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Learn the secrets of the all important ‘hip flexors’

Hip flexors/psoas

You may or may not be an active person, it still affects you, young as well as old people.
These muscles need to be in good condition, otherwise you may suffer a number of common health problems. They are a direct link between your upper body and your legs and are at the centre of your body’s movement. They are very important in a number of ways and they are involved in most activities of daily living - when you sit down doing very little as well as when you do exercise or hard physical work.
It has a lot to do with posture and it is a big player in stabilising the spine and the hips. It is also involved when bending the hip to bring the knee forwards or towards the chest.
The hip flexors consist of the iliopsoas (psoas major and psoas minor)
and the iliacus. The psoas attach to the vertebrae of the lower spine and the thighbone (femur) close to the groin at the other end.
Weak, overused or short:
An all too familiar problem is sitting. Many people sit most of the day and we all know this is not good for us. Even many athletes and people doing regular exercise sit too much. Sitting cause weakness, shortening and may develop into tightness in the psoas muscle, affecting posture, causing pain and even contribute to stress, tension and poor sleep.
Excessive walking, running or too many sit-ups can also negatively affect this muscle.
A tight/short psoas muscle can cause the lower back to arch and thereby pushing the belly forwards. A big belly is not necessarily due to weak abdominal muscles. A strong psoas can significantly affect your appearance. A tight psoas cause misalignment of your spine and your pelvis, often being one of the main reasons for back problems such as herniated discs. This muscle can also affect blood flow and nerve signals through your back, pelvis and hips. It is closely linked to the central nervous system.
So by now we have established that this is a very important muscle in many respects. Fortunately it is possible to do something about a problematic psoas. However it is important that you seek professional help to find out whether the psoas is tight and needs releasing through treatment and stretching, or if it is weak and needs strengthening. Stretching a weak psoas may cause more symptoms than it cures.
Common symptoms caused by a problematic psoas muscle:
• Back pain
• Pain in the buttock
• Groin pain
• Leg pain
• Leg length difference
• Poor posture with increased arch in the lower back
• Pain in the genital area
• Stomach and intestine issues
• Cramps
• Poor sleep
• Affected breathing pattern
• General tiredness
• ‘Bulging Belly’
A few clues:
✓ Don’t sit too much or for long periods
✓ Sit correctly, support your back
✓ Exercise correctly and to a level that suits you
✓ Stretches (dynamic stretching often gives better results)
✓ Professional treatment
✓ Reduce stress
Many years of practicing and instructing Active Release Techniques have given us the ability to treat these muscles very specifically. Sometimes home exercises is not enough to solve the issues you may have, so it is very important to have your body assessed thoroughly first. Based on the findings we can recommend a treatment plan and give you advice on what you can do yourself.

Inflammation: Friend OR Enemy?

Fire is one of man’s greatest tools. It can power large factories as well as keeping our homes warm. At the same time if it is out of control it can burn down thousands of acres of a forest in a day. A small spark inside a house can cause an electrical fire that can destroy an entire home instantly. Inflammation like fire can be very useful in certain situations but detrimental in others.

The process of inflammation is the first and greatest defence of our body. When we hear the term inflammation we usually think that there is a problem in our body. But we miss the fact that the inflammation itself is not the problem, but normally the solution to a problem that has preceded it.

“In a healthy situation, inflammation serves as a good friend to our body,” says Mansour Mohamadzadeh, PhD, director of the Center for Inflammation and Mucosal Immunology at the University of Florida.
“But if immune cells start to overreact, that inflammation can be totally directed against us.”


When the body tissue is injured the immune system begins a response in order to manage the damage. Substances called prostaglandins are released causing the blood vessels in the area to dilate. This allows neutrophils to reach the wound and ‘clean up’ the area while platelets clot the wound site. It also allows for macrophages - another immune cell - to rush the area and release growth factors that help to heal the injured tissues.

This response is crucial to the healing process. However much of the advice we hear regarding treating injuries aims to quell the inflammation which is necessary for the healing. Non-steroidal anti-inflammatory drugs (NSAIDS) halt the release of prostaglandins, diminishing the body’s ability to activate the cells required that heal the area of injury. Additionally they inhibit the synthesis of proteoglycans, a substance required to repair the connective tissue of our ligaments and tendons.
Another commonly prescribed treatment of acute injuries known as R.I.C.E (Rest, ice, compression and elevation). Aims to decrease inflammation, effectively halting the healing process. Even Dr. Gabe Mirkin, the inventor of the R.I.C.E prescription, has called into question the efficacy of this treatment stating that “it now appears that both ice and complete rest may delay healing instead of helping”.
Ice decreases the blood flow to the area, disabling the transport of required immune cells into the damaged tissue. It also decreases the release of growth factors required for healing. Tissues that already have low blood supply, such as ligaments, are particularly affected by this further decrease in blood flow. Ligament injuries that have failed to heal completely are often the root cause of chronic pain in many joints, including the ankles, knees, low back, neck and shoulders.

