This is a particular muscle that a lot of people have interest in. It’s a very prominent structure. You could consider it part of the core of the body depending on how people define core.
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Hello, welcome. And thanks for having us. Thanks to the American Acupuncture Council for welcoming us back. Uh, always great to do these webinars. Um, very frequently I do these with Matt Callison who had something to attend to today, so he wasn’t able to be here. Uh, we’ve kind of put this presentation together, uh, between the two of us, but in some ways, uh, sometimes one of us does a little bit more work on one particular one or the other. So this one, I actually did a little bit more of the setup with, so if he’s going to be out for a particular event, this one was probably as good as any, but it’s always nice to have them here and do this together. But anyways, um, that is why I’m doing this one by myself, but let’s go ahead and jump into the presentation. So what we’re going to be presenting on is the psoas major muscle.
This is, uh, a particular muscle that a lot of people have interest in. It’s a very prominent structure. Uh, you could consider it part of the core of the body depending on how people define core. Um, it can be one of the core structures. That definitely is a very core structure in terms of its stabilizing role on the spine. So we’ll go over all of this in the presentation, but it is such a central muscle that we decided to focus on it. Um, this particular timing, uh, we, we are focusing on it in this presentation because we’re getting ready to put together a, um, a little bit longer of a class, maybe like a three hour class, really much more of a deep dive into the, so as that that’ll probably be out for, um, available, uh, on a webinar for, uh, um, see use later in the, either the year, probably more likely, uh, closer to the new year in January.
So, uh, be on the lookout for that. It’ll be available on our webpage. It’ll be available through net of knowledge. Uh, so this is kind of the preparation for that. It’s a little shorter version of it. And we’re going to go into a little bit of depth in here and give you some ideas of how to work with this really important structure. So let’s go ahead and jump in. So first of all, let’s look at the anatomy. The, so as some ways has two heads on the axial spine there’s attachments, uh, on the vertebral bodies and actually right into the intervertebral discs of L four through T 12. So that tells you something right away that this is going to be involved in a lot of spinal problems in terms of its centrality and how it’s right up against those vertebral bodies with attachments right into the desks.
But that’s one of the heads L four through T 12, but then that one’s available in this image here. But if we were to kind of think, uh, posterior to this, if we were to kind of remove a vital little clicker and could remove the front surface of that. So as we’d see, it’s more posterior head, which is on the lesser trow canter, uh, excuse me, on the transverse processes of L five through T 12. Uh, so we have those two heads, which will be important in a, in a second, when we look at some of the neurology of this structure. Um, but for now just understanding that it really has attachments all the way up from L five to T 12, all the way on the lumbar spine, including lumbar discs for Debo bodies and that, um, the transverse processes, then it sort of descends down.
It crosses over the Elio pectineal Ridge, sort of over the junction between the pubic bone and the ilium, and then crosses and dives down towards the lesser trochanter of the femur. So that’s the territory we’re looking at in the grayed out sort of portion of this structure. We have the iliacus and as you see, and as many of you I’m sure know that the iliac is, has a common attachment on the lesser trow canter with the SOA. So sometimes people refer to as the iliopsoas, including that iliac Cassandra. So as I personally like separating those muscles, even though they have a common attachment on the femur, for reasons that we’ll get into a little bit later, both, uh, something we can see right now. And so as has actions on the spine where the ELA Acus doesn’t, but when we started looking at the channel sinews and some of those relationships, it’s nice to, in some ways have those muscles and separate mental compartments so that we can look at the sort of channel relationships to them. But yes, a lot of times people were referred to the iliopsoas because of that common attachment on the femur. Uh, so that’s the anatomy and that’s the territory that we’re looking at.
So one thing to know, right from the get go with the solo ads is it’s intimately related with the lumbar plexus. Uh, and, and particularly with the nerves that come from the lumbar plexus. So let’s look at this Netter image for a moment and kind of get our orientation straight. First of all, on the right side, we have the so as intact. So if you look at it by right side, I mean the illustrations, right. You know, the, the specimens right on the right side of the size is intact. And if you look at the left, so as not only is it cut as you get a little bit towards L five, you know, imagine you’re doing dissection and never was painting this image, I’m sure he was going by a dissection model. Um, so maybe they had already cut the so as, and, and so we can see the iliac is deep to that.
