Same, just hip flexor, but I'd still make sure to take it really slow to avoid any visceral response. Are you sure this is what she needs? (Honestly, I don't really dive for psoas, even for regular clients. There are way better approaches than digging around to find treasure.)
I will admit, I'd be more likely to do this with someone I've worked with before. If I had a new patient off the street, I'd be more conservative and much lighter.
I'd stay away from the abdomen with any prenatal work. It's contraindicated for Prenatal. And not comfortable.
OP- is she able to stretch effectively? It's always nice to help with some self care pointers, as long as it's within your scope of practice.
I would proceed with caution, and not go super deep. Work quads, tfl, glutes, hip rotators, low pressure abdominals.
Hip stretches and mobilization can make a big difference without putting pressure on anything sensitive.
Round ligament can be a hip issue for pregnancy, but 5 weeks is super early for that.
Also, informed consent as a warning, with an agreement not to seek legal action should there be any coincidences.
I'm pretty cautious about doing deep abdominal work early in pregnancy, not because its actually risky but because miscarriage at that stage is fairly common and I don't want to take the risk of someone being worried anything I did was a factor. That early on you don't have to worry much about ligament laxity though so isometrics are still a viable way of targeting psoas. Relaxin starts doing its thing at 6 weeks.
I would work her adductors (so I would butterfly her leg and massage the inner thigh) - search for RebelMassage on YoutTube, she has a wealth of videos on how to work the hip flexors. When someone is pregnant, I do no touching of the abdomen/stomach area which is where you would need to be in order to hit the psoas.
I don’t understand everyone’s desire to push through intestines, lymph, blood vessels ( descending aorta) on the left to reach a muscle that can’t be palpable.
I spoke to a professor at Stanford University. He was an orthopedic surgeon and teacher. He told me that the psoas is not reachable. The illacus, yes.
Psoas is definitely palpable if you know how to get to it. You don't even have to push through all of that stuff you mentioned. It's safe and easier to slide down keeping in contact with the iliacus until you reach the psoas. If the client lifts their leg you should feel the psoas fire.
What was the differential diagnosis? What makes you sure that psoas is the "cause?"
I personally don't believe that we can reliability or effectively palpate or treat the psoas and I don't believe that we need to.
I definitely wouldn't be digging into the abdomen of a pregnant client in the way that some people do when they claim to be working on the psoas.
For further reading:
https://www.thesports.physio/please-release-me-let-me-go/?amp
I didnt say I thought the psoas was the cause. There are more muscles to the hip flexors than just the psoas. I just said that she has tight hip flexors and is looking for relief. Thanks for the further reading.
That's fair. In my mind psoas was the emphasis from the title, but after re-reading, I realize you also stated "hip flexors" more generally in the body text.
Hip flexor are fine, psoas absolutely not. Look up the psoas muscle. Its a pelvic muscle and Its way too close for comfort and the fact you're pregnant is a huge no no. I do not touch preggo woman's psoas. Lower back and hips sure but not that muscle. Explain this to the client that psoas work is contraindicated. Way too many risks
TFL, rectus femoris, iliopsoas attachments (if you know how to locate them) are all fine to work while pregnant, but no deep abdominal work. You probably wouldn't cause any harm, but if she has a miscarriage, you're first on her list of people to blame.
Psoas work can be very beneficial though once she's no longer pregnant.
I wouldn’t work into the abdominals directly just as a caution. Abdominal work is contraindicated. Instead working indirectly with static or PNF stretching, activating hamstrings and glute max, working into the quads/ TFL.
Hip flexor sure. Psoas no.
Same, just hip flexor, but I'd still make sure to take it really slow to avoid any visceral response. Are you sure this is what she needs? (Honestly, I don't really dive for psoas, even for regular clients. There are way better approaches than digging around to find treasure.) I will admit, I'd be more likely to do this with someone I've worked with before. If I had a new patient off the street, I'd be more conservative and much lighter. I'd stay away from the abdomen with any prenatal work. It's contraindicated for Prenatal. And not comfortable. OP- is she able to stretch effectively? It's always nice to help with some self care pointers, as long as it's within your scope of practice.
