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The quadratus lumborum muscle, commonly referred to as the QL, is a deep abdominal muscle that is often mistaken for a back muscle. It is a significant muscle in the body, contributing to the stabilisation and movement of the spine and pelvis. The QL muscle is also a common source of lower back pain, which can be caused by overuse, tension, or weakness. Stretching and yoga can help alleviate this pain.
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What You'll Learn
The quadratus lumborum muscle's role in spinal movement and stability
The quadratus lumborum (QL) is a 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 located medial to the aponeurosis of the transverse abdominal muscle and is an integral part of the thoracolumbar fascia.
The quadratus lumborum muscle plays a crucial role in spinal movement and stability. It originates from the iliolumbar ligament and the internal lip of the iliac crest and inserts on the 12th rib and the transverse processes of the lumbar vertebrae. The muscle's complex organization makes it challenging to pinpoint the precise actions resulting from its contraction. However, it is generally described as a lumbar spine extensor, stabilizer, and lateral tiltor.
When the quadratus lumborum contracts on one side, it causes lateral flexion of the lumbar spine, elevating the pelvis. Bilateral contraction of the muscle results in extension of the lumbar spine. The QL also assists in inhalation by elevating the ilium and supporting expiration by fixing the 12th rib during movements of the thoracic cage.
The QL contributes to spinal stability by preventing the collapse of the vertebral column in the frontal plane, maintaining frontal plane stability of the pelvis, and acting as a junction for forces exerted by neighboring muscles. However, constant contraction of the QL, such as during prolonged sitting, can lead to muscle fatigue and lower back pain.
To improve spinal stability and support the lower back, specific stretches and strengthening exercises targeting the QL and other core muscles can be performed. These exercises help increase strength and mobility, promoting overall spinal health and reducing the risk of lower back pain.
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Its position and relation to other muscles and organs
The quadratus lumborum muscle, commonly referred to as the QL, is a deep abdominal muscle often mistakenly referred to as a back muscle. It is a paired muscle, with each muscle of the pair in the shape of an irregular quadrilateral. The QLs originate from the wings of the ilium, the iliolumbar ligament, and the internal lip of the iliac crest, and their insertions are on the transverse processes of the upper four lumbar vertebrae and the lower posterior border of the twelfth rib. The QLs are an integral part of the thoracolumbar fascia, a myofascial system covering the posterior trunk and involving parts of the lower and upper limbs.
The QLs are located medial to the aponeurosis of the transverse abdominal muscle and are considered a continuation of this muscle. They are positioned deep inside the abdomen, dorsal to the iliopsoas, and are in close proximity to many structures. Ventral to the QLs are the colon, kidneys, and diaphragm, while the intrinsic back muscles lie dorsomedially. The QLs are also surrounded by nerves, including the iliohypogastric and ilioinguinal nerves, which course on the ventral surface of the QLs after exiting the lumbar plexus.
The QLs play a crucial role in spine and pelvis stabilization and movement. When both QLs contract, they cause an extension of the lumbar vertebral column. When only one QL contracts, the trunk bends towards that side (lateral flexion). The QLs also assist in inhalation by elevating the ilium and fixing the twelfth rib during forced expiration. This muscle is an important means of access for anesthesia during surgery in the back, lower limbs, or abdominal area due to its strategic position.
The QLs are a common source of lower back pain, which can be caused by overuse, muscle fatigue from prolonged sitting, or associated conditions such as scoliosis or weak gluteal muscles. The QLs can experience decreased blood flow and adhesions may develop, leading to muscle spasms. Trigger points in the QLs can cause deep pain in the lower back or a stabbing sensation in the hips or pelvis.
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How overuse and tension can cause lower back pain
The quadratus lumborum muscle, commonly referred to as the QL, is a deep muscle in the lower back. It 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 is a paired muscle of the left and right posterior abdominal wall, originating from the iliac crest and inserting on the 12th rib and the transverse processes of the lumbar vertebrae.
Overuse and tension in the QL muscle can lead to lower back pain, which is a common issue that many people experience. The QL is susceptible to pain due to its constant contraction during everyday activities such as sitting, walking, and standing. Prolonged sitting, especially in a slumped or unsupported posture, can reduce blood flow to the QL and surrounding areas, leading to muscle fatigue and pain. In addition, repetitive motions, such as gardening, lifting heavy items, or even repetitive impact activities like running on uneven surfaces, can cause overuse and strain on the QL, resulting in trigger points and radiating pain.
