Hip Flexor Massage: Psoas & Iliacus

[@MassageSloth]

A frequently asked question about hip flexor work: How do you alter these techniques for clients with more bodyfat? The answer is... there's no need! TFL will be easily accessible, as will iliacus. Both are in regions that don't tend to accumulate subcutaneous fat - just find ASIS, and then move just inferior or medial to find these two muscles. For psoas, it might feel like you're not able to get near the muscle belly in a client with more subcutaneous or visceral fat, but just realize that proximity isn't our goal. What we want is to stimulate the local stretch receptors, and we do that by compressing the abdominal contents. Yes, adipose tissue will distribute your pressure out radially to some extent, but much of it will still compress posteriorly and give psoas and the local nerve endings some stimulus to think about. If you'd like a straighter shot to the psoas region, you can place a small bolster (a pillow or folded towel) under their ipsilateral hip, which will cause them to roll slightly, shifting their abdomen and its contents away from you and your working hand. Having trouble lifting the leg for a hip flexor stretch with larger clients? You can lift the knee just enough to place a pillow underneath, keep their knee bent and their ankle stabilized with one hand, and then do some compressions of the posterior hip to bring the flexors into stretch. Let me know what you think, or if you have any other questions!

[@bettyboop1524]

I've been having issues with either the hip flexor or IT band. I am going for a massage and while watching your low body fat model, I'm thinking that's nice but what about me? Then I read the comments and you answered my question. Thank you

[@bodyworksdwnyc]

@massagesloth that's a great tip! Another way to get into psoas and illiacus when it's hard to access through the belly is to contact the attachment point on the lesser trochanter on the femur and use some cross fiber friction to create a golgi tendon organ proprioceptor response that triggers the psoas, illiacus and (bonus!) pectineus as well :)

[@MrUnmake]

Is it normal to feel a lot og pain in this area for new clients? I tried out your video with someone in this area, who felt it was very helpfull during the massage, but 6-7 hours later felt more discomfort that lasted into the next day. Is it just general muscle soreness like you feel in the back and shoulders or can there be something else?

[@MassageSloth]

@@MrUnmake I'm not surprised by it, but it might indicate that too much pressure or duration was used in that first session (this threshold can vary greatly from client to client). Your client might have experienced some spasm after having these muscles compressed, or this could be DOMS, delayed onset muscle soreness. In any case, my plan would be to err even further on the side of caution and use less depth and pressure in future sessions. This work can be quite gentle and still get results. Play with that "dose," and eventually you'll find one that provides relief without that discomfort!

[@MrUnmake]

@@MassageSloth thank you so much for the reply! I have been keeping in contact with the patient, and it has gradually become better and better, so i think you are correct. I went over your videoes again and realised that i did put too much pressure, and paid to little heed to your warnings over the patients insitence on pain tolerance and wish to go harder. I learned a valuable lesson, and thankfully my patient is not in anymore pain^^

[@Moorefamily4510]

I am a massage therapist for 17 years and I came here for ideas to help a client. Thanks for tbe awesome video! I cant wait to watch the others!

[@elag.198]

This has been my asmr for many years. Plus, I learn cool anatomy and a dreamy massage wish list. Thank you!

[@juliebergstrom-gabler135]

I am a massage therapy student, and I think your videos are excellent!! You explain techniques in a calm, knowledgeable way. Thank you so much!

[@gillianbennett4518]

Thanks Ian. So grateful for your gentle soft presence. Have watched you for years n you have helped me become a far better therapist. ❤️ Thank you so much! Hope the sales of your book have been great!

[@MassageSloth]

Thank you Gillian, that's so kind!

[@anonblonde]

I'm currently reading yoir book! I HIGHLY RECCOMEND! You are amazing talent!

[@Kai_snzz]

these videos absolutely fascinate me as someone who considered going into massage therapy, but ended up deciding against it, such a niche but interesting channel i love it! plus your voice is very soothing makes for great background noise videos 😂

[@jamiesonlamb2852]

Wow, your content is really getting polished. This was an articulate and thorough lesson. Thanks so much!

[@jennw6354]

Best video and most informative, professionally done I've seen on this topic.

[@BC-ny3zb]

I've been watching your videos as ASMR for years man, glad you're still doing videos.

[@SmolAliens]

Thank you for this one. I am seeing a PT for pregnancy related pain and my hip flexor has been the culprit lately, which was surprising to find out. My PT does a lot of massage work and I’m so glad she worked these muscles haha.

[@galinitherapies]

Thanks you so much for this video...and other videos of yours I've followed! Love your explanations and demos, so well presented and informative...and fun! Thank you so much from Tina in the UK

[@iPineapplePants]

thanks for your videos sir, I am an LMT in Oregon and your videos and book have guided me with helping so many patients. Thanks for all of your hard work!

[@prex327]

I watched your videos while in school, a few years back... I'm back again‼️ You're a doctor‼️ The massage genius/sloth⁉️🤔 Work smarter, not harder‼️

[@megangodfrey626]

I’m so excited to try that psoas stretch on the next person that needs it!

