Hidden Prankster Sufferer

by Jonarona
(United Kingdom)

I think that I have this "hidden prankster" syndrome. I have suffered back pain for many many years.

I have tried Pilates but some of the exercises made me worse. The teacher assumed I was not doing them correctly or not bothering at all. I bought the “Lose the Back Pain" program. Some of those exercises helped, but I believe that the stretches were held too long and it caused my muscles to spasm even more.

I’ve had facet joint injections which helped a bit. But they did nothing for the hip and groin pain and the pain in the gluteal muscle that then radiates down the IT Band. What a mess.

I’ve spent so much money and time and even became depressed because I couldn’t ski or play tennis. I have found a good chiropractor and soft tissue therapist.

But when I get the release treatment for psoas and iliacus (very uncomfortable) the pain comes back after 2 days. They are very confused as to why.

Any suggestions?


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Mar 23, 2012
Iliopsoas Syndrome as the Hidden Prankster
by: Stephen from Lower Back Pain Answers

Hi Jonarona,

Sorry to hear you’re in so much discomfort. It does sound like Iliopsoas Syndrome, "the Hidden Prankster," may well be the main problem.

What jumped out at me from what you described above is this:

The fact that when the iliacus and psoas are treated by your therapists that it’s “very uncomfortable.” This is a common mistake in treating, not only this type of problem, but many soft tissue problems.

The optimal pressure to release these muscles should be well within your comfort zone. It’s not a matter of “I can take it as long as it helps.”

Your body’s neurological system has its own rules. In my 22 years of treating soft tissue problems I have found that the fastest, most efficient, most long-lasting way to treat muscles that are in spasm is to use a “less is more” strategy.

That means…

Enough pressure to make “good contact” with the muscle but not enough so that your body braces during the therapy. You may think, “Well, I try not to brace.” But it’s not your job to have to “try not to brace.” It’s the therapist's job to use a gentler pressure.

This may be a MUCH lighter pressure than the therapist is used to applying. And it takes longer to treat muscles in this way. But I assure you it’s ultimately a MUCH faster strategy because you can make lasting progress instead of, as you say, "the pain coming back after 2 days."

Moreover, the muscles wrapping around to your IT Band and gluteals may all need to be treated in this way. That means very specific and detailed, but quite gradual and gentle treatment of these muscles.

I go into some detail about this way of working here…

Treatment Using Neuromuscular Therapy

And here…

Trigger Point Massage Therapy

Last, it’s possible that the antagonist muscle of the iliacus and psoas — namely the gluteus maximus — may not be firing.

In other words, it may have lost its capacity to contract normally. If so, then there’s nothing to counter-balance the iliacus and psoas. These two muscles, then, easily regain their anchor-hold of tightness.

The solution would be to do some toning and strengthening for the gluteus maximus (I hope to have have a video series for this soon), but not before the soft tissue work is done for that and the other gluteal muscles if they are still in spasm.

Attempting to strengthen/tone a muscle that’s in spasm will only serve to aggravate the muscle.

If you would be willing, I would greatly appreciate your sharing in more detail what the “Lose the Back Pain” program is having you do. What you found useful and what you didn’t.

I hope that helps!


Stephen at LBPA

PS I moved your post to the Iliopsoas Syndrome Forum.

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Stephen O'Dwyer, cnmt

Neuromuscular Therapist & Pain Relief Researcher

Stephen O'Dwyer, CNMT


Lower Back Pain Answers

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