Trigger points within the QL muscle can cause severe pain, sometimes leading to complete failure to weight bear in an upright position. Low back pain is more often than not of muscular origin. It is the muscle many practitioner’s consider the main cause of low back pain. It is a postural muscle that gets notoriously tight and overactive in many people. It aids with inspiration during breathing along with allowing the spine to extend and flex laterally (side to side). The QL is a deep muscle located in the lower back, it attaches to the 12th rib the transverse processes of the lumbar spine, and the pelvis (posterior iliac crest). I see such cases on a daily basis, after ruling out potential red flags or neural implications, I go straight to one muscle I know will most likely be implicated – Quadratus Lumborum (QL). The majority of Low Back Pain is classed as non-specific, meaning there is no known specific pathology as to the cause of the pain. The best idea is to keep trying different positions until you find one that relieves you best.Quadratus Lumborum and its role in Low Back Pain Theres heaps of different stretches that can be implemented to relieve lower back pain. Stretching, applying pressure to trigger points, massage or dry needling in the muscle belly may relieve symptoms. Period PainĪcute hypertonicity (abnormally high tension) and spasms of the QL may be associated with pain during menstruation. Hip hiking places excessive side-bending compressive stresses on the lumbar segments. The most impaired movement pattern of hip abduction is when the QL initiates the movement, which results in hip hiking during swing phase of gait. When the gluteus medius/minimus are weak or inhibited, the TFL or QL will compensate by becoming the prime mover. We use this action every day when we step to the side, get out of bed, and get out of the car. Hip abduction is the movement of the leg away from the midline of the body. Hip abduction is performed primarily by the hip abductors (gluteus medius and minimus). Hip Abductionįurther to poor posture whilst sitting, the QL can be over used and overworked in other ways you don’t even realise. A constantly contracted QL, like any other muscle, will experience decreased blood flow, and, in time, adhesions in the muscle and fascia may develop, the end point of which is muscle spasm. Given their comparable mechanical disadvantage, constant contraction while seated can overuse the QLs, resulting in muscle fatigue. If the chair’s that people are sitting in do not have a lower back support then the chance of weak or inhibited lower erector spinae fibres, causing an over use and reliance on the QL is highly apparent. This is very common in today’s society as more people are spending their time during an average day seated. It is fair to say that most people’s routine would include quite a significant amount of sedentary seating in their day to day, whether it be sitting to eat breakfast, drive to work, sit at your desk at work for the day, drive home, eat dinner and watch television. The two QLs pick up the slack when the lower fibers of the erector spinae are weak or inhibited. It connects the pelvis to the spine and is capable of extending the lower back when contracting bilaterally. The QL is a common source of lower back pain. Elevates the ilium bone, with ipsilateral contraction.The quadratus lumborum assists the diaphragm in inhalation.Fixes the 12th rib during forced expiration.Extension of lumbar vertebral column, with bilateral contraction.Lateral flexion of vertebral column, with ipsilateral contraction.It is the deepest abdominal muscle and commonly referred to as a back muscle. The quadratus lumborum can perform four actions: It is a muscle of the posterior abdominal wall. The next muscle that can be stretched easily to reduce lower back pain is the Quadratus Lumborum or commonly known as the QL.
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