Sitting, Sex, and the Psoas (the p is silent). English is weird.

You may think this title is just some clickbait to get you here. Truthfully, it is not. Men's sexual health and erectile dysfunction affect a large population of men. The worldwide prevalence of erectile dysfunction is expected to increase to 322 million men by 2025, affecting 30 million American men.

The iliopsoas muscle and men’s health

I’m not saying that sitting is the primary cause of less-than-stellar sex life or erectile dysfunction. There are many variables to take into account – diet, exercise, stress – that can all affect men’s reproductive and sexual health.

I am going to be focusing on one overlooked piece of the puzzle: the iliopsoas muscle. This muscle is made up of two separate muscles that merge into one: the psoas and iliacus. Together, they connect your upper body to your lower body. Traveling from the vertebrae of your lower back, through your pelvis, and attaching to the femur, the iliopsoas is a neighbor to a lot of important real estate. From nerves and arteries to lymph nodes and organs, any issue with the iliopsoas affects these neighbors as well.

The iliopsoas is one of your hip flexors, and there’s even preliminary research that the volume (size) of the psoas plays a role in male sexual health. Bicep curls are out, leg lifts are in! Balanced bodies are healthy bodies; focus on functional muscles for men's health, not just the obvious eye candy.

Fight, flight, freeze

Think of this muscle as the fetal position muscle: It is strong, and it is meant to snap shut like a steel trap gluing your knees to your chest to shield your vital organs from an attack. This means that this muscle naturally holds tension when stressed, and when we add in 40+ weekly hours of sitting, this tension becomes chronic.

Sitting and sexual dysfunction

Humans did not evolve to sit at 90 degrees. Our hips evolved to sit in a deep squat comfortably (think pooping in the woods). Today, most people can't even get into that position! This lack of mobility can result in some pretty serious issues, ranging from breathing, digestion, and constipation to reproductive and sexual health problems. Without the daily full range of motion of squatting deep to relieve ourselves, the hip flexors stop moving correctly and they begin to tighten until they are chronically contracted. Your body is the master adapter: if you sit with your hips flexed at 90 degrees for 8 hours a day, five days a week, your body is going to make changes to help you continue to do so. Unfortunately, this adaptation causes issues in all other areas of life, from sleeping to sexy time.

How do hip flexors affect sex?

Our hips are meant to be both an endurance runner, an explosive athlete, to walk dozens of miles a day and then cozy on down for some hot and heavy hip thrusts. But as modern men, we lock our hips into a seated position until they become weak and immobile. Over time, this immobility leads to pain, pain leads to dysfunction, and dysfunction is the last thing you want on date night!

Ever watch a hula dancer? Those are some healthy and mobile hips! You know what they say: it's not about the size of the ship, it's the motion of the ocean. And many of our oceans are solidifying into concrete.

Too much sitting locks up the hip flexors, the diaphragm, and the pelvic floor: affecting sexual functioning and the ability to hip thrust. Think of your pelvic floor as a hammock supporting your organs from the bottom and your diaphragm as an umbrella on the top. With each passing breath, the pelvic floor and diaphragm gently move up and down. This gentle up and down movement stimulates blood flow, digestion, and everyday processes. When we sit in a chair with poor posture, this movement stops and we begin taking shorter, more shallow breaths. This shallow chest breathing sends a cascade of stress signals that something is wrong, further compounding tension in the body.

Sexual performance for men: it's all in the hips.

Probably the best line to come out of an Adam Sandler movie. So before you go down the road of little blue pills or chugging beet juice before the third date...

Two steps you can take to promote healthy hips and sexual performance

1. Apply pressure to your tight hip flexors and gluteus muscles
2. Stretch your hip flexors

No different than when someone massages your traps, and you melt into a puddle of bliss, the muscles surrounding your hips need the same treatment. Angry muscles relax under pressure. (This does not apply to an angry spouse: apologize and leave the room, slowly.)

Psoas release with prolonged pressure

Applying pressure to release the psoas and iliacus is tricky, and only possible with the right tool or a skilled practitioner. I recommend the Hip Release Ball, which has the right diameter and density to gently release the psoas. But if you really want to get in there, and release the psoas AND the iliacus (the entire iliopsoas muscle), you’ll need the Hip Hook.

The Hip Hook is a psoas release tool and iliacus release tool. It first releases the psoas through patented angular pressure. When you press down the handle, the Hip Hook pivots up into the iliacus muscle, providing the necessary prolonged (90 seconds) pressure for relaxation. This one tool effectively releases the long-standing tension held by your hip flexor, allowing for corrective exercises and stretches to have a much more lasting and therapeutic effect.

Once you have released the hip flexors, work the ball around the sides and back of your hips looking for tender spots. Once you have found an 'ouch', hold and breath on that spot for 90 seconds while your muscle relaxes around the ball. The usual suspects that get tight from sitting are the gluteus medius, obturator internus, quadratus lumborum, and piriformis muscles.

How to stretch your hip flexors

After applying prolonged pressure to the iliopsoas, now it's time to stretch! The lunge stretch is highly recommended because it stretches the iliopsoas, bringing circulation and length to that muscle.

Step one foot forward with your spine straight. You can do this stretch with your knee on or off the ground. With this stretch, it's important to engage your abdominal muscles, a light cough can achieve this, then contract your glutes by tucking your butt under you. This allows for the iliopsoas muscle to stretch fully over the joint while protecting your lower back from the psoas tugging on it while it's being stretched.

You should feel the stretch in the front of your hip joint or the front of your thigh. If you're not feeling it there or if you're feeling it in a different spot, then stop. You can experiment with bending your spine to the opposite side of the leg you're stretching to increase the psoas stretch.

To get lasting results from your hip flexor stretch, focus on using proper form and take generously deep breaths.

Hip flexor corrective exercises

The glute bridge is going to be THE exercise that keeps you on your A-game. This exercise stretches the hip flexors by activating the glute muscles. Sure, you're just humping the sky, but we all know practice makes perfect, so get on the floor and start hip thrusting at least once per day. A solid goal to work up to is a 3-minute glute bridge, holding at the top of the movement (hips off the ground) for 3 mins as well as 100 full reps. Build stronger glutes and stretch your hip flexors at the same time.

Evolutionarily speaking, men's hips are meant to thrust, ALOT. Unfortunately, it's usually when our partner is in the mood which is not enough to maintain healthy hips. Walk, thrust, walk some more and sit only when you have to. To reiterate the importance, PLEASE DO THIS EXERCISE.

To learn more about how your hip flexors affect your body – and your sex life – check out Christine Koth’s book Tight Hip Twisted Core. For complete psoas release and iliacus release, I recommend the Hip Hook, and the Hip Release Ball for addressing the back of the hips and glutes. Releasing both the psoas and iliacus are important for full range of motion, pelvic strength, and a lifetime of amazing sex.

FAQs about tight hip flexors and sexual health:

Can tight hips cause groin pain?

Yes, tight hip flexors (iliopsoas) can result in misalignment in the pelvis, this misalignment can manifest as pain throughout the pelvic and groin area.

Can sex cause low back pain?

Possibly. A tight hip flexor (iliopsoas) can pull on your low back causing pain and reduced range of motion in the pelvis.

Does flexibility affect sex?

Stretching and tension release activities can promote blood flow and lymphatic drainage to the pelvis thereby improving the health and function of the pelvic floor and sexual organs.