Lower back pain and the QL
Another common cause for lower back pain is an unhappy Quadratus Lumborum ( QL ) muscle.
Let’s take a look at why and how this happens and what you can do to balance the body to releive any lower back pain.
The quadratus lumborum muscle, informally called the QL, is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each muscle of the pair is an irregular quadrilateral in shape, hence the name.
The quadratus lumborum muscles originate from the wings of the ilium; their insertions are on the transverse processes of the upper four lumbar vertebrae plus the lower posterior border of the twelfth rib. Contraction of one of the pair of muscles causes lateral flexion of the lumbar spine, elevation of the pelvis, or both. Contraction of both causes extension of the lumbar spine
The deep QL muscle.
There are a variety of reasons as to why this muscle can become a problem. Thinking about it’s location in the body, what it attaches to and it’s ‘job’, it’s easy to see why we run into problems if this muscle in particular goes into spasm, is too short or has trigger points. More on trigger points later.
Prolonged sitting, especially with poor posture where our core muscles are too weak causes the QL to do more work than it should do and becomes short and tight. Picture sitting in a modern western chair with a rounded low back.
We are generally looking to keep the natural curvature of the spine in seated positions.
Most people i work with initially are too tight in thier lumbar region, not strong enough in thier core ( the deep spinal muscles ) and short in thier hip flexors. This along with other muscular dysfunction leads to imbalances that over time cause the QL and other posterior lumbar muscles to become short, tight and dysfunctional in nature.
If you have a dominanat sided sport or activity, over time this can lead to these imbalances becoming stronger and then we can start to see deeper imbalances in the hip where the body can become twisted and rotated. Pelvic distortion.
You will know when the QL could be the culprit as there will tend to be this kind of twist and rotation in the pelvis as the QL is in a shortened state, pulling, lifting and twisting from the Ilium.
I suffered from this for many years back in my competetive sports days and was extremely painful at times.
It will be difficult to stand up straight, there will be a very deep painfull dull ache from the one side of the lower lumbar region and beding forward ( if the muscle is in a very shortened state ) will feel impossible. Think of leaning forward at the kitchen sink.
When seeing students or myself at times in the past in a mirror you can see the extent of the dysfunction by looking in the mirror. You will look very lopsided.
Relief will only usuallly come from lying on the floor on your back or leaning forward on something to support you. Basically where the muscle is inactive.
Depending on how actue the injury is, walking, gentle supine stretching can bring some relief but more often than not some more work is needed in the form of trigger point therpay or some type of massage.
Please check out The Better Mobility Guide, The Supine Sequence and The Element Series if you are having problems with your low back with more details on how to heal and balance your body.
QL trigger points.
Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. Think of a guitar string and how that could feel within normal softer muscular tissue.
I’ve been studying and practicing trigger point therapy for over 15 years and it’s sometimes needed when stretching and strengthening isn’t enough. Especilly in an acute phase of muscular spasm.
You’ll want to lie on the floor on your back. From there you’ll want to place the tennis ball in the region of the trigger points shown above. Let you bodies weight go onto the ball until you feel tenderness. You will know when you are on a trigger point.
Breathe here and allow the ball to push into the area. It will usually become warmer and more painful. After a minute or two it should potentially twitch, and then soften slightly. Now come off the ball and repeat. I reccomend no more than 10 minutes.
TP therapy on the QL.
Along side the trigger point work you will want to lengthen the muscle. Stretches like these can help.
Variations of Janusirsasana.
Any form of standing side stretch.
These will give you some releif and potentially get you back to moving functionally again but there will always be an underlying pattern that needs resolving.
The body is a complex organism and these localised ‘fixes’ will help, but you will always want to be working with some kind of yoga or mobility programme that looks to create a supple, mobile and stable body so these issue’s get resolved and happen less frequently.
Imbalances in the body are usually the cause
For example there is a direct connection between the psoas and QL as these muscles work together closely in unison. In most cases these back pain issue stem from somewhere else which is why we need to work on the body as a whole, especially with stretching and strength work.
This is why i created The Element Series and The Better Moblity Guide to aid in this so you are always improving you mobility and creating more space and balance within the body.
Check out The Better Moblity Guide below for exercies and sequences to work through from home.
