The Secret To Psoas Tightness On One Side (why is no one talking about this?)

The psoas muscle attaches on the lumbar vertebrae and at the lesser trochanter of the femur (inner portion), allowing it to pull the femur up into hip flexion or move the pelvis into hip flexed anterior pelvic tilt position.

“the psoas attaches on the lumbar vertebrae themselves and also at the lesser trochanter of the femur which is this inner portion of the femur right about here and this attachment allows for that muscle to have leverage to obviously pull the femur up into hip flexion or move the pelvis on the femur into a hip flexed position like this and this is also a position of what we would refer to as anterior pelvic tilt”

The core principle underlying the treatment approach is that joint position influences musculature and vice versa, and addressing both of these factors together is foundational for correcting movement dysfunction and postural imbalances.

“the truth is most people are going to have a really hard time feeling their hamstrings with just that wall reference so we recommend for most people starting off with something supporting their Shin not their entire leg but just this portion of the shin so that they can stay at a 90-90 angle you want to set it up so that the whole foot can still be flat on something so we're not off the wall digging the back of our heel into something the whole foot's flat and then you should be able to feel a lot more hamstring but again this isn't a 10 out of 10 hamstring contraction it should be a four to five out of ten maybe six and then he's gonna come up pulling down with his heels and then doing that little shift and it should be easier for him to maintain that so those are three muscle groups working synchronously in a position of internal rotation then that would be the goal and a great way to start appreciate how the position of the joints are going to influence musculature and vice versa and addressing both of those things together is a unique and foundational principle of my programs”

In the side-lying 90/90 position, the left gluteus medius muscle should activate as a distinct point just behind the greater trochanter (hip bone prominence), differentiated from the tensor fasciae latae (TFL) which runs down the side of the bone.

“what should also be happening is you should feel your left gluten Mead activate that's going to be the muscle if you have this bone right here on the side of your hip it's going to be just behind that not on the bone or the or your tfl muscle which runs down the side of that bone it should be slightly behind the bone that's what you're looking for there and you want to integrate that with the inner thigh”

A tight left psoas in a shortened (concentric) position causes its proximal fibers near the spine to rotate the spine toward the right side and externally rotate the left femur, creating anterior pelvic tilt on the left with posterior pelvic positioning on the right.

“when it contracts and pulls right here and these attachment sites come closer to each other it's going to actually turn the spine in the opposite direction so because this contracts it's going to turn the spine towards the right side as it also pulls this femur forward into an externally rotated position”

To address left-sided psoas tightness, treatment should facilitate inverse joint positions: spine rotation toward the left, posterior pelvic tilt (pelvis rotating back), and internal rotation of the left hip, thereby reducing stress on the left hip flexor.

“what we want to do is we want to facilitate the inverse joint positions pretty much so we've got a pelvis that's more externally rotated and forward on the left side and the spine is facing the right side so we want to facilitate the spine turning towards the left and rotating this left pelvis back and also internally rotating that left hip those would be the solutions towards getting us to really take stress off of that hip flexor on the left”

Right-sided hip flexor tightness occurs because the pelvis tends to be more forward on the left, biasing the right side toward internal rotation relative to left external rotation, making the right side preferentially loaded and the right gluteus maximus underdeveloped and underactive relative to the left.

“the other reason is is that we can't effectively push out of our right side and we are pulling ourselves forward with our right hip flexors what I mean by that is because the pelvis tends to be more forward on the left the right side tends to be biased towards a position of internal rotation relative to left external rotation if that is the case we're more biased towards loading ourselves on the right side right now our right glute Max helps create external rotation of the femur and the hip closing off this space right here so that way we can push from right to left the right glue Max tends to be more underdeveloped and also under active relative to the left because of this”

The treatment for right-sided hip flexor tightness should prioritize educating the right gluteus maximus to push effectively out of the right side, rather than stretching or releasing the hip flexors.

“what would be helpful here is instead of us pulling ourselves forward with our right hip flexors we can educate the right glue Max to push us out of our right side more effectively”

In the 90/90 hip lift with left hip shift exercise, the goal is to pull the left hip from a forward orientation to neutral orientation by engaging hamstrings and creating posterior pelvic tilt while keeping the whole foot flat on the wall.

