The Psoas: Connecting Tight Hip Flexors, Sitting All Day, and Menstrual Cramps

Why Sitting Impacts your Psoas and your PMS

I first had an ah-ha moment a few months ago, when it occurred to me that sitting all day in my chair at work might be having an impact on my menstrual cramps, and more generally, on the health of my reproductive organs and pelvic area.

That ah-ha moment was based on these three thoughts:

  • I do lots of activities that make my hip flexors feel tight, like: sitting for much of the day at work, cycling, lots of walking, squats/ab crunches, and sleeping in the fetal position.
  • The pelvis/abdomen area really isn’t very big and it has A LOT of key organs for health, including those for digestion (stomach, liver, pancreas, bowels), reproductive health (uterus, ovaries), elimination (kidneys, bladder), and stress/energy (adrenals).
  • Every time I sit (or do one of those hip flexor contracting activities mentioned above), the pelvic area is being compressed. It just made intuitive sense to me that long-term compression would have an impact on my body, including on my uterus (if I’m cramping an area that already has cramps, have I doubled the cramps?). At times it felt like I could FEEL the tight hip flexors making things feel worse.

So I decided to google it and what a fascinating result! A few other people have made this link (apparently the light bulb turned on a lot earlier for them), and it was nice to read different confirmations of something that made intuitive sense to me: namely, that tight or imbalanced hip flexors impact menstrual cramps and overall pelvic health.

The Psoas Also Impacts Digestion and Energy 

What I also discovered is that imbalanced hip flexors (or, psoas muscles) can impact digestion and energy levels too, which I find particularly fascinating because those are two areas that are very often linked to PMS. Bloating, constipation, fatigue, exhaustion – how many of us would raise our hands to having those as part of menstruation?

So I got all excited about the psoas connection and dove into some research, and now I want to share that with you.

Really, it’s yet another example of how things in the body are INTERCONNECTED – our muscles, cells, tissues, nerves, emotions, thoughts, and hormones are all constantly interacting and impacting each other. That’s why a MIND-BODY-SPIRIT approach is so important to addressing health concerns.

Let’s Talk About the Psoas

What we call the hip flexor is actually best defined as the Psoas (pronounced “so-as”) muscle, and there are two of them, one on each side of your body – the only muscles that connect your spine to your legs. They are located deep in your core, winding through the pelvic region, and one article described them as a pendulum, “synchronizing the free swinging of the leg when walking.

The psoas keep you upright, help to stabilize your spine, and help you engage in all the interesting 3-D movements your body can make – lifting your knees up towards your chest (fetal position), bending over to pick something up, moving your legs out behind you in yoga or ballet.

The psoas contract and they lengthen. They’re also a bit flexible, to allow for twisting, curling, and bending.

What Do the Psoas Do?

We often think of muscle as the strength of our body – the part that allows us pick things up and purchase a ticket (or two) to the gun show. My reading on the psoas helped me think of it as much more than that. Here are some of the psoas’s many functions and roles:

  • Structural

The psoas connect the spine to the legs, and are located behind the abdominal muscles, nearby and surrounding the digestive and reproductive organs, as well as arteries, veins, and nerves. The psoas also:

  • Create a “muscular shelf” that your kidneys and adrenals rest on
  • Are defined as a muscle but perhaps better thought of as a “sensitive and responsive tissue
  • Are a “messenger of the central nervous system
  • Surround or lie connected to nerves from your reproductive organs
  • Can impact digestion and bladder functioning
  • Impact your pelvic health in terms of the TILT of your pelvis – tight hip flexors can pull on your pelvis and impact its alignment. This has ramifications for your posture and your back, but also for your cramps. If the uterus isn’t in its optimal position, it needs to work harder to empty its lining, leading to additional menstrual cramping
  • Stress, Energy & Psychological Well-Being

The psoas are part of your body’s stress response!  Physically, of course, they play a role because when “fight or flight” kicks in (also called the sympathetic nervous system, this system is designed to get you ready to run – it sends blood to your muscles, but shuts down digestion, tissue repair, reproduction – all tasks deemed non-essential for survival), you need to be physically able to punch, kick, or run, and you need your psoas for that, to allow for those possible motions. Your body tenses to enable you to spring into motion. But if you consider the full implication of that, you understand that every time you feel stress and that system kicks in, your psoas respond, typically by contracting.

