If you have low back pain, you need to learn about the quadratus lumborum. The quadratus lumborum, which is also known as the QL, should be in your lineup of the usual suspects when investigating back pain. It may not always be the cause of the problem. However, if one of its neighbors is dysfunctional, that may be enough to cause the QL to slip into dysfunction as well.
Here’s more about the muscle that may–or may not–be the cause of your low back pain.
The quadratus lumborum originates on the iliac crest and the iliolumbar ligament. The iliolumbar ligament runs from the 5th lumbar vertebra out to the ilium. In other words, it helps to connect the spine to the pelvis.
The quadratus lumborum inserts on the 12th rib and on the transverse processes of the upper four lumbar vertebrae (L1-L4). The transverse processes are the spike-like portion of the bone that sticks off of the main body of the vertebra.
The main function of the quadratus lumborum is to laterally flex the vertebral column. This means that when you bend straight over to the side, that’s the QL working. For example, if you were sitting in a chair and wanted to set something on the floor beside the chair, you would bend to the side to set the object down.
In that example, you are flexing your rib cage toward your hips. The QL works the opposite way, too. As the ribs move toward the hips, the hips may also move toward the ribs. Think about when you’re carrying something on your hip (like groceries or a child), and it starts to slip. Automatically, the hip may jostle the object upward to restore balance. It’s the QL that helps with that movement.
In addition to lateral flexion, the quadratus lumborum helps extend the lumbar vertebrae and provide lateral stability. So, when you take a break and stretch backward, that’s the QL working.
Another function of the quadratus lumborum is that it stabilizes the 12th rib during deep respiration. This helps stabilize the diaphragm for singers exercising voice control.
Unfortunately, the quadratus lumborum can become injured simply by performing its standard actions. If you bend sideways incorrectly or lift from a sideways position too quickly, you can injure yourself. This injury will naturally show up as back pain.
And, although an injured QL can be the cause of back pain, it is frequently falsely blamed. Sometimes, the actual cause of pain can be neighboring muscles like the iliocostalis lumborum or the pain can be referred and from a different area of the body entirely. Personally, I think the psoas, which is a neighbor to the QL, causes much of the dysfunction that leads to low back pain.
Whenever you are trying to decide what you can do to help yourself feel better, make sure to take the time to think through your situation. What were you doing when you noticed pain? Where, precisely, do you feel pain?
Restoring or Maintaining Health
As always, I recommend that if you feel pain, you should first consult your physician. Your doctor can order imaging, medication, and therapy to appropriately and correctly treat your issue.
If your back pain is not very significant and you feel like you want to try some stretches and exercises at home, I have a couple of ideas. First, it’s important to know that tightness = weakness. So, when you’re deciding what you want to do to make your low back feel better, be aware that you will need to stretch and strengthen those muscles in order to feel improvement.
Because the primary purpose of the quadratus lumborum is lateral flexion, I recommend exercises with lateral flexion like Triangle pose. As you do these postures, be mindful that you are working to stretch and strengthen the muscles in your low back that run between your ribs and hips. Take deep breaths into this area to help facilitate stretching. Engage your core and activate the QL to allow it to help you move back to your starting posture.
I consulted The Concise Book of Muscles by Chris Jarmey. Recently, the book was revised and is in its third edition.
Also, I consulted my Flash Anatomy Muscles Flash Cards. If you really enjoy anatomy and want a tool to help you locate specific muscles correctly, I highly recommend these flash cards. I turn to them any time a client comes in with pain.
The link above is a link to buy them on Amazon. If you purchase them from this link, I earn a small commission.
Have you ever had a quadratus lumborum injury? What did you do to make it feel better? Let us know in the comments below.
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