What to do about tight Psoas muscles in Seniors

What to do about tight Psoas muscles in Seniors

After my class yesterday, I was told that we should not be doing any knee lifts in class because most of the seniors hip flexors are tight to begin with and that we need to do more stretching of the hip flexors.

For the seniors that do sit a lot and have tight hip flexors that doesn’t mean that their hip flexors are strong.
What would be the best way to answer this person that approached me? I could not finish the conversation with her because I had to teach another class but I do want to get back to her. On a side note, she is a long time retired Physical Therapist!

Answer from Justine

I understand what the woman is saying….but I have to disagree with her tendency to be dogmatic in her reasoning. Anytime someone says ‘always’ or ‘never’ a red flag goes off for me!

You are SO right, just because the hip flexors are tight does NOT mean they are strong. They are chronically contracted and most likely weak. It is important to strengthen them, but more to the woman’s point – in order to stretch them, they need to be contracted first – doing this multiple times with knee lifts will not only strengthen them, but prepare them to be stretched in a safe way by activating PNF (proprioceptive neuromuscular facilitation) making them more agreeable to a lasting stretch or elongation of the tissue – not only muscular tissue but the fascia as well. Taking a tight muscle and just stretching it will cause it to resist the stretch…..and can be a risk for injury. Better to engage it and shorten in several times before going for a stretch. Later in the class a standing Warrior One will stretch the psoas of the back leg, and the stretch will be enhanced if the arm on the side of the back leg is raised – it will lift the origin of the muscle, and deepening the breath will further enhance it by increasing the movement of the diaphragm, of which the central tendon is the origin of the psoas muscles. IF the pose can be sustained for up to two minutes, all the better as it takes the connective tissue/fascia that long to truly stretch.

Stretching the quads is also important as they are hip flexors as well. But strengthening the quads is equally if not more important than strengthening the psoas (quads are the ‘muscles of independence’ as Sherry says!) Those can be strengthened with knee extensions from a seated position, followed by a seated or standing quad stretch.

In your student’s defense, I am not sure how long she has been retired, but a lot of theory and research in regards to how the body works, in particular the fascia, has been done in the last decade. She might not be up on the latest research. She seems to be coming from a place of wanting to help. I hope this gives you some good talking points! Please feel free to reach out if I wasn’t clear in my description.

…I wanted to add in a little more food for thought……with seniors we also have to be aware of bone health. We want to get circulation into the muscles and keep them limber and ‘juicy’ so to speak. If the tissue is atrophied or dried out, and we try to force a stretch that can have a negative impact on the bones (think fracture or break) If the ligaments/muscles/connective tissues are dried out and brittle, that can be risky for even spontaneous fractures. That is why moving is so essential, and repeating those poses, and movements in all directions (safely!) is so important….to keep everything nourished! I hope this helps.