My goal for this post is to provide you with everything you need to release the quadratus lumborum muscle with both stretches and soft tissue release. I also want to show you how to avoid this recurring pain.
In this case, that shifty-eyed muscle, the one that you think probably is to blame, is the quadratus lumborum. Oftentimes, this muscle is one of the top trouble-causers, and it tends to be very obvious about the pain it causes.
Fortunately, there are several quadratus lumborum exercises you can do to keep this muscle happy, healthy, and pain-free. But, before you scroll down to the exercises, take a moment to learn about this muscle.
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.
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.
In fact, it is incredibly common for people who do their heavy carrying on one side (be it groceries or kids) to injure this muscle. Then, when the quadratus lumborum muscle is injured, it will show up as low back pain.
Because the primary purpose of the quadratus lumborum is lateral flexion, I recommend side-bending exercises. Notice how as you bend to the side, one side of the QL is stretching while the other side of the QL is strengthening.
You can also check out The Concise Book of Muscles by Chris Jarmey to learn more about the quadratus lumborum and other muscles. (When you buy this book through this link, I earn a small commission.)
What is a quadratus lumborum, you ask? You probably know it as your QL, or the deepest of all the back muscles. Located on both sides of your spine, it connects the rib and hip. People frequently experience QL-related pain because this major muscle is used in many physical processes such as sitting, standing, walking, and of course pumping iron.
Since the QL is frequently taxed, people commonly suffer from pain in this area, but there are simple ways to keep your lower back in good check. One of the ways to release lower back tension is to perform this quadratus lumborum stretch.
Myofascial pain syndrome (MPS) of the spinal stabilizer muscles is one of the most frequent causes of chronic low back pain. However, MPS is often overlooked. Among the spinal stabilizer muscles, the quadratus lumborum (QL) is frequently a trigger point and location of referred low back pain Overuse and strain of the QL is one of the major causes of chronic pain in the lower back.
Also, if one part of the body is causing pain, other parts try to support the painful area. For example, if the quadratus lumborum is tight and painful, we may find that the person begins to twist or change their gait by changing their body posture. This changing posture can place an additional load on other parts of the body, such as the hips, further increasing the pain.
Quadratus lumborum syndrome is usually seen in patients with low back pain(as mentioned above) and also in the patellofemoral pain syndrome. In the condition of chronic low back pain, the quadratus lumborum is under tension and presents with trigger points.Manual trigger point therapy is effective and provides relief from trigger points. Dry needling is another form of treatment that provides instant relief in trigger point pain and inurn reduces the tension and sensitivity of the hyperactive muscle. Few commonly used modalities for this condition are TENS and ultrasound. It helps in reducing the pain and irritability.Stretching of the quadratus lumborum is also effective in patients with nonspecific low back pain.The patient can continue self-massage and cryotherapy at home.
And in the pelvis area, the iliacus and the psoas muscles enable you to lift your legs and remain stable while standing; and the quadratus lumborum, a long muscle on each side, helps you bend to the side and back.
The quadratus lumborum (QL) muscle resides in the deep and posterior, lateral, and inferior areas of the spine, involving the iliac crest, the transverse processes of the lumbar vertebrae, and the 12th rib. The muscular organization is complex, and it is difficult to identify precisely the actions that occur through the contraction of fibers. It is an integral part of the thoracolumbar fascia. There is still no certainty that an abnormality of QL is the primary source of back pain. The QL could potentially act as a crossroad of the forces exerted by the neighboring muscles, influencing the vectors of the different tensions produced. Thanks to its strategic position and the entropic scheme of its fibers, QL is a significant means of access for anesthesia during surgery on the back, lower limbs, or abdominal area. The article reviews the latest anatomical and clinical information on the quadratus lumborum.
The quadratus lumborum (QL) muscle is an integral part of the thoracolumbar fascia, a myofascial system that covers the posterior area of the human body, involving part of the lower and upper limbs. The QL muscle is flattened and has a quadrangular shape; along with the multifidus and erector spinae muscles, the QL helps to create an antagonist force compared to the muscles of the abdomen.