Um, but more than that on the left side, you can see that some of that more anterior head that attaches to the vertebral bodies and discs have also been cut away and we can see right into the body of the psoas and see that the lumbar plexus is actually situated right in top or right inside the, so as between those two heads between yeah, right there between those two heads of the, so as, uh, is the lumbar plexus and the nerves that come from the lumbar plexus, uh, and this particular study, uh, I’m quoting here, looked at the, um, dissections for 63 specimens and dissection and 61 of those, that was the case. So there’s variability like everything in human body, but in the majority, the vast majority of the cases that whole lumbar plexus is going to be situated inside the so ads. And then all the nerves that are coming from the lumbar plexus are going to penetrate through the solo ads.
So we can kind of look at that here. If we go back to the right side, we can look at the top most nerve that doesn’t actually penetrate through the, so as cause it’s not part of the lumbar plexus, that’s the subcostal nerve. It does share with the lumbar plexus, but then it wraps around the body, uh, innovate some of the abdominal muscles and the skin kind of, of the, the abdomen then below that we have the Iliad hypogastric and the ilioinguinal nerves, those do actually penetrate right through the psoas cause they’re coming from that lumbar plexus. So then they exit the, so as in those upper portion, uh, upper kind of proximal fibers of the, so as if we continue down from there, we have the lateral femoral cutaneous nerve. So it exits, so as a little bit more distal, a little bit more on the inferior portion of the fibers.
If we go a little bit, medial, you can see penetrating right through the psoas is a genital femoral nerve. And then if we go actually immediate to the, so as in that area, we’d have to kind of pick it out, but there’s the opterator nerve. So all of those have a relationship with the psoas in the sense that they’re all coming from the lumbar plexus, they all, you know, Pierce the, so as, uh, an exit, the, so as, um, and they have, you know, again, this intimate relationship with the psoas muscle. So we’ll get into that later in the importance of that. There’s a lot of importance just thinking about the anatomy. I’m sure you can think of many cases and pain patterns, trigger point referral patterns, how all of that is tied together and makes the, so as such a prominent structure and creating its own pain in the body, but also contributing to, um, various pain syndromes, like maybe back a lumbar junction syndrome, uh, involvement with clean Neal nerves, which are also coming from this lumbar plexus, but they’re on the posterior part, not visible from this image.
There’s a whole bunch of pain patterns. Um, a brief sidestep on this. This is not directly about the solo ads, but for those who are really into channel relationships, my interpretation of the dye, my, uh, is really these nerves that wrap around like those subcostal nerves, dealio hypogastric Leo and wean all lateral framework, cutaneous nerves, there’s nerves that are wrapping around from the back lumbar plaques, plexus and wrapping around the abdomen. I think that that speaks a little bit to the dynamite. I don’t know if I would say that the dynamite equals those nerves, but those nerves are part of the physiology of the dynamite because those nerves also innovate the abdominal muscles, like the transverse abdominis and the mobile leaks. Um, those nerves are influenced, as we know, by gallbladder 41, the oblique muscles are part of the gallbladder send you a channel. So I think somehow regulating tension through gallbladder 41 has an effect on those nerves that really wrap around following the trajectory of the diamond.
One other little thing about this it’s quite interesting is that the, you might have to go back and look this up if you haven’t looked at it for awhile, but the kidney divergent channel links intersects with the, my, uh, at L two, that’s just how it’s classically described intersects at the dynamite. And if you look at the trajectory of the opterator nerve, this other nerve of the lumbar plexus that opterator nerve goes right down and has sensory fibers right down to almost like the kidney 10 region. And that’s where the, um, kidney divergent channel takes off come kind of from that popliteal region comes up the thigh and then meets and intersects at the dynamite at L two region. So I think when we’re looking at the, my we’re looking somewhat at the physiology of the, uh, um, the lumbar plexus and the psoas is as kind of part of that relationship, but little bit more of a different subject, maybe in another day, we can hash that out a little bit more, but since we’re looking at this anatomy, it’s worth taking a moment to kind of, uh, compare and look at that kind of comparative anatomy between Western and Eastern.
All right. So some other, uh, ways that the, so as, um, interacts with the anatomy around it again, let’s get our orientation straight from this Netter image on the right of the specimen. The so as has been cut. So if you look closely, you’ll see the proximal fibers where it’s cut, and if you follow it down, you might even see the distal fibers. That’s kind of right over the [inaudible]. Yeah, they’re right there. So again, that’s so we can see what steep to that. We can see the quadratus lumborum. So the psoas and the quadratus lumborum have a pretty close relationship. The quadratus lumborum being a little bit more posterior takes off from the iliac crest and then goes up to the 12th rib. So there we have the quadratus, lumborum a really important muscle. We could do a class on the quadratus. Lumborum, it’s, it’s also really a, a quite a, um, important structure.