[@Pongant]

Love your videos so much!

[@bobsarfatty4673]

Ian, the great. Thanks for all your great videos.

[@MsSoUnique]

Great video Ian, for those clients that are very ticklish. What will be the best way to work on this area effectively?

[@MassageSloth]

Ah, great question! That's actually one of my favorite reasons to lead with the broad palmar contact to the ASIS and TFL rather than diving in with a sharper tool. It starts acclimating the local nervous system to contact in a way that feels safe, which I think is very important when it comes to whether touch is perceived as ticklish or intense. From there, my recommendation is to use "mime hands" (think of a mime very deliberately placing one hand and then the other on an invisible wall): Keep one hand in a place where you've established safe contact, then slowly but confidently(!) place your other hand in a potentially ticklish area. The hand in the safe area can apply some pressure and even some jostling to distract the nervous system, and then it can join your other hand once the new area is deemed safe. So, in fewer words: Start with what feels safe, and make your way to more reactive areas with small steps rather than in sudden leaps. I plan to have a video on this soon!

[@MsSoUnique]

@@MassageSloth ok awesome thank you ☺

[@chrisferrario1540]

I’ve been to three PT’s , numerous massage therapists and one chiropractor. I rc/o Lilia us and psoas. I’ve had needling and done a ton of “strengthening” since my glutes have weakened with this! I’d like to just do self massage, use my tens and gravity ( do this face down with a yoga block and lacrosse ball b/c I’m tired of requesting this and not getting the support. Can you do a video on self care here? Lots of exclusionary pieces of course but truly, I’ve even shown PT’s videos like this and they don’t address! Please help- thet would be wonderful!!!

[@dorisw2507]

I especially love the tips at the end, which is helpful for pregnancy too!

[@katyjewett9523]

Do you find that you have to change the approach if someone has had a hip replacement? (Different pressures, working around the area instead of with, etc?)

[@MassageSloth]

Not generally! My main concern with hip replacement is their range of motion - some people will be told to keep their hip movement within a certain range, and I'll make sure to honor that. Other than that, just recognize that there will likely be sensitivity and scar tissue in the region, and work with what's comfortable for them.

[@lilianmuchina5088]

I got lost on the lesson with your beautiful voice.😆Thanx you for the video and thanx for sama

[@mrstammimoat]

Very informative Thank you

[@paulafranchittianderson1226]

HI, your demos are so helpful. As a therapist id really appreciate if you can you please do a demonstration on pelvic realignment.

[@MassageSloth]

Thank you Paula! And I'm not really into the whole realignment thing. I think that, for the most part, asymmetry is just a natural part of being human, and I'm only really concerned about it when it seems directly related to pain. And when there is pain? I let the symptoms lead the way. Someone has pain in their left hip crease (inguinal ligament) region, for example. Let's get those hip flexors and extensors soothed and stretched, and I expect it to calm down. While I'm at it, I might as well do the same work on the right side. Won't that wind up with them being imbalanced in the other direction? I don't think so - I think that their nervous system will use all the new stimuli to find its own balance, and the idea that we have direct control over how things wind up is overblown. Anyway, that's my theory, and it's something about which reasonable people disagree :)

[@SweetShine213]

THANK YOU IAN!!!!☆☆☆☆☆

[@angelastermer8501]

Halfway between the belly button and ASIS is the Ileocecal valve. I always thought tension here was a digestive issue.

[@MassageSloth]

You would be compressing that region while working with psoas on the right side, but it's important to note that it wouldn't be in response to abdominal discomfort - I'd be following pain or dysfunction in the low back and hips. If someone came into my office and said they had lower right quadrant pain, I would ask that they see their doctor for evaluation. For abdominal discomfort that had been evaluated and wasn't new or unusual, I would address it more broadly, as in this video: kzbin.info/www/bejne/qJPGlKhrg5lpatU

[@caethorstman4356]

As a Therapist I need this done to me

[@tyrone1son]

Mannn, where are you located??

[@shannongreenlaw321]

can you do a viideo on How to cure cramping in deep tendon/muscle when writing/overuse of right ring finger & pinky

[@Vic-sy6hl]

What kind of camera do you use to record our videos? 😀

[@MassageSloth]

This one was a Panasonic micro 4/3, but coming up you'll be seeing a Sony FX30. No one will be able to tell the difference, but it's fun for me 😁

[@mutamente]

26:36 - hahahaha it's really cool xD

[@lizforee1328]

Dear Massage Sloth, Where have you gone? It has been 5 months since your last video. Hope you are okay.

[@MassageSloth]

I'm aight :) thanks Liz. I've got something new coming up in the next week or so, and then I plan to get back to a monthly schedule. I appreciate the check in!

[@SweetShine213]

Are you on Instagram Ian?

[@MassageSloth]

I am! Just search @massagesloth 😊

[@nobodyspecial3338]

You should check out Raynor massage and how The energetic bands of tension are connected to these areas. Based on old acupressure and Shiatsu techniques. Thanks for sharing