Let’s look at the benefits of a healthy inflammatory response:

  1. It’s the body’s healthy response to outside threats like stress, infections or toxic chemicals.
  2. It helps in protecting a wound or fighting off an illness. The swelling, redness and warmth are signs that your immune system is sending white blood cells, immune cell-stimulating growth factors and nutrients to heal the affected areas.
  3. It prepares you for battle. Your body releases C-reactive proteins in response to inflammation. This is a natural part of your body’s biological “fight or flight” response to stress.
  4. Inflammation is necessary for healing.

However chronic and unchecked inflammation can cause:

  1. Damage to your joints.
  2. Damage to your gut lining which causes good nutrients to escape the blood and allowing pathogens to invade.
  3. Higher risk of depression.
  4. Difficulty losing weight.
  5. Higher risk of heart disease.
  6. Increased risk of cancer.

What can we do to prevent your body’s greatest defense from becoming your body’s greatest enemy?

  1. Help your immune system to work properly by taking a vitamin D supplement.
  2. Make sure that your nervous system is working optimally. (Contact us in order to schedule for a Neuro-Structual Examination)
  3. Remove any foods that cause an inflammatory response, e.g gluten and dairy.
  4. Get 7-9 hours of sleep every night.
  5. Our bodies are designed for moving. Make sure to get 20-30 minutes of daily exercise.
  6. And finally but not least; Do not stress!

When pain just doesn’t go away

Most people come to us because they are in pain. Pain has that function, to move us to do something about whatever it is that might be damaging to our body. And most times we can help and things get back to normal again.

What we also know about pain, is that it is not that easy. If the cause of pain is a door that is squeezing your fingers or a nail that you happen to step on, normally, yes. The pain is quite straight forward; potential or actual damage – I get out of the situation – I, the body itself or some health professional help heal it – pain disappears.

But what about the man that came into the clinic in Australia with excruciating pain in his foot where the nail he had stepped on came out from under his boot and through the top of his foot. He was desperate and had unbearable pain as he came into the emergency room. As they cut the boot open, they saw that the nail had gone through between two of his toes and not done any tissue damage whatsoever!

Then what is pain? Real enough, for sure! For this man, he was in a terrible state of pain, that was real and not imagined.

A common definition of pain says:

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (1).

This definition covers the understanding that it is a sensory and emotional experience (like for the man seeing the nail though the top of his foot, imagine that fear!), and it is associated with an actual or POTENTIAL tissue damage (seeing that nail though his boot as a very potential damage, and the pain signals firing at full alarm in his body).

Understanding pain is a complex thing. That´s why we have investigated and done research and work on it for decades and decades, and that despite of all pain clinics worldwide we have not been able to find The Solution to get people completely out of pain.

So, as in every situation, the question is, what do we know, and what can we do something about in the complex problem of persisting pain?

One thing do we now know; Understanding the mechanisms of pain can help reduce it!



Whenever there is an unpleasant stimulus to the body (like the nail through the foot or a hand too close to a candle), we call these signals noxious, and they are picked up by sensors called nociceptors. The nociceptors are programmed to pick up signals of physical, chemical or temperature stressors. These sensors then send the signals through the nerves to the spinal cord.

Remember, these signals will come if you are on the verge of getting your hand burnt just as well as if you have an actual burn. Potential damage sends the same signals as actual damage. Which is useful, because that gives you the opportunity to consider whether keeping your hand over that candle or doing something about it.

Now, the spinal cord is an exciting place when it comes to the mechanism of pain.


Dr. Greg Lehman is a kinesiologist, chiropractor, physiotherapist and a researcher in the field of pain and biomechanics for more than 20 years, and he gives the example of the spinal cord as the secretary of the boss (the brain).

She gets a call in (pain/nociceptive signal) and can choose on previous experience whether to pass the “call” up to the boss, or to turn it down. The boss can have told the secretary that certain calls are not important (also based on past experience as well as other considerations), and the signal does not reach the brain, it stays in the spinal cord.

Which means we will not feel the pain, we can only feel it when it reaches the brain. Hereby the expression: The pain is in the brain.

