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ql muscle

Back pain, Chronic Pain, groin pain, Hip pain

Quadratus Lumborum – Why it hurts and How to fix it

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Back pain, Quadratus lumborumThe Quadratus Lumborum can cause some real grief through your back, buttock, hip, and groin but with the right management, exercises and self-treatment, you can be pain free – long term.

Where is quadratus lumborum pain felt?

You can see the pain referral patterns below for the deep (closer to the spine) and superficial fibers of the QL muscle. Referral from the quadratus lumborum can vary a lot between people due to this varied referral pattern, in some, it can be a literal pain in the butt and others it is the side of the back, hip or the groin.

Quadratus lumborum pain Quadratus lumborum pain

Quick anatomy

You can easily see from the video below that is the quadratus lumborum tightens up, it can pull at your bottom ribs, vertebrae or pelvis and if this happens one side more than the other, it can lead to some real asymmetry and not just cause back pain but a whole raft of other things.

YouTube player

How can a tight quadratus lumborum effect you?

Apart from being painful, it can also increase the load on quite a few other structures. Often when one side tightens up it can lift that side of your pelvis a little making you feel out of place or out of alignment (even though your back can’t go out of place,1). It can also pull at your ribs, tilting you to the side, limiting your reaching and restricting your breathing. And last but not least if the QL is tight on both sides, you get more compression on your spine.

The QL can also:

  • Cause a sharp stabbing pain in the low back
  • Cause pain and limitation when trying to turn in bed or stand from sitting
  • Make it look like you have a leg shorter than the other by holding one side of your pelvis higher
  • Contribute to a lot of other issues such as patellofemoral pain, trochanteric bursitis and scoliosis due to asymmetrical tension

So how do we fix it?

In three steps:

  1. Ease the pain by decreasing tension by releasing the muscle (stretching often doesn’t help)
  2. Get you back to normal by regaining full range of motion through your back and hips
  3. And finally, treat the cause by improving strength of the QL so that it can handle everything you throw at it

1. Ease pain

For this, we need the muscle to relax so the most important thing is reducing aggravating activities and applying heat. Heat can be applied be a wheat bag, hot water bottle, heat rub or anything similar, it will make a big difference. Of course make sure you don’t make it too hot or hurt yourself, by following the instructions.

Also, you can directly release the quadratus lumborum, which is far more specific than stretching. Check out our past blog post to learn how to do a myofascial release for your Quadratus Lumborum with a simple massage ball or the QL Claw.

2. Regain normal range

We need to now get everything back to normal – not just the quadratus lumborum but the muscles that have changed because of the asymmetry that the QL caused. The following stretch is perfect for this, just remember to relax into it and that it isn’t, no pain-no gain.

Gluteal stretch: This will help even you out and regain hip range

YouTube player

3. Strengthen

Now get you quadratus lumborum stronger so that it can handle what you want to be able to do. A stronger QL means less pain and you have more control and power, without having to avoid things constantly.

To load the QL, we need to load the side of your body and the best way to do this is the side planks and the one sided farmers carry:

Side plank Level 1

Hold for up to 1 minute. Once you can do that comfortably, progress to level 2 below.

side plank for core strengthening

Side plank Level 2:

In the side plank, raise your top leg up and down up to 10 times. Repeat 3 times each side.

Side plank leg raises

one sided farmers carry for QL strengtheningOne-sided farmers carry:

Hold onto a dumbbell, kettlebell or anything with a bit of weight to it in one hand and do some laps (e.g. 10 x 10m laps on each side).

Carrying a weight on one side makes the QL and obliques on the opposite side work hard to keep you upright.

Note: Don’t do two-sided carry like in the picture! Carrying in on the right for example makes the left torso work hard to stop your upper body tilting over and vice versa but also do one side and then the other. This can work great to strengthen not only your quadratus lumborum but also your lateral hip and obliques.

Tip: try to stay upright!

And that’s it.

Heat

Release

Stretch

Strengthen

Work at that most days and notice the results. For a more detailed rehab plan, download our  Complete Low Back Self-Rehab Guide to get great results.

On a side note, once you are feeling improved, don’t slack off on the exercises, they are great to do just to maintain yourself in great condition, even if it is just three times per week.


Back pain, Core strengthening, Spine

QL Muscle Strengthening: Beat Low Back Pain

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Your Quadratus Lumborum muscle (better knows as your QL muscle) can cause you all sorts of back pain and refer pain into your hip and glutes. Having weakness in your QL muscle can mean recurring and frustrating back pain that can cause way too much trouble

So following on from our previous article on how to treat the QL yourself through an easy muscle release, here is how to strengthen it up and beat low back pain.

