The Quadratus Lumborum (QL) is a muscle of the posterior abdominal wall.
The deepest muscle in the abdominal wall, it is commonly referred to as a back muscle.(1)
Broader below than above, it is irregular in shape and reaches from the last rib to the upper four lumbar vertebra.
Latin name: Musculus quadratus lumborum
The word quadratus comes from the Latin quadrus meaning “square.”
Lumborum comes from the Latin lumbus for “loin.”(2)
To sum it up, there are basically two attachments.
The Iliac crest and the medial half of the 12th rib. The muscle is vaguely rectangular in shape.
The Quadratus Lumborum stems from the aponeurotic fibers, into the iliolumbar ligament and the iliac crest.
Once into the iliac crest, it flows for, roughly, 5 cm.
The muscle is fairly thin and usually has an additional layer of muscle around it.
The muscle itself will vary from person to person.
What does that mean?
It means that everyone is unique.
Everyone has basic muscle structure, but no two people are the same in muscle mass.(3)
Ventrally to the muscle lie the diaphragm, colon, and kidneys.
The Quadratus Lumborum Function
The functions of the QL are quite important to body movement.
This muscle stabilizes the movement of the pelvis and the spine.(4)
You will find the term bilateral contraction in association with this muscle.
What does that mean?
It refers to two paired muscles contracting at the same time.(5)
When the muscle is only being used on one side that means that the body is bent toward the direction of the muscle being used.
The QL also fixes the 12th rib in place during tilting of bending of the trunk.(6)
The QL is in use again if you tilt your pelvis.
It’s truly amazing how each muscle leads to another right down to the tiny detail.
Without the QL, you’ll find it impossible to bend from side to side or even remain upright.
It’s not seemingly prominent and it’s not overly large, but it plays a large role in a body’s movement.
Muscle Spasm
When you’re having problems with your QL, you may not even realize that your QL is to blame for the pain and discomfort that you’re feeling.
The Quadratus Lumborum is a common source of lower back pain.(7)
If you are constantly in a seated position, use a chair with a lower back support, or both, this will keep the QL in a constantly contracted state.
If a muscle is contracted for an extended period of time it will lead to a decrease in blood flow to that muscle.
The end result will eventually be serious muscle spasms.
Trigger Points
The mechanics of the QL muscle are moderately antagonistic of each other.
For example:
If the QL on the left side of your body is producing trigger point activity, then the QL on the right side is doing more work.
If the QL on the right is doing more work then it will develop stress of its own.
If a therapist does not focus on the Quadratus Lumborum muscles on both sides of the body then chances are great that the issue will never be relieved.
What is a Trigger Point?
A trigger point is when you have an area of the body that is irritated or stimulated causing an effect in another area or part of the body.(8)
A lower QL trigger point lies within the area where the para-spinal muscles meet the iliac crest.
An upper QL trigger point is the area where the para-spinal muscles meet the twelfth rib.
The middle trigger point is located closer to the spine near the third and fourth lumbar.
The lower trigger point pain areas are most often found in the hip joint area.
The upper trigger point pain areas refer to the lower back, crest of the hip, and the groin areas.
The middle trigger point pain areas of the Quadratus Lumborum are around the sacro iliac joint and the buttocks.
This particular trigger point may cause sharp “lightening-like” pain to shoot into the thighs.
Some of the symptoms that you can expect from these trigger points are as follows:
» A deep ache in the lower area of the back whether you are moving or staying still and resting. This ache is usually worse when sitting or standing. The upright position is the most painful.
» Stabbing pain when moving the hips or pelvis area.
» Moments of severe pain when coughing or even sneezing can occur because the muscle contracts.
» The inability to roll either left or right when laying on the back.
What Types of Activity Can Cause Trigger Points From the Quadratus Lumborum Muscle?
Surprisingly, quite a lot of everyday movement can cause QL trigger points.
If you bend at the waist, you can cause a trigger point.
Bending over and picking a piece of paper up off of the floor can aggravate the QL muscle.
