Logan Steele
The quadratus lumborum (QL) is a deep core muscle located on either side of the spine, running from the pelvis to the lower ribs. Tight QL muscles can cause lower back pain and discomfort, and may restrict your ability to bend and twist. This can be caused by a variety of factors, including daily habits, posture, injury, overuse, and weak muscles. To loosen tight QL muscles, there are various stretches and exercises you can do, such as yoga, aerobic exercise, and stability exercises. Massage therapy, foam rolling, and acupuncture can also help to relieve muscle tension and pain.
How to Loosen QL Muscles
| Characteristics | Values |
|---|---|
| Muscle Location | Deep core muscle located in the back, connecting the spine and the bottom of the rib cage to the pelvis |
| Muscle Functions | Lateral flexion of the spine, extension of the lumbar region of the spine, same-side trunk side bend, rotation, and extension of the trunk to one side |
| Causes of Tightness | Overuse with a specific activity, compensating for weakness elsewhere, doing too much too soon, overstretching causing microtears, imbalance |
| Stretching Exercises | Child's pose, seated QL stretch, standing stretch with arms overhead, kneeling stretch with leg extended to the side, Pilates-inspired stretch with breathing exercises, rolling |
| Stability Exercises | Trunk stability exercises focused on other muscles, light stability exercises targeting the QL |
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What You'll Learn
Identify the quadratus lumborum muscle
The quadratus lumborum (QL) is a deep core muscle located in the back, which runs from the top of the pelvis to the bottom rib on either side of the spine. It is the deepest muscle of the posterior abdominal wall, and it is often mistakenly referred to as one of the muscles of the back. Its shape is irregular, but is generally quadriangular, which is the reason why it is described as 'quadratus' in Latin.
The QL is an integral part of the thoracolumbar fascia, a myofascial system that covers the posterior trunk and involves parts of the lower and upper limbs. The muscle works with the multifidus and erector spinae to antagonize the abdominal muscles. The QL originates from the iliac crest's inner lip and the iliolumbar ligament and inserts on the 12th rib's internal surface and the transverse processes of the lumbar bodies of L1 to L4. The muscle is generally located medial to the aponeurosis of the transverse abdominal muscle.
The QL is a significant means of access for anaesthesia during surgery on the back, lower limbs, or abdominal area, thanks to its strategic position and the entropic scheme of its fibres. The colon, the kidneys, and the diaphragm are located in front of the muscle, whereas the intrinsic back muscles lie dorsomedially. The iliohypogastric and ilioinguinal nerves course on the ventral surface of the QL after exiting the lumbar plexus and continue towards the lateral abdominal muscles.
The QL can become extremely hyperactive, causing it to go into a 'guarding' state. This can be a result of overuse with a specific activity, the QL compensating for a weakness elsewhere, or simply doing too much too soon of something new that the body is not used to. Overuse and strain of the QL are major causes of chronic pain in the lower back.
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Understand causes of QL tightness
The quadratus lumborum (QL) is a deep core muscle located in the back, which runs from the pelvis to the last or bottom rib on either side of the spine. It is the deepest muscle of the lumbar region and is responsible for lateral flexion of the spine and extension of the lumbar region of the spine. It also assists with diaphragmatic breathing by controlling the last rib.
The QL is a common source of pain, usually caused by overuse, but can also be caused by weakness and tension. The pain is often described as a deep aching pain but can also be felt as sharp and acute, depending on the cause. The type and severity of the pain may vary. It may be felt during everyday activities such as walking, standing, coughing, sneezing, or rolling over in bed.
Prolonged Sitting or Standing
Sitting or standing for long periods can cause continuous contraction or tightening of the QL muscle. Constantly standing in the same position will also reduce blood flow, leading to pain.
Occupational Stress
Occupational stresses such as prolonged sitting or standing at the workplace or continuous lifting activities can cause QL tightness and pain.
Weak Back and Pelvic Muscles
If the muscles surrounding the QL are weak, it can cause the QL to work harder than necessary, leading to overworked and tense muscles. Weak back extensor muscles can also put a load on the QL, causing pain.
