Logan Steele
The quadratus lumborum (QL) muscle is a deep abdominal muscle, often referred to as a back muscle. It is a paired muscle, with each side having an irregular quadrilateral shape. The QL has several functions, including spinal stabilization and lateral flexion of the lumbar spine. The muscle is also associated with lower back pain, which can be caused by overuse, weakness, or tension. With its complex organization and strategic position, the QL plays an important role in the anatomy of the trunk and spine.
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What You'll Learn
The QL muscle is a side bender and spinal stabilizer
The quadratus lumborum (QL) muscle is a structural lower back muscle that contributes to spinal strength and stability. It is the deepest abdominal muscle and is commonly referred to as a back muscle. The QL muscle has two primary functions: side bending and spinal stabilization.
When one QL muscle contracts, it causes a side flexion of the spine to that side. This is the first function of the QL muscle, which is side bending. This movement can be observed when standing and contracting the QL muscle on one side, which results in a hip hike.
The second function of the QL muscle is spinal stabilization. This involves both QL muscles working together to maintain a strong, neutral, and safe lower back. The QL muscles play a crucial role in spinal stabilization during high-impact sports such as football, basketball, and hockey, helping to prevent lower back injuries.
The QL muscle is also involved in assisting the diaphragm during inhalation and exhalation. It contributes to forced expiration by fixing the 12th rib and aids in diaphragmatic breathing by controlling the same rib.
The QL muscle is susceptible to overuse and strain, which can lead to chronic lower back pain. Sitting for prolonged periods, especially with weak spinal and core muscles, can result in constant contraction of the QL muscle, leading to muscle fatigue and pain. Therefore, it is important to maintain a healthy and strong QL muscle through exercises such as isometric resistance training, which effectively targets the QL muscle without twisting or bending the spine.
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It can be the source of back pain
The quadratus lumborum (QL) muscle is a deep abdominal muscle, often referred to as a back muscle. It is a paired muscle, with each muscle of the pair originating from the wings of the ilium and inserting on the transverse processes of the upper four lumbar vertebrae and the lower posterior border of the twelfth rib. The QL has two primary functions: side bending and spinal stabilization. When one QL muscle contracts, it causes a side flexion of the spine to that side, and when both QL muscles work together, they help to extend the lumbar spine.
The QL muscle can be a source of back pain, which is typically caused by overuse or strain. People who sit for prolonged periods, especially with weak spinal and core muscles, are at risk of QL-related back pain. Constant contraction of the QL muscle due to prolonged sitting can lead to muscle fatigue and decreased blood flow, resulting in adhesions and tension in the muscle and fascia. This can cause pain in the lower back, pelvis, and hips, with trigger points in the QL muscle causing deep pain or a stabbing sensation.
Another cause of QL-related back pain is an imbalance of the pelvis or spine, which forces the QL muscle to stabilize them. For example, weak gluteal muscles can contribute to the likelihood of QL pain as the QL has to compensate for hip abduction. Kyphosis, an increased arch in the back, can also lead to QL-related back pain. Additionally, direct damage or trauma to the QL muscle can result in heterotopic ossification or myositis ossificans, causing pain in the lumbar region.
Occupational stresses, such as prolonged sitting, standing, or continuous lifting activities, can also contribute to QL-related back pain. Constantly standing in the same position or sitting with a reclined seat can reduce blood flow to the QL muscle, leading to pain. Furthermore, the QL muscle may be a source of pain in individuals with scoliosis or unequal leg lengths, as the muscle works to stabilize the spine and pelvis.
While the QL muscle can be a source of back pain, there is uncertainty in the literature about whether a QL abnormality is the primary source of back pain. The size of the QL muscle does not differ significantly between people with and without low back pain. However, trigger points involving the QL muscle can cause lumbar area pain syndromes, and manual trigger point therapy can provide relief in such cases.
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It is a paired muscle of the left and right posterior abdominal wall
The quadratus lumborum (QL) muscle is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and its complex structure makes it difficult to precisely identify its actions through the contraction of its fibres. It is a flat, quadrilateral-shaped muscle that originates from the iliac crest's inner lip and the iliolumbar ligament. It inserts on the 12th rib's internal surface and the transverse processes of the lumbar bodies of L1 to L4. The number of attachments to the vertebrae and the extent of its attachment to the last rib can vary.
The QL muscle has three layers of muscle fibres with different vectors. The thin anterior layer comprises iliocostal and iliothoracic muscle fibres, which terminate with a tendon or muscle. The middle layer is made up of lumbocostal muscle fibres, which originate from the transverse processes of the lumbar vertebrae and insert on the 12th rib. The posterior layer has not been well described in the literature.