And maybe someday that’ll be a subject of one of these webinars. Um, I do want to highlight that anatomy because we have a dissection video coming up that is on the, so as, and that’s why I put it on here, but it does also cover the QL because if you look just distal to the quadratus, lumborum on the right. You can see how it shares fibers into the iliacus muscle, which isn’t that kind of pelvic bowl. And then that iliac is muscle. Like we looked at that common attachment on the lesser Cho canter, really farms, a continuous myofascial plane, all the way down to the ad doctors. You’ll see this in another image coming up and I’ll highlight it again. Um, but that in our interpretation and sports medicine, acupuncture is part of the liver send you a channel. You wouldn’t think of the quadratus lumborum as being part of the liver channel because in some ways we have to needle it from the back, but it’s not really a back muscle.
It’s a core, it’s a central muscle. It’s really a yin muscle on the inside of the body. Um, none of the medial thigh from the ad doctors, but then it blends in at the spinal attachments that we looked at and it really then becomes part of the kidney send new channel, which is interesting because not only is it part of the kidney send a channel, but we can see that the kidney organ is right up against that. So as, and in visceral osteopathy, they talk about how that, so as moves along the rails of the, so as you know, that if you kind of picture the psoas as being a rails of a train track, you know, that the kidney moves along the, so as the fascia is really intimately related with the, so as the renal fascia, and so as muscle, um, and by moves, what I mean is every time you take a breath that, so as moves about two centimeters down as the, as the diaphragm descends, it pushes the dominal contents, including the kidneys, all of the organs, liver, all of that.
But in this case, the kidney itself, it moves along. It kind of follows along that rail of the solo ads. So if you think about how many breaths you take every day, I don’t have the exact figure. This is something that when Matt was here, because he does know this Lennox, I heard him say it recently, but, um, but it’s quite a large amount of distance that, that kidney travels two centimeters isn’t that far, but two centimeters, every several seconds, all day that’s, that’s a lot of territory. So what happens now, if the renal fascia and the kid in the psoas, fascia are all adhered to each other and there’s limited capacity for that kidney to descend, well, then we’re going to have, you know, maybe restrictions in the psoas restrictions in the, in the hip flection. Uh, we’re going to have inability for the diaphragm to descend, you know, it’s going to cause some kind of obstruction, some kind of congestion that’s going to cause some health issues.
So when you’re working with the psoas, I think what I would take home from that relationship is when you’re working with the psoas, to some degree, you’re working with the kidney, if there’s more movement and more movement potential. And so as there’s more movement potential in the kidneys, and one of the ways that the kidneys become ill, and I don’t mean like kidney disease, um, in Western Sant standpoint, but in terms of lack of function is that they start to lose that mobility and motility of the Oregon kind of moving along the, um, the, so as, and then that can maybe descend a little bit. It can put pressure on those nerves we were looking at and it can cause their own symptomology. So being able to free up this region can really, um, both include improve function in the hip muscles. But, um, but also in the internal organs, the other thing that we can highlight, if you go back to the right side, we can see that proximal part of the, so as it’s cut, we can see how intimately related that is with the Dyer for him.
So that’s the cut portion yet right there. So in this nice, clean, better image where they take off all the fascia, you can see that it touches it, but in a real dissection with the fascia intact, you can see how integrated those fascial components are. And they become really one in the same, those sort of feed the crew of the diaphragm, the extensions and attachments of the diaphragm with the proximal. So as, so when you get people who are posterior tilt of the rib cage, maybe their pelvis slides forward and the rib cage tilts back. And it compresses that region of the diaphragm on the, so as that can have implications in breathing, I’m already thinking of kidney, not, um, grasping lung Chi is one way that I see it manifest. Um, so it’s gonna, it’s gonna decrease the ability of the diaphragm to descend, but it also can actually turn off the, so as, and cause problems with SOS its ability to stabilize the spine.
So when you start getting patients who maybe have back pain after starting to run, or they’re out dancing, moving in the back, pain comes on maybe five minutes as they start to tax their breathing. That’s one to start thinking of that relationship. And we have ways that we work on that in sports medicine, acupuncture. Unfortunately it won’t be in this webinar, but we’ll look at some ways that would affect it. Um, also, so kidney, so as QL, those are all and diaphragm. Those are all pretty intimately related. So let’s go into the next image, the next slide.