Poor Posture
Slouching, leaning to one side, or sitting without back support can cause the QL to become sore and tight. An increased arch in the back, often caused by weak spinal and core muscles, can also lead to QL issues.
Uneven Leg Length
Uneven leg length can place additional strain on the QL. If one leg is shorter than the other, the pelvis may tilt, leading to a shortening of the QL and muscle strain.
Trauma
The QL can be injured due to trauma, such as a car accident or sports injury.
Sleep Position
Sleeping in certain positions, such as on a mattress that is too soft or with too many pillows, can cause QL tightness and pain.
Overuse
The QL can become hyperactive and go into a "guarding" state due to overuse in specific activities or compensating for weaknesses elsewhere in the body.
Overstretching
The QL can become injured and strained if it is overstretched beyond its maximum length, causing microtears in the muscle fibers.
Understanding the causes of QL tightness is important to address the issue effectively and prevent further discomfort or injury.
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QL stretches to relax your spine
The quadratus lumborum (QL) is a deep core muscle located in the back, which runs from the top of the pelvis to the bottom rib on either side of the spine. It is a large muscle that helps connect the spine and the bottom of the rib cage to the pelvis. The QL is responsible for lateral flexion of the spine and extension of the lumbar region of the spine.
When the QL muscle is hyperactive, it can go into a 'guarding' state, which can be caused by overuse or overstretching. This can lead to low back tightness, soreness, and even spasms. Therefore, it is important to focus on both mobility and stability when dealing with QL pain.
Seated Quadratus Lumborum Stretch
Position yourself to the side of a seat until you are almost off the edge. Extend your leg out in front of you, allowing your body weight to even out and straighten the side of your torso. Stretch the quadratus lumborum by reaching your arm overhead and bending the trunk away from the side.
Kneeling Stretch
From a kneeling position, extend your right leg to the side with your toes facing forward or to the right. Bend to the right, placing your right hand along your leg. Extend your left arm up and over, reaching to the right. Extend through your left fingertips and roll your left ribs up toward the ceiling. Hold this position for up to 1 minute. Repeat on the opposite side.
Standing Stretch
From a standing position, raise your arms overhead and interlace your fingers. Press into your feet and legs as you tilt to the right. You will feel a stretch from your hips to the tips of your fingers. Tuck in your chin and gaze down toward the floor. Hold this position for up to 30 seconds.
Lying Down Stretch
Lie on your back with your knees bent and your feet in toward your hips. Relax your upper body and tuck your chin in slightly. Engage your core as you press the small of your back into the floor. Hold for 5 seconds. Relax for a few breaths and repeat 8-15 times.
Yoga Stretch
Begin on your hands and knees with your hands under your shoulders, fingers spread, and your knees under your hips. Hug your belly button toward your spine to support your lower back. Arch your back and tuck your pelvis, rolling up one vertebra at a time, with your head coming up last.
Remember to build up your stretching routine slowly and gradually. You may experience some discomfort when starting these exercises, but it should subside with time. Always listen to your body and adjust the stretches as needed.
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Stability exercises to relax the QL muscle
The quadratus lumborum (QL) is a deep core muscle located on the posterior side of the trunk and abdominal wall. It runs from the top of the pelvis to the bottom rib on either side of the spine, providing support to the lower back and keeping the spine in alignment.
When the QL becomes hyperactive, it can enter a "guarding" state, which may be due to overuse or overstretching. This can cause low back tightness, soreness, and spasms. Therefore, it is essential to focus on both mobility and stability to promote gentle movement of the QL muscle without causing sharp pain.
Seated Quadratus Lumborum Stretch
- Position yourself on the side of a chair until you are almost off the edge.
- Extend your leg out in front of you, allowing your body weight to even out and straighten the torso.
- Stretch the QL by reaching your arm overhead and bending the trunk away from the side.
Kneeling Side Stretch
- From a kneeling position, extend your right leg to the side, with your toes facing forward or to the right.
- Bend to the right, placing your right hand along your leg.
- Extend your left arm up and over, reaching to the right, and stretch through your left fingertips.
- Roll your left ribs up toward the ceiling.
- Hold this position for up to 1 minute, then repeat on the opposite side.
