  And living in the comfort zone  leads to atrophy and dissatisfaction.  I would rather, when it’s all said and done, push my boundaries and experience all the emotions and trials that come along with that, than continue doing what I already know how to do and staying in that safe (but ultimately very dangerous) comfort zone.

I feel as if I should have gotten some intense psychotherapy before taking this leap.  All of the changes in my life, location, career, friends, etc. has brought to the surface so many limiting beliefs that I have unconsciously held for my 41 years of life.  These beliefs (I’m not good enough, mistakes and failure are bad, etc.) are intensifying this experience so much.  Or, is this experience bringing these beliefs into the light of awareness, so I can process them and let them go?  So I guess things are working out as the wise universe intended.  So I just need to ride that flow and trust the (painful and awesome) process.