Supine or sitting
If you wish to palpate on the skin, provide a private room or a sheet for cover. If you think this is necessary, ask the patient if he/she is willing to uncover the abdomen. While the skin can not be viewed with clothes covering the area, the psoas major might be palpable over clothing.
Anterior to the patient for supine and posterior to the patient for sitting.
Please lie on your back (or sit leaning forward). May I touch your abdomen? (or point to the demonstrated area). While you breathe out several times, I am going to gently press my fingers deep in your abdomen to touch a muscle (or demonstrate). Now slightly lift your knee.
Guide the patient to lie on his/her back (or sit) with the hips and knees flexed and feet supported. With the patient relaxed and with permission, place your fingers near the lateral edge of the rectus abdominis. As the patient exhales, gradually press your fingers posteriorly and medially toward the psoas major. You will be palpating the psoas major through the intestines. Ask the patient to ever so slightly lift the knee to activate the psoas major and without activating the rectus abdominis.
If the patient sits, stand posteriorly to the patient and reach around the trunk for the same finger placement and procedure.
If the patient sits, stand posteriorly to the patient and reach around the trunk for the same finger placement and procedure.
VH - Psoas major