What is the Quadratus Lumborum?
The quadratus lumborum — sometimes known as the QL — is a muscle located in the lower back. Its main action is to help flex the trunk of the body sideways and is involved in a large number of twisting activities. The muscle is also involved when a person lifts an object and helps to fix certain ribs during expiration. Due to the muscle’s involvement in a range of daily activities, it can commonly cause back pain and is often the subject of physical therapy.
The insertion of the quadratus lumborum muscle is on the 12th rib and hence this is the rib it helps to fix during expiration. From this point, it runs downward, although it also has attachment points on the L1-L4 bones of the spine. The origin is on the iliac crest, and the innervation is via the subcostal and lumbar nerves. Its blood supply comes from the lumbar arteries.
An example of a daily activity that uses the quadratus lumborum is bending sideways. Any action that requires lifting an object will also involve the muscle, however. There are several other actions that the muscle is involved in. For example, it helps to extend the lumbar column when there is contraction on both sides of the body and also helps to elevate the ilium.
The quadratus lumborum muscle is a common source for pain in the lower back. This is because the QL muscle attaches to both the spine and the pelvis and therefore is regularly involved in daily activities. Due to the muscle’s position, it often has to take over some of the excess strain from other muscles, which can result in fatigue. When the muscle is placed in an over-stretched and loaded position for a long period of time, it will eventually start to spasm, which can cause pain.
There are a number of stretches that can be used to help prevent this problem. For example, a simple side stretch can open up the quadratus lumborum muscle and reduce the chance of an injury or spasm occurring. To perform a side stretch, the stretcher should stand up straight before reaching upward with one arm. In a slow and fluid movement the stretcher should lean sideways to the opposite side of the raised arm until a stretch is felt along the side of the body. This stretch should be held for at least 20 seconds and be repeated three times.
I hurt my quadratus lumborum awhile back. I swear, you don't realize how often you bend sideways until it hurts to do it! For instance, I go to coffee shops a lot to read or work or whatever. Usually I sit my purse down next to my chair. My normal way of picking up the purse would be to bend sideways to get it! And that's just one small example. I was totally miserable the whole time I was injured.
I ended up having to get physical therapy before it got better. That wasn't fun either, but I was happy to go, just so I could return to normal and bend to the side without pain!
I was able to almost completely avoid having any lower back pain during my pregnancy by doing carefully chosen back exercises. I had a couple of really good prenatal exercise DVDs and I just was careful how I moved around, too. If I needed to go sideways, I tried to go with my whole body.
I think most people can keep their lower backs from hurting too much if they do the right exercises. For me, the combination is twists, strengthening exercises, and stretching exercises.
For strengthening, there are a lot of options but the safest and simplest is the cat variation. You get down on your hands and knees and raise one arm and the opposite leg. (Look this up online to get pictures and tips.) For stretching, I usually do cat pose, which involves hollowing and then arching your back. Of course, as I got more and more pregnant, I couldn't get as much of an arch going any more!
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