So here’s the, uh, image I put together for the send new channel relationships. So we’ve already talked about them. I don’t think I need to spend a whole ton of time saying it again, but, but we can see it from a different capacity now. So we have that medial thigh with the ad doctors, especially at Dr. Longest brevis and Peck tineas Priscilla’s could also be included in that these are part of the liver, send you a channel for those who know anatomy pretty well. The posterior muscle of this ad doctor group adductor Magnus attaches to a different portion on the back of the femur. It’s in a little bit different that, um, region that’s a little more posterior than this group that would be part of the kidney send new channel. So we’re looking at the thigh portion. We’re looking at the liver, send you a channel as it comes up to medial thigh, and you can see both the iliac is in the, so as the Eylea.
So as is part of that, liver send you a channel coming from distal, going up into the body. Uh, we talked about the iliacus and the QL. You can kind of find that in this image that it’s marked on the right [inaudible], that’s following that liver sinew channel all the way to the 12th rib. And then the, so as starts to attach more into the bodies of the vertebra blends in with the anterior longitudinal ligament, and it becomes part of the kidney sinew channels. So the SOA has this kind of a crossover. It takes off this delay from the liver sinew channel, and it ties into, um, the kidney send new channel. So which isn’t, well, we talk about it a couple different ways when you’re working with the distal ileus. So as for like grind strains, then more often than not there’s direct needle and you can do of course, but if you’re using disappoints, it’s going to be liver channel points that are going to have more of an effect on it.
Liver for liver five, those types of points are going to have a stronger effect on that liver. Five’s going to have a really strong effect on the quadratus lumborum through that, that QL iliacus relationship, but it would also have an effect on the distal Lilya. So as, so really when you’re talking about that distal portion, as it comes over the alien pectineal Ridge, and then God goes down to attached to the femur, you can kind of think of that as, as liver territory, liver sinew, channel territory, as it dives deep into the body. And we’re talking more about stabilization of the lumbar spine. We’re talking about how that stabilizes and moves and supports the lumbar spine. Then I’m going to put on my kidneys and new channel hat and think about its role more from the kidney sinew channel and how that’s going to affect it.
We will look in this webinar at a way of affecting that relationship when it’s not stabilizing the spine. And if the, um, so as this sort of testing week, um, but if I were going to use distal points, I might start thinking more kidney points, give me seven, the tone of vacation point on the kidney channel, uh, can sometimes wake up that ability for the SOS to support the lumbar spine. Uh, so if you’re thinking more body of the size, I guess you could say kidney, if you’re thinking more distal iliopsoas, you can think liver’s a new channel. I can say it a different way that if I’m thinking excess, I tend to see more of a relationship with the liver sinew channel, uh, excess meaning hypertonic restrictive. When I start seeing situations where it’s more about stability and support, then I see more of a relationship with the kidney channel kidney, send new channel a kidney channel points, distally.
So that’s a way of kind of making sense of its roles in terms of these two channels and it connects with all right. So actions of the SOS, the, so as does hip and trunk flection, hip flection, of course, we think about that with walking trunk flection. I want to come back to and a couple of slides. So just kind of put a little asterisk by that one that does lateral rotation of the hip, unless you see a source that says it does medial rotation of the hip. Um, lateral rotation is the bigger consensus, but I think gets rotation on the hip is negligible. I don’t really think about it so much personally, unless I’m doing a manual muscle test and you’ll see in the image coming up for that, that, um, there is a slight, uh, lateral rotation, but I don’t think it has a real large role in terms of lateral or medial rotation of the hip. Um, and sources say different things about it. So maybe it varies depending on the person’s position and how their body’s structure is hip flection, definitely trunk flection, definitely. Um, this third bullet point also definitely lateral flection of the spine and contralateral rotation. So if you can kind of picture that. So as contracting on one side, it’s gonna side them, that’s fine until a lateral flection to that side and rotated away.
Okay. So let’s think then about that. The, so as could be shortened, it could contract and shorten can contract and shorten and movement have flection and all that. But if it’s chronically hypertonic, it’s going to Paul on the lumbar spine it’s going to, and this is the consensus it’s going to pull it into more of a excessive lordotic curve. It doesn’t attach directly to the pelvis, but in the process of that spine being pulled into a lordotic curve and exaggerating that hyperextension of the spine, as it pulls the spine closer to the lesser trow canter, it’s going to pull the pelvis into an anterior tilt. So that top image is showing a neutral pelvis. Matt has a measurement at the ASI S and then I’m in the front and then a PSIS in the back. And there’s about a quarter inch. We’ve got about a finger width between that.