Other activities could be such things as putting on pants, moving on a sloped surface, and even sleeping on a mattress that is too soft.
Exercises
There are Quadratus Lumborum exercises that can be done to try and keep the muscles healthy.
Correct blood flow is one of the biggest keys to trying to avoid a trigger point.
One such exercise is a stretching exercise.
Some key points to make clear, before attempting to do any stretching or exercising, is do not push yourself to pain.
This is not a “feel the burn” kind of stretch.
Go only so far as your body will allow. Pushing through the pain, as it were, is not the goal here.
With that in mind, take it easy and don’t rush.
It is also a good idea to rule out any serious back injury before you attempt self-care for your back pain.
Seeing your doctor is the only way to know if you have such things as herniated disks or lumbar facet joint syndrome.
• Start with your legs straight and your feet together
• Raise the arms above the head, keeping them straight
• Slowly and slightly, stretch your arms to the right side of your body
• Remember, it is very important to keep your arms unbent
• Bend slowly at the hip towards the right side as well
• Go only so far until you can feel the muscles begin to stretch
• Hold your position for about thirty seconds and then relax
• Switch to the other side and repeat the instructions
• Stretch a total of six times; three times for each side
Do these stretches a couple of times a day.
Treatment
Treatment usually includes massage therapy, exercise, and stretching.
Many sufferers also find relief in yoga.
If self-care does not help then it may be time for you to see a physical therapist.
A physical therapist will look deeper into any muscular problems and find a treatment that is put together specifically for you.
This may be anything from swimming to special stretching techniques.
No one should have to suffer from chronic back pain.
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References
(1)https://en.wikipedia.org/wiki/Quadratus_lumborum_muscle
(2)http://www.anatomyexpert.com/app/structure/5307/
(3)https://books.google.hr/books?id=T0fbq_b89cAC&printsec=frontcover&dq=skeletal+muscle+structure+function+and+plasticity&hl=en&sa=X&ved=0ahUKEwiu3t-C0afLAhWjYpoKHcRzAucQ6AEIGzAA#v=onepage&q=skeletal%20muscle%20structure%20function%20and%20plasticity&f=
(4)https://books.google.hr/books?id=PCKxhwL1sSQC&pg=PA89&lpg=PA89&dq=Quadratus+Lumborum++stabilizes+the+movement+of+the+pelvis+and+the+spine&source=bl&ots=UtYKoocGKa&sig=WA-TLL-5zjfHcsV6EoBH-A7tMf8&hl=en&sa=X&ved=0ahUKEwiMvYe50afLAhXBNpoKHRVoBdkQ6AEIKDAC#v=onepage&q=Quadratus Lumborum stabilizes the movement of the pelvis and the spine&f=
(5)https://biomedgerontology.oxfordjournals.org/content/51A/1/B21.full.pdf
(6)https://books.google.hr/books?id=a3R3j6vpp8EC&pg=PA216&lpg=PA216&dq=Quadratus+Lumborum+also+fixes+the+12th+rib+in+place&source=bl&ots=_fk2B4wpoX&sig=-GzpYzDjn3xd8UaW8q2SBejfOPA&hl=en&sa=X&ved=0ahUKEwiJuprU0qfLAhVlCpoKHVJyDB8Q6AEILzAE#v=onepage&q=Quadratus Lumborum also fixes the 12th rib in place&f=
(7)https://books.google.hr/books?id=M3LjgMrhD0MC&pg=PA196&lpg=PA196&dq=Quadratus+Lumborum+is+a+common+source+of+lower+back+pain+study&source=bl&ots=0fj6hE4FSj&sig=KzZmvzu7KzdbbjViVZqrrZ9IU5w&hl=en&sa=X&ved=0ahUKEwjsrYnl06fLAhUnJJoKHXyrDQY4ChDoAQgcMAE#v=onepage&q=Quadratus Lumborum is a common source of lower back pain study&f=
(8)https://www.painscience.com/tutorials/trigger-points.php
(9)http://www.thera-bandacademy.com/elements/clients/docs/bishop-2011-biofreeze-neck__634648161867898000.pdf
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