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  Back pain lying supine or prone? Could be a "tight weak" psoas! Pilates Information
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  1. Is your back pain worsened by lying "prone" (see diagram below)? DiamondPressStrt
  2. Is your back pain worsen by lying "supine" (see diagram below)? -
  3. Is your pain reduced when your legs are brought up so that you are lying "semi-supine" (see diagram below)? -
If you are answering yes to these questions, your likely cause of pain is a "tight weak" (i.e. "tight" at rest & when stretched, & "weak" in terms of its ability to pull against a load) Psoas muscle, that is pulling the lumbar vertebrae forward & compressing them together. Please study the following diagrams and discussion for information about the "tight weak" Psoas muscle...
Diagram 1: The Psoas muscle runs from the lumbar spine to the thigh bone. It becomes short & tight in response to low back pain.

The Ilio-psoas Muscles
Diagram 2: (Spine & pelvis from rear): The lower segments of the Multifidis muscle run from the lumbar spine down to the pelvis & sacrum. It becomes weak in response to low back pain.
The Multifidis
The Ballance between the Psoas and Multifidis 
muscles Diagram 3: Side view of pelvis and lower lumbar spine: The red lines represent the directions of pull of the Multifidis muscle (Left hand side), and the Psoas muscle (right hand side).
Discussion: The "Tight Weak" Psoas Muscle :-
When you fully straighten your hip joint, your over-tight psoas muscle pulls your lower lumbar vertebrae forward (that's called "anterior glide"), & together (that's called "compression"). The result is that lumbar discs & facet joints are put under strain & the sciatic nerve roots are pinched. The solution is three fold:-
  1. Teach the psoas muscle to relax instead of attempting to brace the lower spine.
  2. Reactivate the weakened multifidis, so that it can counter the forward force of the psoas.
  3. Reactivate muscles that tension the ligaments that support the lower spine (Latissimus dorsi & Lower trapezius from above, Gluteus max & medius from below, Transverse & oblique abdominals from the side).
Traditional Pilates is good for rebuilding the Multifidis and abdominal muscles. The Back Maintenance Manual takes this further with "Evolved Pilates" exercises that help to relax the tight psoas & rebuild the weak Gluteus maximus & other muscles.
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The Back Maintenance Manual
Buy Now! The Back Maintenance Manual
Futher reading:
(1) "The Gluteus maximus can stabilize your back!"
(2) Trigger Point Massage of the Psoas provides a powerful extra tool in management of a "tight and weak" psoas muscle. Ref: Triggerpoint Therapy Workbook -
© Bruce Thomson, EasyVigour Project