So that’s, uh, the, the measurement for a normal kind of a neutral pelvis. It’s about a quarter of an inch higher on the back, that’s normal. Um, but in the lower picture, you can see now that, uh, that quarter of an inch that is greater than a quarter of inch, that ASI S is situated, uh, much lower than what you see in the top image. So that’s what you had started seeing with bilateral shortness or unilateral if we’re just looking at it from one side, but let’s imagine that the, so that the pelvis bilaterally in that anterior tilt that same measurement and he’s doing on the right would look very similar on the left, this measurement, you know, it takes a little practice. You have to be right at the center of the PSIS. You have to find the upper border. You have to find the lower border, kind of find the lateral medial border and get right in the center of it.
And then the highest part also of the ASI S and that’s going to give you the measurement, cause you can kind of picture if I’m at the top border of the, um, uh, geez, it looks like I’m a mirror image here. I’m going to change my Android phone. See if, I don’t know if you guys are seeing the same thing I am. Um, if I’m, if I’m at the top border of the PSIS and the lower border of the ASI S it’s going to give me a false read, I need to be in a very consistent place. And that would be at the peak, you know, the central aspect of the PSIS and DSIS, um, and that’s gonna give me a sort of a more accurate measurement, but, um, that’s how you would measure it. But, you know, just looking at it, if you just look at that lower image, you can see that there’s a greater inclination forward, uh, anterior tilt of that bottom image.
So that was that way on both sides. And I would be thinking that the so as is in a locked short position, bilaterally polling, that’s fine into an excessive lordotic curve, taking the pelvis with it into an anterior tilt. Sometimes it looks like the person can’t fully stand up, picture them, seated, their hips flex. They go to stand up. And it’s like, as if they, that last few degrees of hip hip extension isn’t there, and they’re kind of held into hip flection and their spine tends to be a little bit more arch. This is the consensus with a shortening of the, so as at least bilaterally, uh, Tom Myers has an interesting perspective on it that I do kind of think there’s some merit to this, and he looks at the upper fibers versus the lower fibers. So when you remember back to those images were talking about the anatomy.
There is, it’s almost like six muscles, right from, from L five all the way to T 12. I did it as dissection at university of Tampa with a physician assistant group, um, where they’re there for the students, for the physician assistants. And I was helping lead this dice, the kind of group of dissections, and one of the specimens had really severe scoliosis in the spine and the lumbar spine almost became horizontal. And you could really see on that side, there’s six individual slips of the muscle as they were kind of widen that whole aspect of the psoas. And you’d see those each of those little slips going and attaching to the various side, um, attachment sites on the, on the spine. And with that spine orientation change to kind of widen the whole. So as, and, and almost gave that appearance of the six muscles.
So if you think of that, that way, those upper fibers, the ones that are accessible more laterally are the ones that go up higher, uh, on the, uh, on the, on the T 12 L one region, if those are shortened, like in that upper picture on the right, that might actually pull the spine more into a, uh, straighten kind of curve as if the person is on the floor doing trunk flection, like a curl, which the so as would be involved with, I would say that, that in that case, it’s more of the upper fibers, whereas the lower fibers in that bottom right image and kind of drawing, that’s really showing more of the lower fibers, pulling the spine into a hyperlordotic curve. I think this plays out quite a bit, especially when you get people whose pelvis has shifted forward and the rib cage has shifted back.
Sometimes those upper fibers are the more involved ones. So you can almost see the, so as, as being, uh, an antagonist of itself, you know, upper fibers versus lower fibers, this is not the norm, a normal view. This is not the consensus. This is an alternate view, but I kinda liked this view. And it kind of does give me some suggestions of how I work, especially with manual therapy, unilateral shortening, like we mentioned, is going to pull the spine into lateral flection to that side and contralateral rotation. When you’re looking at somebody, the umbilicus will look like it’s pointing away from the, the short. So as, so it’d be, that’s a, that’s a simple way of looking at it. You can kind of see the, uh, the umbilicus saying, you know, I’m pointing away from it that said the direction is pointing to would be more of the length.
And so as the, the direction is pointing away from would be the short. And so as there’s a lot of things that can involve that can affect the iliac. I mean, the umbilicus a position there could be scar tissue there. So I don’t take that too literally. That’s, um, it’s not an way, but you can sometimes come over the person and look down the spine and you can see that lumbar spine rotating one way or the other. So the side that’s more posterior is going to be the length and side. Um, in the side, that’s more anterior is going to be the shortened side. We’ll look at another way to, uh, to address this in a second.