The quadratus lumborum muscle involves the 12th rib (internal surface) and the transverse processes of the lumbar bodies of L1-L4, while it comes from the iliac crest (inner lip) and the iliolumbar ligament.
The anatomy texts describe the quadratus lumborum muscle as an extensor of the lumbar spine, a stabilizer of the lumbar area, capable of tilting laterally and capable of acting as an inspiratory accessory muscle. A cadaver study has raised many doubts about the action of QL. During the extension, the QL exerts a force of 10 N, compared to 100 N and 150 N of the erector spinae muscles and the multifidus. It seems unlikely that it can extend the lumbar area on a sagittal plane with such a small force (10 N).
QL gets its vascular supply via the lumbar arteries and a lumbar branch of the iliolumbar artery. The lumbar arteries are four on each side, born from the posterior face of the aorta at the level of the first four lumbar vertebrae. They run posteriorly behind the sympathetic chain and under the arches tendon of the iliopsoas muscle to finally meet the QL muscle. The first three arteries pass posteriorly to the quadratus lumborum, while the fourth passes anteriorly.
Dr. Blanco Rafael was the first to use quadratus lumborum anesthesia in surgery in 2007. Both anterior or posterior access are valid approaches, either lateral or intramuscular, with the help of ultrasound-guided assistance. Anesthesia administered in this manner covers dermatomes from T4 to L2; the anesthetic passes through the paravertebral spaces and then distributes via the blood and lymphatic vessels and nerves. The use of this method can be useful not only before surgery (abdominal surgery, colostomy, cesarean section, laparoscopy, pyeloplasty, gastrotomy, and more) but also in the postoperative period to relieve pain.
Patients presenting with hip fractures are commonly clinically complicated secondary to advanced age and an increased number of medical comorbidities. Thus, innovative anesthetic techniques that ideally balance the risk of anesthesia without compromising pain control are a major goal of the overall treatment and management of these patients. The quadratus lumborum block (QLB) has demonstrated clinical efficacy and, when used in isolation or combined with other analgesic modalities, has demonstrated clinical efficacy in perioperative pain control for this group of patients.
There is no consensus in the literature whether an alteration of the tone of QL may be the primary cause of back pain. The size of the quadratus lumborum is smaller in the dominant's side leg compared to the opposite side. In the case of low-back pain, the QL does not vary much in its size compared to people without pain.
A recent study has shown that the use of dry needling on the gluteus maximus muscle and quadratus lumborum is able to relieve pain with improved performance in athletes suffering from patellofemoral pain syndrome. 
The quadratus lumborum muscles, or QLs for short, are found on either side of the lumbar spine (lower back) and are important core muscles that help stabilise the lower back. They essentially connect the lower spine to the pelvis and assist with movements like side bending and raising the hip.
The quadratus lumborum is often overworked when we are sitting. A strong core is very important to stabilise your lower back when sitting for long periods of time. If your core is not that strong, your QL (the marathon runner of muscles) works overtime in supporting you. This means it gets tight and tired. So work on your core to protect your QL!
Your deeper gluteal muscles (medius and minimus), among many other things, help to stabilise your pelvis during walking. So the quadratus lumborum and the glutes work together to stabilise our posture when moving. If your gluteal muscles are weak, again your QL will overcompensate.
Like a relationship between two people that may need a bit of counselling to regain balance, the simplest dilemma in this region of the body is that the iliacus and psoas (known together due to their combined insertion on the femur as iliopsoas) are tight and weak from overflexing and the quadratus lumborum are tight and weak from trying so hard to bring the body back upright to neutral.
This can lead to tightness in the quadratus lumborum and strain on the piriformis, which attaches from the sacrum (lower fused part of the spine) to the femur (thigh bone) and is responsible for external rotation of the hip. 2b1af7f3a8