“the purpose of this is to pull that left hip from a forward orientation to more of a neutral orientation so to set up for this we need to get in a 90 90 position where we have a 90 degree Bend at both our knee and our hip and the feet are flat on the wall and we have a ball in between our knees that allows us to keep our knees in line with our toes and our knees in line with our hips”

During the 90/90 hip lift, the practitioner should feel hamstring engagement on both sides initially but the hip shift should isolate left-side inner hamstring and left groin muscle activation while minimizing right-side muscular tension.

“I'm going to have Trevor shift his right knee up and his left knee down which is going to move his hips and that's okay and then I'm going to have them pressed gently into the ball with just his left side not his right side so at this point he should feel his left inner hamstring and his left groin inner groin muscle engage the right side should have maybe a little bit of hamstring but not a lot of muscular tension is happening on this right side”

The breathing pattern in the 90/90 exercise (exhale through mouth with 5-10 second duration, inhale through nose) helps activate side abdominal muscles and should be maintained for 5 breathing cycles to reinforce the corrective movement pattern.

“then he's going to Exhale through his mouth getting all that air out really all that soft five to ten second exhale until he feels his side ABS not his six-pack but a little bit side abs and then hold that tension nice and soft as he inhales through his nose he sure feels ribcage expand he's going to do five breaths of that maintaining this position right here”

For practitioners who struggle to feel hamstring engagement with only wall reference, starting with shin support (not full leg support) while maintaining 90/90 angles with whole foot flat improves hamstring activation to 4-6 out of 10 intensity.

“the truth is most people are going to have a really hard time feeling their hamstrings with just that wall reference so we recommend for most people starting off with something supporting their Shin not their entire leg but just this portion of the shin so that they can stay at a 90-90 angle you want to set it up so that the whole foot can still be flat on something so we're not off the wall digging the back of our heel into something the whole foot's flat and then you should be able to feel a lot more hamstring but again this isn't a 10 out of 10 hamstring contraction it should be a four to five out of ten maybe six”

The right-side line 90/90 position involves 90-degree bends at knees and hips with head supported by the right hand, a compressible ball between knees, right foot flat on wall, and left foot positioned slightly above knee level in internal rotation range.

“what we're going to do here is we're going to get in this right side line 90 90 position I mean we have a 90 degree Bend at both our knees and our hips and we're just going to support our head with our right hand and arm to make sure that our head is nice and relaxed and chill and the first thing we're going to do is make sure we have a ball in between our knees which is pretty compressible and when you're just kind of resting in this position it allows your knees to stay in line with your hips and also your feet like that now depending on the individual some people will benefit from having the ball further up other people feel it more when it's further back in between their thighs a little bit more you can experiment around and see what works best for you what we need to do is make sure that his right foot is flush on the ground right here but flat on the wall and this left foot is going to be slightly above the level of the knee I would recommend staying within within your active internal rotation range whatever that is I would start there”

If practitioners feel pinchiness in the side of the hip (TFL involvement) instead of gluteus medius activation during the side-lying 90/90, they should increase distance from the wall to approximately a 60-degree hip/knee angle while maintaining the internal rotation and breathing sequence.

“if you are feeling that pinchiness and the side of your hip and your hip flexor so I'm uncomfortable sensation maybe in your tfl instead of your glute meat then you can try getting a little further away from the wall and I wouldn't go beyond about a 60 degree angle at your knees and your hips but you can work getting a couple inches further away doing the exact same thing getting this up a little higher turning it in and then that should help most people”

Common errors in the side-lying 90/90 exercise include losing foot contact (particularly the right foot coming off the wall) and allowing shoulders to roll forward, which can lead to discomfort and pinchiness in the hips.

“the most common mistake in this is that people are going to lose their foot contacts so they'll lose something on their foot or their right foot will come off of the wall make sure both feet are flat but the focus is on that left heel the other thing is people's shoulders are going to roll forward like that and that can lead to some uncomfortable Sensations and pinchiness in the hips so make sure you got your shoulder and head stacked over your pelvis here”

In most people, the asymmetrical left-forward/right-back postural pattern is the dominant bias, and addressing the left hip in the corrective exercises is beneficial in the overwhelming majority of cases.

“keep in mind this asymmetrical pattern is what most people are biased towards and I see in the overwhelming majority of cases most people benefit from addressing the left hip in this context”

Practitioners who cannot feel adequate gluteus maximus activation on the standing leg can move slightly further away from the wall, which provides different hip flexion angles and improved glute activation for those with reduced hip flexion capacity.