All right. So we have a cadaver video coming up. I just want to remind people, who’ve seen some webinars where we have cadaver videos that these are, um, you know, it, shouldn’t be kind of viewed in public if you’re at Starbucks right now, and there’s somebody who can see your screen, maybe it’d be good to, to not watch this. Now, come back and watch it later. Just be mindful of your surroundings. This one, no faces are shown, but this one is pretty internal. And I think it could be disturbing for people who aren’t medical professionals of yourself. Do you find this stuff kind of disturbing, maybe don’t watch, but especially be mindful of your surroundings. Don’t take screenshots, don’t share these don’t record and share these videos. You know, we have to be really respectful for the donors. This is for medical professionals. Um, so just have that caveat when you’re watching it. And let’s go ahead and look at this. It’s going to show the, so as it’s going to show that QL and iliac is relationship and some movement.
So one last that aspect with the solo ads is we can look at the different fibers medial versus lateral, and how that relates to the lumbar spine. So if I look at these medial fibers, the medial fibers are going to be attaching to L five and L four and the lower portion, but the more lateral I go, the higher up the fibers become. So the fibers that are going up to T 12 L one upper portion are going to be the lateral fibers. And the ones that are going into the lower lumbar spine are going to be the medial fibers. So there’s some indications and some viewpoints on this that the medial fibers would be more involved with an anterior tilt and with lordosis, as they would be pulling the lumbar spine into a hyperlordosis hyperlordotic position, pulling the a L five L four L three lower portions into lordosis versus a posterior tilt where maybe the T 12 L one portion could be putting the, uh, lateral fibers and more upper fibers into a shortened position.
It’s not the common view, it’s just an alternate view, but interesting to think since the muscle is multiple slips, that this could be both involved in an anterior and posterior tilt, depending on which fibers you’re looking at, especially relevant for manual work, um, because we’re, we could highlight the different fibers. Last thing we can look at since we’ve talked about the quadratus lumborum is we get a good view of the quadratus. Lumborum now coming to the medial portion of the iliac crest and joining facially, at least the fascia has been taken off, but you can see the same fascial plane in through the iliacus. And then of course, down into the liver channel, as it travels and meets with the, uh, fascia of the abductors, as I go up from there, the diaphragm has been removed during the evisceration process, or at least disturbed, but we can appreciate that that same fascial plane then would blend into the cruise or the feed of the diaphragm from the upper fibers of the QL. And of course the so as itself would be a very, uh, integrated with the upper fibers of the diaphragm.
Actually, Alan, I think there was a, a little bit more of that video. I wonder if we can go back and slide forward a little bit, if we can’t do this, it’s no big deal instead of watching the whole thing. I don’t know if this can be a jumped up at the middle,
Okay. Yeah, no worries. No worries. Yeah, no worries. Okay. So let’s go to the next side that this one just shows some of the, like, kind of move the rib cage and you can see the, so as like side bending the spine, but I think we got a pretty good, pretty clear idea with that. Um, just by description. Uh, so this, uh, test here is, uh, lumbopelvic rhythm. This, we look more at for the urinary bladder, uh, channel relationships and new channel. It’s looking at the normal position where the lumbar spine moves in a one-to-one relationship with the nominate bone in the middle one. It’s showing that the innominate bone, um, is not moving so that you’re getting all, all movement in the lumbar spine, showing a restriction in the hamstrings, in the farthest, right. One, the nomina bone is moving, but the lumbar spine, not some more of that restriction in the urinary bladder sinew channel at the level of the lumbars.
Why am I showing it here? Because after we do this test, we can go to the next slide and we can have the person, uh, facing away from us and we can look at them from the back. And if you look at that image and I’ll let you look at it for a minute, um, from the back, can you see that one side is up higher? And by one side, I mean, the lumbar spine is up higher than the other side. So going back to that information of what the unilateral imbalance does at the, so as that Ray’s side is going to show us, show us the likely locked long inhibited. So as whereas the lock short, so as it’s going to be on this case, on the right side, which is pulling that accessibly into rotate rotation, or the left side is failing to support the spine, which is it, is this excess or deficient excess on the right deficient on the left, in relationship to each other, but on any given person, then we have to figure out, is this more about that excess more about the deficiency or both, but at least it’s telling us there’s an imbalance there.
