J9B – The following is the second part of a two–part article. It has 812 words and three photographs. Copyright permission is granted when used without alteration and bio is included.

Part II – The Treatments

Cyclists Can Prevent Low Back, Hip and Knee Pain

By Julie Donnelly, LMT

As mentioned in Part One, one of the quirks of a contracted iliopsoas is the way it interacts with the quadriceps muscle group. The shortened quadriceps are pulling the pelvis further down, increasing the pelvic tilt, and the pain, caused by the contracted iliopsoas. In order to release the pelvis properly you need to alternate between the iliopsoas stretch taught below, and then the quadriceps treatment and stretch, and then back to the iliopsoas again. Continue going back and forth between the two areas until you feel relief of your back pain, or until you feel as though the two muscle groups are completely free of spasms and the fibers are fully stretched.

Tight Hamstrings and iliotibial band (ITB)

While working with athletes through the years, I´ve found that the hamstrings can feel very tight, and there can be tension & burning at the bottom of the gluteal area as well as behind the knee. This feels tight to the touch, but simply stretching the muscle (through massage or stretching exercises) actually causes more pain. I describe the tension on the hamstrings, and the ITB, by using this analogy: if I hold the end of my hair, the hair is still limp and there is no pain. However, if I pull hard on the end of my hair, the hair now feels tight and my scalp hurts. The only reason the hair is taut is because it is being pulled. Likewise, in the case of the hamstrings and the ITB, they are only taut because they are being pulled. Treating the quadriceps and stretching the iliopsoas will rotate the pelvis back to its normal position and release the tension on the hamstrings and ITB.

Stretching the iliopsoas removes tension from your lumbar vertebra, pressure from the disks between each vertebra, and releases any impingement of the nerves that pass through the vertebra.

An effective stretch for the iliopsoas is possible when you hold your pelvis totally still and then lean back. The most important part of the stretch is to make sure that your hips don´t move or you lessen the effectiveness of the stretch. This is a small movement; you are only trying to stretch the area of the lumbar vertebra, from the top of your waistline to your rib, about the width of your palm if you put your pinky on your waistline. Only go to the point of a "feel good" stretch, not to the point of causing sharp pain.

To effectively stretch the iliopsoas stand up with your back to the kitchen sink, placing your butt on the front of the counter and your have your calves touching the cabinet below. Keep your face forward by bringing your chin down toward your chest and lean back over the sink, being careful not to move your hips or legs away from the counter/cabinet.

Go as far back as you can until you feel discomfort in your low back, then go ½" further to stretch the iliopsoas fibers. Slowly strand up straight and then repeat the stretch again. Do this ten times, ending with a forward stretch and moving your hips in a circular manner.

The second method of stretching the iliopsoas is very interesting because it stretches both the iliopsoas and the quadriceps at the same time!

Stand up and hold onto a fence, or other solid object (see image below). Bring your ankle back and hold it with your hand, drawing your bent knee to a level that is behind the standing knee. After you have held this for approximately 30 seconds, bend your body back so you are actually arching your back and rounding your abdominal area. You will be stretching the iliopsoas, and also stretching the quadriceps. Hold this stretch for another 30 seconds and repeat on your other side.

To complete this treatment you need to press out the spasms that are on the outside of your thighs. Simply take a length of dowel, and slide down the outside of your thigh from the very top of your leg to just before your knee joint (see image below). Don´t be surprised to find a bump, and a tender spot, midway down your thigh. This point is common when the iliopsoas is in spasm, and you cannot release one without releasing the other. Continue sliding the dowel down your thigh until you feel the bump release tension and the pain decrease.

Will it return again? Certainly the iliopsoas muscle is likely to shorten again as you continue cycling for a long periods again, but since you will know how to lengthen it, you won´t need to suffer, you´ll just need to stretch.

© 2002

Julie Donnelly is a licensed massage therapist specializing in the treatment of chronic pain and sports injuries. She has co–authored several self–treatment books, including "The Pain–Free Triathlete" and "Carpal Tunnel Syndrome–What You Don´t Know CAN Hurt You." She teaches Julstro self–treatment workshops nationwide and is a frequent presenter at Conventions and Seminars. Julie may be contacted through her website: www.julstro.com.