Strengthen QLSo, what does your QL muscle do?

Easy, it comes from the top of your pelvis (the iliac crest) and attaches on to the bottom rib and the side of your spine. From there, it acts to help you extend backwards, bend to the side, bend forwards and can help in breathing.

So the QL does rather a lot. Not only that but because it attaches to all your lumbar vertebrae and your pelvis, when it goes into spasm, it can really pull on your spine and can also lift one side of the pelvis – Making it seem like your “back is out”

Strengthen Quadratus lumborumAnd you know what? The QL can be a real pain in the butt.

Literally. As with a lot of muscles in the body which cause you to feel pain elsewhere and not where the real issue is. The QL refers pain into the buttock and side of the hip, making it quite deceiving as to where the pain is actually coming from.

Symptoms of QL muscle dysfunction:

  • Deep, aching in the low back, often worse in sitting or standing
  • Pain with coughing and sneezing
  • Pain rolling to either side when lying on your back
  • Pain can refer to the groin and mimic sciatica symptoms
  • You may have one side of your pelvis lifted higher than the other

Strengthening exercises for the QL:

  1. Side plank

Level 1: Hold

Side plank QL strengthening

Build up your QL endurance by holding a side plank.

Aim for a one minute hold (this is the goal, you may not be able to do it straight away!)

Tip: don’t stick your bum out, tuck it in

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Level 2: Leg lifts

Side plank leg raises

When you can hold a straight side plank comfortably for a minute, step it up.

Lift your hips up into a side plank but now lift your top leg up and down while holding the side plank.

Aim for 3 sets of 10 reps, but you may need to start with less reps!

Tip: don’t let your top leg come forward or toes point up.

2. One sided farmers carry

one sided farmers carry for QL strengthening

Here, the QL muscle on the opposite side to the weight you are carrying is working hard to keep you upright.

Hold onto a dumbbell or kettlebell in one hand and do some laps (e.g. 10 x 10m laps on each side)

Tip: try to stay upright!

And that’s it. Easy. Combine those few exercises into your workout at least 3 x weekly to improve the strength of your QL muscle and help beat back pain.

Looking for more? Download out Complete Low Back Self-Rehab Guide

Tip: This is a great stretch to help unload the low back!


Spine

QL muscle release – Exercise for low back pain

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Your Quadratus Lumborum (QL) muscle is a very common cause of back pain, so being able to treat this yourself, effectively, can be a huge relief. Here is a great self QL muscle release to loosen off your low back and reduce your low back pain.

First of all, here is a bit of information about the QL:

QL release anatomyAnatomy:

This muscle runs down either side of your low back, from the top of your pelvis, all the way to your bottom rib. This is why it can affect your breathing when it is in spasm and it pulls down on the lower rib of yours. It also attaches along the way to the side of your spine.

Purpose:

  • Side flexion/bending of the spine
  • Fixation/stabilization of the low rib

The problem:

QL release trigger pointsWhen muscle knots form in the Ql or it goes into spasm due to overload or injury, then it can give you real grief! Often this is more one-sided than the other also, giving you a real lopsided feeling and can make it seem like you have one leg shorter than the other or that your “pelvis is out” (which can’t really happen). The QL refers pain elsewhere and isn’t always felt at the muscle. The referred pain is generally felt in the outer hip and in the glutes and is often described as a deep ache but can be a sharp pain when moving. The trouble is that this muscle is very hard to stretch – but, it is quite easy to do a QL muscle release!

QL muscle release: Release your low back

QL muscle release1. Position

Lie on your back and place a firm massage ball (or a specific, purpose made tool like what the QL Claw) under your QL muscle, which you will find in-between the top of your pelvis and your bottom rib, off to each side of your spine.

QL muscle release low back and erector spinae2. Action:

Bring the knee on the same side as the ball up towards your chest, which puts pressure on the ball. Once you feel like you have the right spot (you will feel it!), holding onto your knee you can either:

1. Rock your knee out to the side and then in again and repeat, OR

2. Repeatedly bend your knee up and down towards your chest.

Slowly and gently work into it for 1-2 minutes on each side and feel free to move the ball up or down slightly to get the right spots.

Do this great myofascial release once a day for two weeks for longer-lasting results and check out new Complete Low Back Self-Rehab Guide that you can download that is packed with self-treatment advice and exercises for more.

Tip: Help prevent this recurring and giving you ongoing trouble by strengthening your QL and the surrounding muscle so that they can handle everything that is asked of them!

Note: If you have acute low back pain, pain going down your leg, or any neurological symptoms please see your local health professional first.


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