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The quadratus lumborum (QL) is a deep muscle in the lower back, connecting the pelvis to the spine. It is the deepest abdominal muscle and is commonly referred to as a back muscle. The QL is important for stabilization and movement of the spine and pelvis, and it assists in inspiration during breathing. The muscle is susceptible to pain formation due to overuse, weakness, tension, and muscle fatigue from constant contraction. QL stretches can help to relax the spine and support the lower back, increasing strength and mobility.
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What You'll Learn
The quadratus lumborum (QL) is the deepest abdominal muscle
The quadratus lumborum (QL) is a muscle in the posterior inferior trunk lateral to the spine. It is the deepest abdominal muscle, although it is often mistakenly referred to as a back muscle. The muscle is flat and quadrangular in shape, with three layers of muscle fibres. 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 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 colon, the kidneys and the diaphragm are located in front of the muscle, while the intrinsic back muscles lie behind it.
The QL is a lumbar spine extensor, stabiliser, and lateral tiltor, and an accessory muscle for inspiration. It is a postural muscle that gets notoriously tight and overactive in many people. It 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 QL is susceptible to pain formation, with trigger points causing pain in the lower back, pelvis, and hips. This pain can be caused by overuse, weakness, tension, or muscle fatigue from constant contraction due to prolonged sitting. Stretching the QL can help to relieve this pain.
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The QL is a common cause of lower back pain
The quadratus lumborum (QL) is a muscle in the posterior inferior trunk lateral to the spine. It is the deepest muscle of the lumbar region, extending from the pelvis to the last rib. The QL is a significant means of access for anaesthesia during surgery on the back, lower limbs, or abdominal area. Its complex organisation makes it difficult to precisely identify its actions through the contraction of its fibres.
The QL is also susceptible to pain formation due to overuse, weakness, and tension. Constantly standing in the same position will reduce blood flow and pave the way for pain. Trauma to the muscle from a car accident or sports injury can also lead to QL pain. Common everyday activities done incorrectly, such as lifting heavy objects, can strain the QL. QL pain may interfere with everyday activities, including walking, standing, and rolling over in bed, which may aggravate the pain.
Trigger points are common in the QL muscle. When pressed, they may cause a sensation of deep pain that radiates into the lower back, pelvis, and hips. Trigger points can cause deep pain in the lower back or a stabbing sensation in the hips or pelvis. They can also cause sharp pain when the QL shortens, such as during coughing or sneezing.
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The QL is an integral part of the thoracolumbar fascia
The quadratus lumborum (QL) is a muscle in the posterior inferior trunk lateral to the spine. It is the deepest muscle of the posterior abdominal wall and the lumbar region. The QL is an integral part of the thoracolumbar fascia (TLF), a myofascial system that covers the posterior trunk and involves parts of the lower and upper limbs. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separate the paraspinal muscles from the muscles of the posterior abdominal wall.
The QL has a complex muscular organization, with three muscle fibre layers that have different vectors. This makes it difficult to identify precisely the actions that occur through the contraction of its fibres. The thin anterior layer comprises iliocostal (iliac crest to ribs) and iliothoracic (iliac crest to the T12 vertebral body's lateral margin) muscle fibres, which terminate with a tendon or muscle. The middle layer comprises lumbocostal muscle fibres, which originate from the transverse processes of the lumbar vertebrae and insert on the 12th rib. The posterior layer consists of lateral iliocostal fibres and medial iliolumbar fibres, connecting the iliac crest to the lumbar vertebrae's transverse processes.
The QL is positioned laterally and exerts a force of 10 N during a lateral trunk tilt. It is generally located medial to the aponeurosis of the transverse abdominal muscle. The QL is considered a postural muscle and part of the core muscles, which are essential for proper load balance within the spine, pelvis, and kinetic chain. The QL likely serves as a junction for forces exerted by neighbouring muscles, influencing the vectors of various tensions due to its strategic position and fibre arrangement.
