Very good points. For most psoas (and other areas) issues, I don’t feel that movement exercise can truly resolve the restriction if injury, trauma, or postural patterning has set the tightness firmly in place. I think of the restriction as scar tissue, holding on with physiological changes in tissue make up.

Your image of the whisper is an apt one. Stability with choice is what we are seeking.

I have had many clients who benefit from Pilates. I believe it comes down to not putting everyone in the same box. Whether it is cookbook-style core strengthening from physical therapy or Pilates, without an understanding of an individual’s specific needs and impairments, it can be a recipe for disaster.

Maintaining a fixed posture of hip flexion, when preexisting psoas region dysfunction exists, can really be a problem. If I have a client who is doing either core work or Pilates, I will demonstrate what the danger poses/exercises are, educated them on why, and encourage them to back off or eliminate those exercises for the present time until we lengthen the region, or at a minimum to stress elongation of the anterior spine and hip following any type of this work. More often than not they have already begun to suspect that certain postures increase their pain, so they are usually willing to alter their routine.

look forward to your response
Antonia

I give the majority of my patients a simple home psoas stretch. Not terribly painful when I select which of the stretches suits them best, based on their tightness and pain level. (This and other stretches are available on the Archives page of my website for you to download). I have found, though, that unless I start the process of releasing the psoas, etc in session, the home self stretching is less effective.

The Low Dose Naltrexone website has a large amount of information on the benefits of this medication and the disorders with which it is effective, with the science to back it up. Unlike some of the unsubstantiated claims that are made on behalf of some supplements and herbal therapies, the influence that naltrexone, in low doses, has on the body has been proven.

Medication can mask symptoms, or it can make a change in the physiology to elicit changes. The choice is often not left to the patient, but is usually up te the physician. They may or may not be aware of newer advances in medications such as this one, which need to be compounded from stronger doses and are not available from the average pharmacy. More importantly, this medication has been in the generic realm for years (very little profit for the drug companies), so the normal push from commercial interests is absent. No profits made equates to no advertising, which means little public awareness.