So this lumbopelvic rhythm, great test for the urinary bladder, you a channel, but we can, uh, look at it from the back and get a window into the kidney sinew channel. So we have that left side showing that a relative length and position compared to the right side. And we can take that right into a manual muscle test manual muscle test of the psoas is having the hip and about 35 to 40 degrees. Fluxion that image is showing a little bit more than that. I think I put the wrong image in that. I noticed this just before we went live. Uh, this looks like the iliacus manual muscle test. So imagine that same position, but a little less hip flection. Yeah, yeah. About that angle of hip flection. So they look alike and I just grabbed the wrong one. But, um, so as manual muscle tests, everything else would be approximately the same, but it’s more of that 35 to 40 degrees of abduction flection, and then abduction to about 35 degrees driving UV 58 back towards the table.
So you’re taking them and slight AB duction, but really focusing on the extension and the so as it’s called onto to support that. So that is a manual muscle test of the so as you can do that immediately after the, um, seeing that, that sign, that, so as signed in the previous task store, you might do this on its own, but this is going to give you a window into how the so as is, are supporting the body. You have the person, you kind of give an initial load and as you over pressure, the, so as you’re seeing of that, so as fibers has enough cheese to lock on, we’ll talk about GB 27 in a second at top, probably we’ll close with, but you could also try even just putting a point in something like kidney seven and seeing if that wakes up, you might have to draw the needle back before you test and then retest and see if there’s a little bit more strength than the, so as kidney 27, we’ll definitely do it.
But, um, but you can also look for other points like kidney seven, kidney, three, kidney, six other channel points that might affect it. I’m not going to talk about 62 and [inaudible], that is a little bit longer of a discussion. Um, let’s go then to the next slide. So that goes into treatment. We have motor points that lie deep to UV 24 and UV 25. I’m not going to go in and into the needle technique for these because they involve a pretty deep needle technique that really takes some time to, to talk about, um, and we’ll allude to it, but it’s really something that needs to be spent a lot more time, uh, for safety reasons, but you can needle the, so as directly from the back, um, there’s these two motor points, they lied deep to a U B 24 and UV 25 physician is going into the next slide is through the back.
There’s a needle technique that kind of follows the edge of the, um, Leo Castelli’s lumborum muscle and goes along the lateral Rapha, right to the, the, so as, um, it’s safe if it’s done properly, but to go through all the details in such a quick, uh, class, like this would be a little bit irresponsible cause this one can cause damage. Cause it’s a fairly deep technique and there’s some, some complications, first thing going to reflect some spasm. You just have to be aware of some things before doing it. Um, this could be though useful for the excess side, particularly. So it is one of the, to consider learning at some point. Um, but the next one is going to affect the psoas actually quite well, especially for the, the locked long inhibited. So as, um, this is a technique that Matt, uh, came up with years, uh, years and years ago and as used and taught and a lot of people have used it quite successfully for a long time.
And this is using, uh, gallbladder 27. So with gallbladder 27, you’re angling it slightly lateral. And with like a slow sort of in and out, um, green turtle searching for the point, uh, noodle technique until you get either one of the following sensations, either wrapping back around the diamond, uh, wrapping down towards the liver channel towards the groin or following the stomach channel down the side of the leg, effecting either the lateral femoral cutaneous nerve down the stomach channel, the Elio hypergraph gastric nerve going towards the groin or the ilioinguinal nerve wrapping around. Um, maybe I think I have that back rail hypogastric wrapping around the DMI ilioinguinal wrapping to the groin, but it’s affecting one of those nerves from the lumbar plexus then, which is going to reflexively turn back the, so as on kind of stimulate that same neurology, cause it’s also in an innervated by that lumbar plexus and turn that so as back on, so it doesn’t have to be a strong sensation, but you need one of those three sensations and that will turn kind of calm down.
We’ll lock short. So as, but this technique really shines for the lock long inhibited size. Right. And I think I was wasn’t sure timing if we’d have time to show a manual technique, but, um, I think we have a little bit of time. It’s not real long, so let’s go ahead and go into that because I think this will bring it together. This is from a blog post. We just came out in October. Um, so it’s not sports medicine acupuncture. If you’re looking at this, um, webinar later on, um, it’s the October post. You don’t need to know that you can just find it, do a search warrant or find it, but it’s called working with SOS. Um, and it goes into this technique a little bit of setup, but then into this technique a little bit more in depth, uh, this technique is also on our YouTube channel, this video you’re about to see so you can access it there.