More stress = more activated sympathetic nervous system = more contracted and tight psoas.

There may also be a negative feedback cycle – stress leads to the contraction of the psoas, and a chronically contracted psoas might also lead the body to think that it is stressed, bringing along the host of issues (adrenal fatigue, exhaustion, hormonal imbalance) that come with chronic stress.

  • Breathing

The psoas play a role in breathing – they are connected to ligaments that then connect to the diaphragm; they also connect to the hip muscles through fascia that then connect to the diaphragm. That’s two touchpoints to the diaphragm. So when you breathe, the psoas are part of the process. If the psoas are tight, it could limit range of motion resulting in more shallow breathing, which in turn has its own impacts on energy and stress (shallow breathing is linked to anxiety, for example, while deep breathing helps with relaxation).

  • Circulation & Nerve Health 

Circulation to the organs in the pelvis is pretty important and some articles noted that the nerves of the reproductive organs are embedded throughout and around the psoas muscle. A tight muscle can impact those nerves. Considering that healthy blood flow is critical for all tissue health, but particularly important for that region (think pleasure, orgasms, sexual vitality, etc), suddenly this seems particularly noteworthy. The psoas also impact circulation to the legs and feet, since we generally want unobstructed blood from from heart all the way down to toes and they lie smack dab in the middle of that journey.

  • Emotional

Our nervous system responds to emotional stress just like any other stress, as do our adrenals. Given that the psoas links to both the nervous system and the stress system, it makes sense that the psoas would be “intimately connected with our emotional state.” For many of us, that emotional state is chronically stressed. In yoga, the hip area is also thought of as the place where we keep stored emotions. This might because…

  • Sacral Chakra

Tight hips have a chakral meaning as well! I really like learning about the Chakras (it’s a holistic spiritual concept that I really enjoy, linking energy and emotions to the body and spirituality) and the psoas are part of the Sacral Chakra. Located in the lower pelvis, the Sacral Chakra is an energy centre that links to sexuality, desire, pleasure, fertility, creativity, and zest for life. The tasks of the Sacral Chakra include allowing for emotional and sensual movement in our life, being open to pleasure, and learning how to “go with the flow.” As one article states, “a relaxed psoas is the mark of play and creative expression.

Doesn’t this sound like the opposite of cramps, tights hips, and sitting all day?

How Can You Tell If Your Psoas is Out of Balance?

Given their functions in the body, and their important physical and emotional connections, imbalanced psoas muscles have been linked to:

  • menstrual cramps, or other pelvic organ issues
  • knee pain, back pain, pelvis pain, hip pain, knee pain, ankle pain
  • posture problems
  • difficulty with bowel movements or constipation, or other digestive issues
  • shallow chest breathing
  • fatigue and exhaustion
  • poor circulation or nerve issues

What Contributes to Psoas Imbalance?

The biggest contributors to tightness are typically things that result in the psoas muscle being contracted for longs periods of time. For example, consider sitting in a chair: the ends of the psoas are brought closer together meaning they’re in a contracted position for (typically) a long period of time. They end up shortening.

We do/experience lots of things that contribute to psoas contraction/imbalance, such as:

  • sitting for long periods of time
  • sitting in chairs where your legs are higher than your hips (i.e. bean bag chairs or deep lounge chairs, or, quite frankly, many office chairs)
  • sleeping in the fetal position (I definitely do this, especially in winter when it’s cold)
  • lots of crunches or situps (again, that contraction)
  • activities that tend to shorten and contract the muscle, like lots of running, walking, horse-back riding, cycling
  • trauma (as in a car accident or sudden braking)
  • dehydration (tissues and muscles including the psoas require lots of water for cellular health and flexibility)
  • wearing heels all of the time (tips your pelvis out of alignment)
  • continual or chronic stress, which activates the “fight or flight” sympathetic nervous system

For Psoas Relief, try Constructive Rest Pose

I’m not a massage therapist or physiotherapist, but my reading suggests that psoas muscles can EITHER be:

  • tight and in need of stretching, or,
  • overstretched and in need of strengthening

The remedy for each might differ. I’ve focussed thus far on tight, so please do a bit of additional research if you suspect overstretched is your situation.