The QL muscle has two primary functions: side bending and spinal stabilization. When one QL muscle contracts, it causes a side flexion of the lumbar spine, elevation of the pelvis, or both. When both QL muscles work together, they help to extend the lumbar spine and provide spinal stability. This function is particularly important during high-impact sports like football, basketball, and hockey, where the QL muscle helps to keep the spine together and protect against lower back injuries.
The QL muscle is a common source of lower back pain. Overuse and strain of the QL muscle can lead to tightness, poor posture, and muscle spasms. Constant contraction of the QL muscle during prolonged sitting or standing can result in decreased blood flow, adhesions in the muscle, and pain. Additionally, weakness of the back extensor muscles can also lead to pain as it puts a load on the QL muscle. QL trigger points can cause deep pain in the lower back or a stabbing sensation in the hips or pelvis.
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It assists with diaphragmatic breathing
The quadratus lumborum (QL) muscle is a deep muscle in the posterior abdominal wall, often referred to as a back muscle. It is the deepest abdominal muscle and is flat and quadrangular in shape. The QL muscle is an integral part of the thoracolumbar fascia, a myofascial system covering the posterior trunk and involving the upper and lower limbs.
The QL muscle assists with diaphragmatic breathing by controlling the 12th rib. It helps to elevate the pelvis and extend the lumbar spine, which are crucial movements during respiration. The diaphragm is located ventrally to the QL muscle, and together with the QL, they work to facilitate inhalation and exhalation.
The QL muscle originates from the iliac crest and the iliolumbar ligament, attaching to the 12th rib and the transverse processes of the lumbar vertebrae L1 to L4. This complex structure allows the QL to influence the movements of the spine and rib cage during breathing.
The QL muscle is also involved in spinal stabilization and side bending. It helps to keep the lower back strong and stable, especially during high-impact sports such as football and basketball. However, overuse and strain of the QL muscle can lead to tightness, poor posture, and chronic lower back pain. This pain may radiate to other areas, such as the pelvis and hips, and can be treated through manual trigger point therapy, dry needling, and stretching.
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It is an integral part of the thoracolumbar fascia
The quadratus lumborum (QL) muscle 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 thoracolumbar fascia is a complex, multilayered structure of fascial and aponeurotic layers that separate the paraspinal muscles from the muscles of the posterior abdominal wall, including the QL muscle. This fascia tissue is a thick connective tissue that covers, organises, and supports the muscles, bones, tendons, ligaments, and organs of the body.
The QL muscle is the deepest abdominal muscle and is often referred to as a back muscle. It originates from the iliac crest and the iliolumbar ligament, attaching to the 12th rib and the transverse processes of the lumbar vertebrae L1 to L4. The thoracolumbar fascia covers the QL muscle and other muscles of the posterior abdominal wall.
The QL muscle plays a role in bending the trunk to the side and maintaining a healthy upright posture. It also assists in respiration by aiding the diaphragm during inhalation. The thoracolumbar fascia is involved in load transfer between the trunk and limbs and is tensioned by the action of muscles such as the latissimus dorsi, gluteus maximus, and hamstring muscles.
The thoracolumbar fascia is thought to play a role in lower back pain. It contains nerve endings that may cause pain due to injury or inflammation. Studies suggest that the lumbodorsal fascia may generate back pain through micro-injuries, inflammation, and increased sensitivity to pain due to nerve stimulation.
The thoracolumbar fascia is a critical component of the myofascial girdle that surrounds the lower torso, contributing to posture, load transfer, and respiration. It assists in maintaining the integrity of the lower lumbar spine and the sacroiliac joint. The complex arrangement of multilayered fascial planes and aponeurotic sheets provides support and flexibility to the back.
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Frequently asked questions
The quadratus lumborum muscle, also known as the QL, is a deep abdominal muscle that is often referred to as a back muscle. It is located in the lower back and is responsible for spinal strength and stability.
The QL muscle has two primary functions: side bending and spinal stabilization. During side bending, one QL muscle works in isolation to facilitate the movement. During spinal stabilization, both QL muscles work together to keep the lower back strong, neutral, and safe.
QL muscle pain is often caused by overuse, especially in individuals who sit for prolonged periods. It can also be caused by weakness and tension in the surrounding muscles, leading to increased load on the QL muscle.
Treatment options for QL muscle pain include manual trigger point therapy, dry needling, TENS, ultrasound, and stretching. Self-massage, cryotherapy, and isometric resistance exercises can also help relieve pain and improve muscle function.
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