By Dr. Ross Turchaninov

          In an Issue #4, 2015 of JMS we published a review of an article written by Til Luchau. In this article the author suggested working on the iliopsoas muscle using a deep approach through the anterior abdominal wall and through the abdominal organs. In the author’s view it is absolutely safe therapy since according to the article, when the therapist applies vertical pressure into the abdominal cavity trying to reach iliopsoas muscle, which forms the posterior abdominal wall, all abdominal organs are going away the same way as plastic balls are going away while we put our hand into a box filled with them. Technically speaking this is unfortunate, but a very common view on iliopsoas work and the author just re-enforced it.
          We wrote an extensive review of the original article and used as much as possible illustrations to show therapists how erroneous this treatment option is. Despite reducing the tension in the iliopsoas, such ‘therapy’ dramatically affects the function of small and large intestine by unnecessary traumatizing intestinal walls. We are not going to repeat our arguments since therapists may read them in the link to our original review. Please click here to read it:


          Many therapists agreed, saw great value in our review and changed the way they start to work on the iliopsoas muscle. Unfortunately, a large number of therapists profoundly disagreed with our recommendations and supported the author’s views based on the fact that they had successfully practiced the intra-abdominal approach for a number of years, and because of that it is completely safe. It was very frustrating for us since incorrectly treated patients suffered from wrongly advised therapy. In our clinic we periodically see patients who were previously treated with such ‘therapy’ and we observed short and, in some cases, long time effects of it.
          There is no doubt that intra-abdominal work will reduce tension in the iliopsoas muscle, but repetitive traumatization of the intestinal walls is completely unnecessary. Its results may show themselves later in the patient’s life and they won’t even link their symptoms with the work by therapists who did that several months or even years prior. For example, intestinal trauma may cause the formation of adhesions between intestinal loops followed by twisting and obstruction of the intestinal lumen, as well as various posttraumatic changes in peristalsis.
          Recently our former student Angela Bitting, CMMP, LMT sent us a video where the same issue was examined and illustrated in the cadaver study. We think it is great visual proof which supports our original clinical recommendations. Please watch it carefully. We hope that therapists who still use such pseudo-clinical treatment will change their views and immediately stop application of incorrectly applied therapy.
          The first rule of medicine is “Do No Harm!” and treatment suggested in the original article does exactly that: it harms patients in the long run while indeed helps with current symptoms of iliopsoas muscle tension. It doesn’t matter who taught and recommended this treatment or how long therapists have successfully practiced it – this nonsense must be stopped asap. Please think about your patients/clients first!

Video from Physio Network: Are We Really Reach the Psoas?

Are we really reaching the psoas?

Are we really ‘releasing’ the psoas? ????What do you think?With manual therapy you can’t change tissues DIRECTLY. But how does manual therapy work then? Here is a great blog on clinical reasoning in manual therapy – credit – Rob Haddow from Haddow Massage Therapy ????

Posted by Physio Network on Tuesday, October 22, 2019


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