The QL is also susceptible to tension and pain when the surrounding muscles are weak or inhibited. For example, weak gluteal muscles or weak back extensor muscles can lead to the QL overcompensating to stabilize the spine and pelvis, resulting in increased tension and pain. This compensation can also occur due to unequal leg lengths, placing more stress on one side of the body. Additionally, conditions such as kyphosis, scoliosis, or tight rhomboid muscles can contribute to QL tension and pain by altering the body's alignment and posture.
To alleviate lower back pain caused by QL overuse and tension, various treatments are available. Myofascial therapy, including trigger point therapy, dry needling, and stretching, can help release muscle tension and alleviate pain. Strengthening exercises for the core, lower body, and back muscles can also provide support and improve stability. Yoga, Pilates, and tai chi are effective practices for core strengthening and improving flexibility, which can help manage and prevent QL-related back pain. Maintaining good posture, staying active, and seeking early treatment for any pain are essential for preventing and managing QL-related lower back pain.
In some cases, QL-related lower back pain may require more specialized treatments, such as manual trigger point therapy, TENS (Transcutaneous Electrical Nerve Stimulation), or ultrasound therapy. Seeking advice from a healthcare professional or movement therapist can help individuals find the most suitable treatment plan for their specific condition.
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Stretches and exercises to strengthen the muscle
The quadratus lumborum (QL) muscle is a large, deep muscle located on the posterior side of the trunk and abdominal wall, with a left and right side. The QL muscle is responsible for lateral flexion of the lumbar spine, elevation of the pelvis, and extension of the lumbar spine when both muscles contract.
As with any other muscle, the QL can experience muscle spasms and decreased blood flow if it is constantly contracted. This can be accelerated by kyphosis, which shifts the body weight forward, forcing the muscle to work harder. Therefore, it is important to stretch and strengthen the QL muscle to prevent pain and other issues.
Stretches and Exercises to Strengthen the QL Muscle:
- Medicine Ball Exercises: These exercises can help improve mobility and stability, which is important for QL rehabilitation, especially if you are experiencing pain.
- Oblique Leg Lift: This exercise involves moving the trunk, which is different from other exercises that focus on moving the pelvis and lower body.
- Anti-Movement Exercises: These exercises help to resist motion and are common core stabilization exercises.
- Dynamic Motion Exercises: Creating dynamic motion is the other side of the coin to resisting motion and is an important aspect of muscle strengthening.
- Sling Muscle Exercises: The QL works with other muscles, so exercises that focus on the 'sling' muscles can be beneficial.
- Power Strengthening Exercises: Before returning to sports, add in some power-strengthening exercises to protect your QL and back.
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The muscle's shape, layers and fibres
The quadratus lumborum muscle, also known as the QL, is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal and back muscle. Each muscle of the pair is an irregular quadrilateral in shape. The QL muscle is flattened and has a quadrangular shape.
The QL muscle originates from the iliac crest and inserts on the transverse processes of the lumbar vertebrae and the lower part of the twelfth rib. The number of attachments to the vertebrae and the extent of its attachment to the last rib may vary. The QL muscle is a continuation of the transverse abdominal muscle and is located medially to the aponeurosis of this muscle.
The muscular organisation of the QL is complex, comprising three layers with muscle fibres that have different vectors. It is part of the thoracolumbar fascia, a myofascial system that covers the posterior area of the human body, involving part of the upper and lower limbs. The QL helps to create an antagonist force to the muscles of the anterolateral abdomen wall, along with the multifidus and erector spinae muscles.
The disorganised scheme of its fibres, combined with its strategic position and function in the myofascial system, allows the QL to act as a crossroad of the forces exerted by neighbouring muscles. This influences the vectors of the different tensions produced.
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Frequently asked questions
The Quadratus Lumborum muscle, or QL, is a muscle in the posterior abdominal wall, often referred to as a back muscle.
The QL muscle is located in the posterior inferior trunk, lateral to the spine, and is an integral part of the thoracolumbar fascia.
The QL muscle contributes to the stabilization and movement of the spine and pelvis. It also assists in inhalation by elevating the ilium and supporting expiration.
There are several QL stretches that can help stabilize your spine and support your lower back. One example is to stand with your feet wider than your hips, fold forward halfway, and hold this position for up to one minute.
Yes, the QL muscle can be a source of lower back pain, especially with overuse or weakness of the surrounding muscles. This pain can be felt in the lower back, pelvis, and hips.
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