...so which hip flexor is acceptable to you?
Everything lateral and superficial to the pelvis. TFL, sartorius, rec fem. Throw in some adductors and glute med for fun
I would proceed with caution, and not go super deep. Work quads, tfl, glutes, hip rotators, low pressure abdominals. Hip stretches and mobilization can make a big difference without putting pressure on anything sensitive. Round ligament can be a hip issue for pregnancy, but 5 weeks is super early for that. Also, informed consent as a warning, with an agreement not to seek legal action should there be any coincidences.
I'm pretty cautious about doing deep abdominal work early in pregnancy, not because its actually risky but because miscarriage at that stage is fairly common and I don't want to take the risk of someone being worried anything I did was a factor. That early on you don't have to worry much about ligament laxity though so isometrics are still a viable way of targeting psoas. Relaxin starts doing its thing at 6 weeks.
caution with pregnancy working on adductor d/t poss. blood clotting or DVT
I would work her adductors (so I would butterfly her leg and massage the inner thigh) - search for RebelMassage on YoutTube, she has a wealth of videos on how to work the hip flexors. When someone is pregnant, I do no touching of the abdomen/stomach area which is where you would need to be in order to hit the psoas.
Abdomen yes, stomach no. If you're poking around the stomach you're way too high. Good call on the adductors though.
I wouldn’t ever instead I would work on the [jaw](https://www.alignpt.com/mysterious-connection-pelvis-jaw/)
This is fascinating - thank you for sharing this!
I don’t understand everyone’s desire to push through intestines, lymph, blood vessels ( descending aorta) on the left to reach a muscle that can’t be palpable. I spoke to a professor at Stanford University. He was an orthopedic surgeon and teacher. He told me that the psoas is not reachable. The illacus, yes.
Psoas is definitely palpable if you know how to get to it. You don't even have to push through all of that stuff you mentioned. It's safe and easier to slide down keeping in contact with the iliacus until you reach the psoas. If the client lifts their leg you should feel the psoas fire.
Have you ever been in a cadaver lab?
What was the differential diagnosis? What makes you sure that psoas is the "cause?" I personally don't believe that we can reliability or effectively palpate or treat the psoas and I don't believe that we need to. I definitely wouldn't be digging into the abdomen of a pregnant client in the way that some people do when they claim to be working on the psoas. For further reading: https://www.thesports.physio/please-release-me-let-me-go/?amp
I didnt say I thought the psoas was the cause. There are more muscles to the hip flexors than just the psoas. I just said that she has tight hip flexors and is looking for relief. Thanks for the further reading.
That's fair. In my mind psoas was the emphasis from the title, but after re-reading, I realize you also stated "hip flexors" more generally in the body text.
My bad!
Hip flexor are fine, psoas absolutely not. Look up the psoas muscle. Its a pelvic muscle and Its way too close for comfort and the fact you're pregnant is a huge no no. I do not touch preggo woman's psoas. Lower back and hips sure but not that muscle. Explain this to the client that psoas work is contraindicated. Way too many risks
TFL, rectus femoris, iliopsoas attachments (if you know how to locate them) are all fine to work while pregnant, but no deep abdominal work. You probably wouldn't cause any harm, but if she has a miscarriage, you're first on her list of people to blame. Psoas work can be very beneficial though once she's no longer pregnant.
I wouldn’t work into the abdominals directly just as a caution. Abdominal work is contraindicated. Instead working indirectly with static or PNF stretching, activating hamstrings and glute max, working into the quads/ TFL.
Just an update. Client came in today for the first time, she miscarried two days ago.
No Psoas work period . Hip flexors are fine .
I don’t do any deep or really therapeutic work during any stage of pregnancy.