Standing Side Stretch
- Stand with your feet wider than your hips, with your right toes forward and your left toes turned out slightly.
- Keep your hips facing forward while raising your arms parallel to the floor, palms facing down.
- Fold forward halfway, pausing when your torso is parallel to the floor.
- Lower your left hand to your right leg, a block, or the floor, and raise your right arm straight up, turning your palm away from your body.
- Gaze down at the floor or to the side, or up at your extended hand.
- Hold this position for up to 1 minute, then repeat on the left side.
Lying Down Stretch
- Lie on your back with your upper body relaxed and your chin tucked in toward your chest.
- Bend your knees and bring your feet in toward your hips.
- Gently drop your knees to the right, keeping your upper body stable.
- Hold for 20-30 seconds, then repeat on the other side.
- You can place a cushion under your head or between your knees for added comfort.
Side Plank
- Elevate your torso and legs off the ground, keeping your body tight and straight with a neutral spine.
- This exercise helps build abdominal strength while also targeting the QL.
It is important to note that if you are experiencing QL pain, you should consult a professional before attempting any exercises that may cause further discomfort. Start with gentle movements and build up gradually.
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Massage therapy to release QL tightness
The quadratus lumborum (QL) is a deep core muscle located on the back, with a left and right side of the spine. It is the deepest muscle on the "back of the back" and is responsible for lateral flexion of the spine and extension of the lumbar region of the spine. It is also responsible for the specific motions of same-side trunk side bend, rotation, and extension of the trunk to one side.
When the QL is in a hyperactive state, it can trigger symptoms of low back tightness, soreness, and even back spasms. This can be caused by overuse with a specific activity, the QL compensating for a weakness elsewhere, or simply doing too much too soon of a new activity.
Massage therapy can be an effective way to alleviate QL tightness and discomfort. It helps to relax the muscle, increase blood flow, and aid recovery. Deep tissue massage or trigger point therapy can target the QL directly, relieving tension and promoting flexibility.
- Slow fascial techniques: Start with slow fascial techniques to soften the surrounding tissue. Work from the side toward the spine instead of from the top down to create space between the muscle layers.
- Massage glides: Due to the attachments on the ribs, pelvis, and spine, perform upward and downward massage glides, as well as direct compression on the attachment points to cover the muscle thoroughly. Avoid pressing directly into the 12th rib, also known as the "floating rib," with an elbow as it may be injured by excessive force.
- Post-isometric relaxation: After massage therapy, add a frequent QL muscle stretch to maintain the effects. The post-isometric relaxation technique can be done in the side-lying position with light resistance applied to the top of the hip or pelvis.
- Self-massage: The Theracane is a tool that can be used for QL self-massage and reaching trigger points in this area. When using this tool, avoid using excessive pressure and only use about 50% of the maximum pressure you can tolerate.
In addition to massage therapy, it is important to focus on both mobility and stability exercises to promote reciprocal inhibition of the QL muscle and improve overall trunk and low back movement.
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Frequently asked questions
The quadratus lumborum (QL) is a large, deep muscle located on the posterior side of the trunk and abdominal wall. It runs from the top of the pelvis to the bottom rib on either side of the spine. The QL is responsible for connecting the pelvis to the spine, stabilising the spine, and allowing side-to-side bending and twisting motions.
QL muscles can tighten due to various reasons, including prolonged sitting, weak muscles, imbalanced workouts, injuries, and daily habits and posture. Standing or sitting with a sway or twist can cause uneven pressure and muscle imbalances, with the QL being susceptible to tightness on one side.
There are several techniques to loosen and stretch tight QL muscles:
- Massage therapy: A licensed massage therapist can help soothe tense and tight QL muscles, making it easier to perform stretching and strengthening exercises.
- Trigger point massage therapy: This specific type of massage therapy can help relieve muscle pain and bring healing nutrients to the area.
- Foam rolling: Similar to massage therapy, foam rolling can help relieve trigger points that contribute to pain.
- Yoga and aerobic exercise: Practising yoga and aerobic exercises can help alleviate lower back pain and improve posture.
- QL stretches: Various stretches targeting the QL muscle can help improve flexibility and alleviate discomfort.