That said, all of my research points to the Constructive Rest Pose as being the ultimate psoas replenisher, regardless of whether your psoas is tight or overstretched. It looks really simple – basically lying on the ground with your knees bent for 10 to 20 minutes – but the idea is that it lets gravity help release tension from your psoas muscles. Here is an excellent video demonstrating how to use Constructive Rest Pose to release your tight muscles. This awesome article also has a great description of how to do Constructive Rest Pose, along with more excellent psoas information.


To Sum It Up:

I subscribe to science and evidence-based nutrition and lifestyle choices, but I also believe that there is validity in the lived experience of being in MY body, and sometimes as part of that, certain things just make intuitive sense to me. The connection between the psoas muscle and menstrual cramps (and indeed, the other physiological and emotional angles too) is one of those things. When I think about it, it just clicks.

If any of what I’m describing seems like it calls to you, try incorporating some of these practices into your day/evening, particularly around the time of your period. Perhaps combine Constructive Rest Pose with some reading, relaxation, meditation, or even a castor oil pack to help with your menstrual cycle, and let it help you manage stress at the same time.

And of course, continue to nourish your body and mind and hormones in all the usual ways: eating a whole foods diet, building pleasure and joy into your daily experience, drinking lots of water, getting lots of sleep, and moving your body on a regular basis.

For Further Psoas Reading – A Collection of the Best Articles I Found During my Research:

© Emily Joldersma, R.H.N. Eat Well, Live Vibrantly

Looking for more ways to be vibrant and healthy? Grab a free copy of my e-book here. It’s all about easy daily actions for clear skin, balanced hormones, and vibrant living.


6 responses to “The Psoas: Connecting Tight Hip Flexors, Sitting All Day, and Menstrual Cramps”

  1. I knew my ‘constipation’ was mechanical but couldn’t figure out what was specifically happening. I came across Psoas info before. Thanks for such an in depth article because it addresses every single problem I’m having. I’m going to try these suggestions. THANK YOU SO MUCH.


  2. Will strengthening my psoas help keep them from being tight… or is stretching the only option? I also have a question that may or may not be related to my tight hip flexors. I am fourteen but have yet to get my period and was wondering if having tight psoas might be the problem. I am pretty much fully developed and had stopped getting discharge for a year and a half or so, but when I did some stretches and strengthening exercises for my psoas, I could swear I noticed a little more discharge. Is that a possibility that my psoas could be affecting my period, or is it something else (I also have digestive issues)?


    • Hi Elise! Thanks so much for your question. I’m not a psoas-expert or a chiropractor or physical therapist, but my understanding is that while strengthening your psoas is great, stretching might also be required to keep the psoas from being tight, since lots of things we do contribute to tightness – like sitting, sleeping in the fetal position, even certain workout moves. So yes, in addition to strengthening, I think stretching is probably required (unless your psoas are overstretched, which is a different situation – you might need an actual physiotherapist to check if you aren’t certain if you psoas are weak or overstretched). I can’t give you personal nutrition and health advice in an online comment like this, and without knowing more about your health history it’s difficult to say what might be behind the fact that you haven’t gotten your period yet. I think there can be lots of reasons why it might not have have arrived yet – it can depend on your family history, athletics, hormone health, and more. I haven’t seen information suggesting that a tight psaos might delay your period from happening in the first place; that said, if you feel like your stretches and strengthening are helping, there’s definitely no harm in continuing to support your body in that way.


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