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Arturo Garcia 03-02-2011 10:00 AM

Re: Possible cause for foot turned outwards (Steven Low please read).
Just want to update.

I still feel some pain in what feels like the right psoas. It gets some relief after stretching it, although stretching it is uncomfortable and a little painful at first. After a while it doesn't hurt as much to stretch it.

I have found out that the psoas is an external rotator of the hip! Who would've said that? I never even considered the psoas to be the cause of my issues and everything points to that bastard of muscle. Sure, other muscles had trigger points like my piriformis but I rolled it so much I can now sit on a tough little ball forever if I wanted to. The tight psoas also gives the "illusion" of having a tight hamstring because it tilts the pelvis in the opposite direction and that is EXACTLY what I always wondered... why is my right hamstring tight and gets a little torn which some drills if I feel it's actually quite flexible when I do certain stretches? Answer: tight psoas pulls the pelvis down from the front and overstretches the right hamstring.

I think I've found my answers. I had done tons of hip flexor stretches in the past but never cared to brace the abs hard, I always arched the lower back a lot which I guess still targets the other hip flexors but not that psoas.

I don't do anything that hurts and it still hasn't healed. I can feel the pain a bit when walking. Every other test, like pushing against force at 90 degrees of flexion, produces no pain. L-sits produce no pain even! But a standard plank hurts a bit. Hurts more if I lift the "good" leg and only support on the side that hurts. After stretching it, even these planks don't hurt as much, just a little bit. I was avoiding stretching the psoas but I wonder if maybe some light stretching throughout the day is benefitial. All the tennis I played last weekend probably didn't help, on both sat. and sun., so I'll drop any activity that requires even a jog but will continue my weight training and see if it can heal.

Gosh I wish I could find an ART practitioner to dig in there....

Steven Low 03-02-2011 12:27 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
Yep that sounds like psoas issue.

Messed up psoas tends to hurt the muscle itself or lumbar area in a plank position, and obviously can do the things you describe.

You can look for some videos on youtube and see if you can find some that teach how to do ART for the psoas...

Or just do a lot of mobility and slowly stretch/mobilize that sucker out

Arturo Garcia 03-18-2011 01:46 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
I'm discovering more things now.

First, I will say that although a couple of months ago, after rolling my piriformis 2-3x/day with a tough ball, I got rid of the trigger point I had there, BUT, I never ever decided to stretch those hip rotators. I think this was a bad idea.

You see, all the piriformis stretches I've found produce the following result: I'm more flexible in the RIGHT side (the one externally rotated) than on the left side! It makes no sense to me. But I think I was wrong to think this way. I think maybe as my right glute was weaker and lenghtened from years of sitting cross-legged, it was more flexible, and since the piriformis is right there under the glutes it's hard to stretch them without also stretching the glutes. I discovered just last night that I should have stretched the piriformis even when I seem to be more flexible on the right leg!!. Here's why:

While laying in bed facing the roof, I can turn my left leg inwards and touch the bed with the big toe. I cannot normally do it with my right leg. But after stretching the piriformis, I could do it. And yes, in this stretch the right leg gets much more ROM than the left. I know, makes no sense.

So maybe I have to now get obsessed with stretching that muscle 2-3x/day like I got obsessed with rolling it with the ball a few months back. Maybe it will do the trick.

I noticed something odd too: when I internally rotate the left leg, while laying in bed facing up, I see my left thigh only internally rotating, but it doesn't raise up (from my point of view, laying down, chin to my chest so I can see). But when I try to internally rotate my right leg, the right thigh comes up higher! I can definitely notice quite a difference. What on earth could this mean!?

Steven Low 03-18-2011 08:49 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
Er, I think you have some of that backwards.

Sitting cross legged or with knees splayed outwards is external rotation of the hip. Glutes, piriformis, even psoas are external rotators of the hip. When you externally rotate the hips you put these muscles into a shortened range of motion. Over time, these muscles adapt to the position and actively shorten and get hypertonic/tight.

Glutes are the exception because they get weaker because even with the external rotation when you're sitting they're actually in a more lengthened position so they become weak/inactive and enlongated.

So when you internally rotate your hip you're actually stretching your hip external rotators (glutes, piriformis, possibly psoas if its really tight).

This is why I never liked piriformis stretch where you externally rotate the hip and pull it to your chest. You're deluded into thinking that external rotation is stretching the piriforimis but it's not. What really stretches it is when you pull your knee to your chest. Even though the hip is externally rotated when you pull the hip up that far you will lengthen it enough to get the stretch.

This is why I like the hip internal rotation stretch better for piriformis because you can hang out it in longer without too much effort or you can use a table about waist height and put the inside of your leg on it and stretch it that way as well.

To answer the question in your last paragraph the fact that the right leg "comes up" into flexion is already answered in the above post. Try to figure it out before going to the next paragraph.

Use mouse to highlight for answer: Remember that the psoas muscle is an external rotator of the hip. So when you internally rotate the hip, you're lengthening the psoas major muscle. Thus, when you hit the limits of your psoas muscle length, your leg cannot rotate further internally. Thus to keep rotating internally your hip will flex to shorten your psoas muscle so that you can keep rotating.

This indicates that your right psoas is much shorter than your left.... which we already know (mainly because you told us that it was the problematic tight one.

So basically this is telling you that your right psoas still a tightness problem that needs to be fixed.

Arturo Garcia 03-19-2011 07:29 AM

Re: Possible cause for foot turned outwards (Steven Low please read).
Heh heh, I figured it out before hilighting! I'm proud of myself now :p

Thanks Steven. It makes perfect sense actually. And for a few weeks now I know I have to stretch that psoas. The thing is, it was kinda strained several weeks ago and it's healing sloooowly. I don't want to stretch it while strained as it's a bit painful and although I could do it through the pain, I figure it would only make recovery longer. So I just gotta wait until the pain is gone and see about stretching it later. I guess I wont report back here until that's done!

Steven Low 03-19-2011 08:35 AM

Re: Possible cause for foot turned outwards (Steven Low please read).
Oh yeah, if it's strained yuu definitely don't want to be stretching it. Just non-painful mobility

Arturo Garcia 07-27-2012 12:37 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
This thread might be over a year old, but it beats starting a new one, huh?

Yesterday I had a breakthrough: I finally, after many failed attempts throughout the last year or two, could find my PSOAS!!!

Ball against the floor filed. Pushing with the fingers as described in my Trigger Point Therapy book had failed numerous times.

But today, it worked. I found it. I have to to push quite deep, my fingers get tired after maybe 20-30 seconds. It is indeed quite tender.

Everything, and I do mean everything I've ever read pointed towards the psos being the cause of everything. Other books and authors kept repeating things like: if you have trigger points in the QL, chances are it's coz your psoas has problems, etc... I'll try to hit it at least 3x/day and see what happens over the next few weeks. I am actually kindof excited about this.

Steven Low 07-28-2012 06:14 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
As long as you can dig it out and it starts to loosen up then we shall see!

Donald Lee 07-29-2012 09:20 PM

Re: Possible cause for foot turned outwards (Steven Low please read).
After I started reading The Trigger Point Therapy Workbook, I started digging in my pelvic region to get at my hip flexors, and half my body was numb for a day.

So don't do that. ;)

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