Now, what can happen is that the assistant gets a little excited, or perhaps stressed, and she can make some mistakes.

If the boss has given the instruction that all calls are equally important, she might confuse the different signals. “Calls” from the line that informs about touch can be confused with those of pain (like the man with the nail, he probably felt the touch of the nail between his toes), just as well as those that tell about movement of a joint or of pressure. So now instead of just feeling touch or pressure, we feel pain, because that is the information that the brain gets!


Alarms are meant to make us do something. And that is ultimately why we have pain. It’s a way the body moves us to take action.

When your hand gets near a fire you will feel pain and will move your hand away from the fire. The alarm comes on and tries to protect you.

If you sprain your ankle you will feel pain when you move it. Initially, the alarm is pretty good and it tells us to minimize walking or heavy loading on the ankle while it starts to heal.

The long term pain alarm is not a very good alarm.  Meaning it is disconnected from the initial problem.  Alarms don’t tell us how much smoke there is nor do they tell us if there is even a fire.  A smoke alarm can even go off when there is no smoke. 

Our pain alarm can work the same way.  The fire can have been put out but the alarm is still going off.

And when we have pain for a long time we can even increase the sensitivity of the alarm. So movement, pressure or temperature change can reach the brain in the form of pain (like our secretary confusing the “calls” she receives from different senses or signals and passes them all up to the boss as dangerous/important pain signals to act upon).


The brain makes the decision on what to do with the alarm (nociception/pain signals). It will do that – mostly subconsciously – based on previous experience and on knowledge, but also on expectations (“I always get neck pain when we drive over speed bumps”), beliefs (“My disc will slip out if I don’t hold my spine stiff”) and attitudes (“All things pass, I´ll get through this one as well”).

Based on the total decision, the brain will send inhibiting, calming instruction to the body (the muscles relax, less stress hormones are produced, back-to-normal body functions) or exciting, alarming instruction to stay alert and on guard (tensing muscles, increasing heart beats, more adrenaline, less energy to everyday body functions like digestion and more).

The same nociception, pain signal, can therefore have a completely different outcome on how much we actually feel that pain.

This does not mean that when we feel pain, we are just exaggerating, or we just imagine it. The alarm is going off, the nociceptive signals are firing – it IS painful! The question is if there is anything we can do when it seems clear that there is no mechanical reason for this persisting pain (after having been examined sufficiently to discard that).

The great answer is yes, we are multidimentional, so is pain, and therefore we can use various ways to calm down these signals when they have started to fire away on their own.



Pain is an alarm that might have been disconnected from its inicial source of damage but is still firing off.

How we understand pain can influence how strong it will be.




In my next article I will discuss more about what happens with a body that is in persistent pain and different ways to deal with pain that is disconnected from actual damage.

Key sources:

5 Steps to Improve your Immunity



Find yourself getting frequent colds? Your immune system may not be functioning as it´s supposed to

A well functioning immune system is necessary for optimal health. But how do you get one? Follow these recommendations to aid your body fight off the bugs and make room for health.

1.Take probiotics. Probiotics are the good bacteria that go into the digestive system and aid in the digestion of food. Research has linked the strength of the immune system to the quantity of good bacteria inside the stomach. Good sources are yogurt, fermented vegetables (miso, sauerkraut) and fermented tea (kombucha).

2. Avoid sugary foods. Sugar is an anti-nutrient. I am talking about the refined simple sugars that contain no nutrients and, upon entering the body, take nutrients away from the body’s storage in order to be metabolized. Once these storehouses are depleted, further weakening our body and making our immune system face an even greater challenge in fighting off colds and flus.

3. Get nervous system checked. Your nervous system (brain and spinal cord) controls every cell, tissue, organ, and organ system within your body. The key here is to be sure that your spine is in its proper alignment so it can send out correct and unhindered signals to the rest of your body. See your chiropractor today!

4. DON’T let stress get to you. The more stress you subject yourself to, the weaker your immune system becomes. When our body is under stress we produce more cortisol, which is a stress hormone that increases blood pressure and blood sugar leading to a weakened immune system. Perhaps stress-relieving techniques such as meditation, yoga and exercise is something you want to try ?

5. Take Vitamin D3 supplement. The «sunshine vitamin» is necessary to switch on the genes that activate the immune response. The primary source is sun exposure which very few of us get enough of, especially since sunscreen blocks it out. Many foods rich in Vitamin D aren´t very common in the typical modern diet, like fish liver oil, beef liver and egg yolks.

Healthy New Year!


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Edificio Palatino 2
03581 Albir, Alicante

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