PSOAS IT GOES: Psoas Muscle Assessment in Musculoskeletal Low Back - - PowerPoint PPT Presentation

▶
psoas it goes
SMART_READER_LITE
LIVE PREVIEW

PSOAS IT GOES: Psoas Muscle Assessment in Musculoskeletal Low Back - - PowerPoint PPT Presentation

Apr 12, 2023 209 likes •382 views

PSOAS IT GOES: Psoas Muscle Assessment in Musculoskeletal Low Back Pain Jennifer Boyd, PA-C New River Health Association West Virginia Practice Based Research Network Financial Disclosures: None Survey Research through the WVPBRN: Information

slide-1
SLIDE 1

PSOAS IT GOES:

Psoas Muscle Assessment in Musculoskeletal Low Back Pain

Jennifer Boyd, PA-C New River Health Association West Virginia Practice Based Research Network

slide-2
SLIDE 2

Financial Disclosures: None

Survey Research through the WVPBRN: Information and survey included in your packet

slide-3
SLIDE 3

Objectives

  • Create awareness of psoas muscle’s role in musculoskeletal low back pain
  • Increase awareness of psoas assessment on physical exam
  • Increase awareness of simple psoas stretch
slide-4
SLIDE 4

Back Pain:

  • Over 80 percent of the population will experience an episode
  • f LBP at some time during life.
  • Recurrences of LBP are also common, with the percentage of

subsequent LBP episodes ranging from 20–44 percent within 1 year for working populations, to lifetime recurrences of up to 85 percent. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339077/

  • 72% of PBRN CORE survey respondents report assessing back

pain at least weekly.

The Problem

slide-5
SLIDE 5

Psoas assessment

  • Standard in osteopathic and chiropractic curricula
  • Psoas Major: a case report and review of its

anatomy, biomechanics, and clinical implications. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 2796950/ )

  • Psoas Syndrome: A Frequently Missed Diagnosis.

(https://jaoa.org/article.aspx?articleid=2094465# 73002821)

  • 52% of PBRN CORE survey respondents had no

training in psoas assessment.

  • 74% had no subsequent training after

their obtaining their professional degree.

slide-6
SLIDE 6

https://kirkyoga.com/online-yoga-courses/

My experience

  • Clinical experience: lack of

correlation of complaints with PE findings

  • Training in yoga therapeutics
  • Education on psoas assessment
  • Integration into practice
  • Education of colleagues
slide-7
SLIDE 7

Anatomy

Psoas Muscle

  • Hip flexor and spinal support muscle.
  • Large, thick muscle.
  • Origin at T12-L5, passes through the pelvis, joins with

iliacus, passes over the hip joint and inserts at the lesser trochanter of the femur.

  • “Guy wire”
  • Patients familiar with anatomy, (e.g. hunters) may

know it as the tenderloin or loin.

  • Not palpable on back exam. Palpable on abdominal

exam.

slide-8
SLIDE 8

Function

Hip Flexion Spinal flexion and stabilization

slide-9
SLIDE 9

Postural Contributors To Dysfunction

Wide based stance or gait with thighs forward and

  • ut turned feet may lead

to shortening, observed as decrease lumbar curve Prolonged sitting, with decreased lordosis

slide-10
SLIDE 10

History

Mid to low back pain, often after a history of lifting, forward flexion or prolonged sitting.

“My back hurts right HERE!”

slide-11
SLIDE 11

Decreased lumbar Lordosis Thighs forward

Exam: Inspection Postural patterns and cues

Also look at feet: often one or both are everted

slide-12
SLIDE 12

Locate the point midway between the flank and the naval. Gently palpate for a firm or sore psoas. Flex hip to confirm.

Exam: Palpation

slide-13
SLIDE 13

Therapeutic options:

  • Education
  • Rest in flexion
  • Trigger point
  • Supine stretch
  • Referral:

PT Osteopathy Chiropractic

  • Medication
slide-14
SLIDE 14

Supine stretch instructions

Iliopsoas (“ILL-E-O-SO-AS”) Muscle Stretches To Help Relieve Low Back Pain Lying down:

  • 1. Lie on your back on a firm surface with your head down, the floor if you are able, or your bed.
  • 2. If possible, place your feet firmly against a wall with your toes pointing straight up. (If there is

not a wall for your feet, merely stretch out your legs with your toes pointing straight up.)

  • 3. Bend your RIGHT knee and place your RIGHT foot on the floor or bed.
  • 4. Keeping your LEFT leg straight, gently but firmly press your LEFT foot into the wall, pressing

especially through the ball mound of your big toe. (If you do not have a wall, just pretend you do and firmly press the ball mound of your foot forward.)

  • 5. Gently but firmly press your LEFT thigh toward the floor, (or bed).
  • 6. Stretch your LEFT arm beside your LEFT ear and straighten it, like you are reaching for the wall

behind you.

  • 7. Gently press down through your LEFT foot as you reach back through your LEFT hand and

fingers, creating a long stretch through the LEFT side of your body. Breathe three times slowly then release.

  • 8. Repeat on the OPPOSITE side.
slide-15
SLIDE 15

Benefits:

  • Decreased pain: acute and chronic
  • Patient empowerment
  • Provider satisfaction
slide-16
SLIDE 16

Thank you

  • Please try assessment of psoas in your

patients with low back pain

  • Please join my study and let me know your

experience

  • Please feel free to contact me:

Jennifer.boyd@nrhawv.org