“now if you don't feel a good bit of glute of the foot that's on the wall you can modify this by getting slightly further away from the wall sometimes this helps people especially those with less hip flexion create a better push into the wall with the inner edge of it to feel that glute Max”

In the alternating leg gluteus maximus exercise, practitioners exhale and tuck their pelvis while pulling one leg off the wall to rest on the opposite leg, then alternate legs while maintaining wall contact and posterior pelvic tilt focus.

“so now he can pull this leg back feel that same foot pressure everything stays the same as he exhales he's going to try tucking just slightly more trying to reach that back pocket towards that heel as he keeps the inner edge of that foot driving into the wall breathing through it exhaling through his mouth until he feels a little bit of side ABS pausing inhaling through his nose”

In the right-side 90/90 position, the movement sequence involves: slightly turning left toes down into internal rotation, posterior pelvic tilt, exhale while shifting left heel back into wall and pushing into ball, then inhaling while shifting knee further back to intensify left inner thigh and left gluteus medius activation.

“what we're going to do is slightly turn the left toes down this is going to bias a little bit more in internal rotation to initiate this we're going to slightly tuck our hips do a little posterior pelvic tilt now inhale keeping both feet flat on the wall but focusing on the left heel and shift the left knee back exhale push down into the ball you can feel your left inner thigh activate also it can help to push your right knee down into the floor so both knees go down on the exhale inhale through your nose shift the knee a tiny bit further back if you can't get any further back have the intention to and that will kick on your inner thigh a little bit more”

In the gluteus maximus activation exercise at 90/90 position, practitioners should exhale through the mouth while pulling one leg off the wall and hugging it to the chest, then dig into the wall with the inner edge of the heel and ball of the big toe of the standing leg.

“so to set up for this we want to be at about a 90 degree angle now I'm going to discuss different lengths you can be away from the wall to feel more glute but most people are going to feel a lot of glute in this 90 90 position so Trevor what I want you to do is I want you to Exhale through your mouth as you pull one leg off of the wall and hug it to your chest staying nice and relaxed and dig into the wall pushing into wall feeling the inner edge of his heel and also the ball of his big toe he's keeping the whole foot flat but the purpose of this is to drive into the wall with this ball of the big toe and also the inner edge of the heel”

A study showed that the normal human spine naturally faces the right side in most cases, meaning the left side predisposionally sits more forward and the left psoas has a structural predisposition toward tightness relative to the right side.

“there's a study that showed that a relatively normal human spine curve actually faced the right side in most cases so if we're facing the right side and have a predisposition to facing the right side that means that the left side is going to be more forward which means that the left psoas is going to have a predisposition towards being more tight than the right side”

The two most common reasons for right-sided hip flexor tightness are related to the asymmetrical left-forward/right-back pattern, including (1) inability to effectively push out of the right side and (2) compensatory pulling forward with right hip flexors.

“now a lot of you may be asking what if my right side has tighter hip flexors in this case it's usually one of two potential things now I'm going to be talking about the most common reasons why I see tighter right hip flexors”

During the gluteus maximus activation exercise, the practitioner should feel gluteus activation on the standing leg while breathing and exhaling, and with each exhale should tuck the pelvis slightly more toward the back pocket to maintain posterior pelvic tilt.

“now as he does that he's going to breathe through it he should feel some glute on the down leg every time he exhales he wants to tuck just a little bit more trying to reach his back pocket for his heel there that's going to allow him to keep and maintain that tuck he should feel a good bit of lower glute of the leg that's on the wall”

The 90/90 hip flexion position (90 degrees at both hip and knee) biases internal rotation of the pelvis and targets the hamstrings, adductors, and oblique muscles that collectively create posterior pelvic shift, pelvis rotation back, and leftward movement.

“a great place to start is a 90 90 position meaning 90 degrees of both hip and knee flexion because 90 degrees of hip flexion biases internal rotation of the pelvis and it's also going to help us Target muscles that help create that internal rotation and also help create a shift of the pelvis back and towards the left those muscles are particularly your hamstrings which attach on the back of your pelvis help pull the pelvis back on that side your adductor muscles which when you are in 90 degrees of hip flexion help create internal rotation and a shift towards that side and also your oblique muscles because those muscles attach at the top of your pelvis and they help rotate the pelvis back and also turn you towards that side”

The exercises for left-sided psoas tightness may be helpful for right-sided issues, but right-sided hip flexor tightness usually requires additional steps beyond what is required for left-sided addressing.

“that doesn't mean that this isn't going to be potentially helpful for your right side it could be it's just that you might need to take a couple extra steps on top of that”