Quadratus Lumborum (QL) Part 1 of the grumbly muscle series.

In my clinic, I see particular muscles that are often sore and painful on clients and I like to explain what the muscles are designed to do and why the muscle is causing pain…

Anatomy

The Quadratus Lumborum (QL) muscles run up from the posterior hip bone (ilium) or sometimes the iliolumbar ligament and insert onto transverse processes of L4 to L1 and the bottom 12th rib.

What do they do?

  • They help us flex to the side and when both sides work together, they help us to bend (extend) the lumbar spine backwards.
  • They are a deep abdominal and diaphragm stabiliser and assists with inhalation.
  • They also work with Gluteus medius (a hip muscle) to stabilise the hip while we’re walking and running.

Why then does this muscle cause a lot of pain?

As discussed above, it works with Gluteus medius to stabilise the hip, but if Gluteus medius fatigues too easily then the QL’s can be left taking the brunt of the load in terms of hip stabilising and become very tight and prone to spasming from decreased blood flow and adhesions in the fascia of the muscle. This tends to occur because we’re often seated too much. The car, our desks, sitting all evening on the sofa etc…

When clients come in complaining of lower back pain, one of the first test I do is to look at what happens to their hip when they stand on a single leg. If the hip hikes abruptly then I know that QL is overworking. Often, when I palpate the muscle, its painfully tender.

Good news!

It responds very well to soft tissue treatments and releases and it calms down well when hip stability is restored with targeted rehabilitation.

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