And if you wanted to review it later, um, or of course it’ll be in the recording for this class. So quick set up and then we’ll look at the video I’m working on both sides at the same time. It’s a very integrated technique. I’m going to do a movement that simulates walking. And then as simply I could say, I’m pinning down the cell ads and just letting that kind of free up each side, but really I can do more than that. I can kind of nudge, you know, maybe so as it’s really narrow and pulled medial, I can nudge it more wider. I can kind of work on those medial fibers and nudge it out a little bit. I can nudge the lighter side more, even more medial and kind of even that out that way. So, um, depending on which fibers are short, I can kind of affect it.
I can feel when I’m in there, that one, so is going to be much more medial and that’s going to be probably the last kind of short side and the way it kind of changes the orientation of that. So as the, um, other thing is when the person presses their foot move into, you’re going to see in a second and lifts the other foot, there’s sort of a down on the foot, they press, there’s sort of a downward movement and an upward movement on the foot they lift. And you can feel if those are even, and I can nudge it down or nudge it up. So I can kind of look for an even movement of the psoas. But what I’m really doing is using the SOA as its puppet strings to sort of mobilize and get an easement, even rotational movement in the lumbar spine and all the way through the pelvis. So simply I can just hold it down and kind of free, or I can influence movement. I can kind of mobilize in various directions. I kind of say this in the video, but I don’t think I go quite in as much detail. So let’s go and look at the video.
So we’re going to do it. So as technique, this one is going to be, um, working on both sides left and right at the same time, it’s very much of an integrative technique because we’re trying to sort of get an even tone between the two sides, but also an even movement. So let’s look at the movement aspect. First, the patient is going to slowly lift one foot up. At least they’re going to lift the weight up. They might not actually lift the foot off the table, but they’re going to start to bring the weight off that foot while they push the weight into the other foot. It’s like a walking motion. There you go. You don’t have to actually lift the foot up. It’s more about the pushing, but than it is about the, um, lifting foot. So they don’t have to literally lift it off the table.
There you go. Now decrease that movement by about 60, 50%. There you go. Yeah. So it’s a small movement. So she’s starting to do a movement. That’s very much like walking. So when I’m in working on the SOA, as at the time, I’ll be able to feel the movement that’s happening associated with the so as I’ll be able to feel the tone of the size, but also the rotation aspect that’s happening in the spine and through that area to the sacrum. So go ahead and relax. I’m going to find the ASI S going to start following the slope of the iliacus muscle, and we’ll be able to, to get down to the depth of the solo ads. So it’s like, you’re kind of going into a, um, a slope going medial, which will take you right to the iliopsoas. I can move a little bit, medial moving, any visceral or neurovascular tissue off to the side.
And now I feel like I’m at the depth of the size before she does the movement. I want her to lift and lift your left foot. Relax. I can just fine tune where I want my pressure and lift the left foot again. Here we go. Good. Now I’m right. The psoas on the left. And I go ahead and lift the right side, right side already feels like there’s a little bit more tone. Okay. So now I’m on the sides on either side. So start slowly doing that movement. It doesn’t have to be a big movement. It’s just about encouraging an alternating contraction with the as, and I can do two things. I can soften the right side, but I can also follow that rotation and help try to get an even movement to where it kind of sinks more easily on the left side, right side feels like it doesn’t want to go, but I can follow it into that movement And just wait for the tissue to sort of normalize and feel a little bit more similar between the two sides. There we go. Now it’s starting to move, starting to soften a little bit too. Okay. Definitely want to work respectfully with SOS because it’s very sensitive and you want to take your time and not bully through the tissue.
You might also, with this one, find that you work a little bit more on the medial aspect of the psoas and one side and the lateral aspect on the other, which I’m doing on the right side. I’m hooking into that medial aspect and helping bring it lateral.
One more time. That’s good. Okay. Now I’m just going to hold and just have her just do that movement a little bit. I’m not going to do so much this time just to let the body function normalized a little bit. Okay.
All right. So that is ed. Here are some references. If you want to go back and look at any of, of those, um, just from the presentation, but I think that is, uh, the presentation for today. If you wanted to look at that blog post, it goes into that last technique a little bit more in depth. Um, and like I said, hopefully by new year, we’ll have a three hour class, so we’ll be able to go through a little bit more of the needling and more, um, comprehensive. But I think hopefully this is something you can use right from the get-go. So, uh, Lorne Brown is going to be here next week. So tune in for that and thanks again to the American Acupuncture Council for having us and look forward to seeing you guys next time.