The QL is often associated with back pain, with uncertainty about whether a QL abnormality is the primary source. QL syndrome is a synonym for lower back pain and can be caused by overuse, weakness, tension, or direct damage. Stretching the QL can help reduce pain and irritability in patients with nonspecific low back pain. The QL is also a significant means of access for anaesthesia during surgery on the back, lower limbs, or abdominal area, thanks to its strategic position and fibre arrangement.
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The QL is a paired muscle of the left and right posterior abdominal wall
The quadratus lumborum (QL) is a muscle in the posterior inferior trunk lateral to the spine. It is the deepest muscle of the posterior abdominal wall and is often mistakenly referred to as one of the muscles of the back. The QL is a paired muscle, with each muscle of the pair having an irregular quadrilateral shape. The 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 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 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 consists of lumbocostal muscle fibres, which originate from the transverse processes of the lumbar vertebrae and insert on the 12th rib. The posterior layer consists of lateral iliocostal fibres and medial iliolumbar fibres, connecting the iliac crest to the lumbar vertebrae's transverse processes.
The QL plays a crucial role in stabilising and moving the spine and pelvis. When the muscle contracts on one side, the trunk bends in that direction, and when both muscles contract, the lumbar vertebral column extends. The QL also fixes the 12th rib during movements of the thoracic cage, supporting expiration. Additionally, it assists in inhalation by aiding the diaphragm during breathing.
The QL is susceptible to overuse and strain, which can lead to chronic pain in the lower back. Prolonged sitting, standing, or repetitive movements can contribute to muscle fatigue and tension. Trigger points in the QL can cause deep pain in the lower back or a stabbing sensation in the hips or pelvis. Treatment options include myofascial therapy, dry needling, stretching, and strengthening associated muscles.
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The QL is a postural muscle that gets tight and overactive
The quadratus lumborum (QL) is a deep muscle located in the lower back. It is often mistakenly referred to as one of the muscles of the back, but it is actually the deepest muscle of the posterior abdominal wall. The QL is a postural muscle that gets notoriously tight and overactive in many people. It is a significant source of low back pain, which is more often than not of muscular origin.
The QL is a paired muscle, with each muscle of the pair originating from the wings of the ilium. Their insertions are on the transverse processes of the upper four lumbar vertebrae and the lower posterior border of the twelfth rib. The twelfth rib is fixed during movements of the thoracic cage, supporting expiration. The QL also assists the diaphragm in inhalation.
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. It has three muscle fibre layers with different vectors. The thin anterior layer comprises iliocostal and iliothoracic muscle fibres, which terminate with a tendon or muscle. The middle layer comprises lumbocostal muscle fibres, which originate from the transverse processes of the lumbar vertebrae and insert on the twelfth rib. The posterior layer consists of lateral iliocostal fibres and medial iliolumbar fibres, connecting the iliac crest to the lumbar vertebrae's transverse processes.
The QL is susceptible to pain formation due to its constant contraction during everyday activities such as sitting, walking, and standing. Overuse and strain of the QL are major causes of chronic pain in the lower back. This can be caused by the habit of sitting at a desk with a reclined seat, releasing and weakening the intrinsic back muscles. Constant contraction can lead to muscle fatigue, decreased blood flow, and adhesions in the muscle and fascia, which can result in muscle spasms.
Trigger points in the QL can cause severe pain and are often described as small knots. These can be caused by overload and overuse of the muscle through repetitive movements such as gardening, lifting heavy items, or even continuous lifting activities at work. Trigger points can also be caused by a sudden quick movement, such as lifting a heavy item, or trauma from a car accident.
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Frequently asked questions
The QL muscle, short for quadratus lumborum muscle, is a deep muscle located in the lower back. It is often mistakenly referred to as one of the muscles of the back.
The QL muscle is located in the posterior abdominal wall, lateral to the spine. It is the deepest muscle of the lumbar region.
The QL muscle aids in the stabilization and movement of the spine and the pelvis. It also assists in inspiration during breathing.
The QL muscle is commonly associated with low back pain. This can be due to overuse, muscle strain, weakness, tension, or trigger points within the muscle.
Treatment options for QL-related issues include myofascial therapy, trigger point therapy, dry needling, stretching, and strengthening of associated muscles. Self-treatment options include heat application, myofascial release using a spiky ball, and specific QL stretches.
