The Quadratus Lumborum Muscle

He came in with a visible tilt to the right and a sore low back.  From his posture and his report of diffuse pain in the right lumbar area that was worse with walking and standing and went away when seated and laying down I suspected the quadratus lumborum muscle.

The red line points out the QL, laying next to the psoas major.

The red line points out the QL, laying next to the psoas major.

The quadratus lumborum is a thin sheet like muscle that lives between the iliac crest and the 12th rib.  It also attaches to the transverse processes of the lumbar spine (L1-L4).   Its actions are lateral flexion of the trunk, extension  of the spine (if both engage) and stabilization of the trunk.  It is at work when we walk and stand keeping our low back aligned.  If one side is habitually contracted it can lead to lumbar scoliosis and /or “hip hike” when one side of the pelvis is higher than the other.  It is often involved in low back pain and can be overlooked.

If you want to experience this muscle find a comfortable seat with your sitz bones planted on a chair with a hard surface.   Sink your thumb into the soft area between your ribs and your pelvis.  Use the top of your pelvis as a guide and now gently press toward the spine until you bump up against a thick band of muscle.  That thick band is the erector spinea group.  The pad of your thumb is now Posterior view of QLresting on the QL.  Keeping your thumb there, gently begin to lift that hip off the chair.  You will feel the muscle engage under your thumb.  Welcome to the QL!  Now feel the other side.  Are they the same?

Going back to our friend who came in with the sidebend to the right and low back pain.  In the session we found a very tight QL with trigger points that referred pain into his hip.  With specific attention to the QL and facial balancing of the low back and pelvis, our friend left walking taller in the world and with much less pain.

Resolutions, habits and the body

So much of what we do is habit, unconscious action.  And thank goodness, because otherwise so much effort would be needed, so much remembered, to go about our simple yet complex daily activities.  The new year is a time of resolutions.  A time when we consciously try and change our habits.  I have seen over the years that our posture, our way of moving in the world is a place where people can often flex the habit changing muscle.  Pain can be an effective motivator and bodywork can be a way to gain insight.

An example.  I worked recently with a woman who had a bad case of tendonitis in her elbow.  We did some soft tissue work on the inflamed tendons but also during the session noticed that her palm was tight on that hand.  She reported a limitation in sensation in that hand- like things were further away when she touched them.  During the session I coached her in opening up the sensory channels of her palm. As she did the tension in her forearms relaxed.  We had small_367363319found a habit.  A habit of clenching and not feeling as much with that hand.  After the session she went away with the homework of paying attention to her palm and to keep it soft even when grasping the bucket handle or lifting the firewood.  Over the next couple sessions the inflammation reduced and the pain went away.  But more importantly she changed a habit.  She learned how to keep the center of her palm soft while working and in doing that felt more and used less effort.  This simple change supported the specific soft tissue work so she can go on with her life and work with a much smaller chance of reinjury.

With this new year I think we can learn from the example of the soft palm.  A small change, committed to and achieved, can over time make big changes in our lives.