Quadratus Lumborum and the impact on both lumbar/thoracic spine and pelvis

Frank Panetta

One of the most frequent causes of chronic myofascial pain of the low back is the quadratus lumborum muscle.The quadratus lumborum muscle is a flat sheet muscle in the lower back.


It sits deep in the back waist, one on each side, attaching to the top of the pelvis and travelling up to the last rib (12th) and the sides of the lumbar vertebrae and works hard to stabilize your spine.

 

Introduction and Cause of Back Pain


Back pain is caused by a wide variety of

  • Physical
  • physiological and
  • environmental factors


The major underlying factor in back pain is muscle imbalance which can eventually lead to many other problems, such as
spinal joint degeneration (arthritis), disc herniation and disc degeneration. These conditions can lead to pressure on delicate nerves to cause an extremely painful condition.

It's easy to see that without proper maintenance, your back muscles can get overworked and become painful. If you don't stretch and strengthen your back muscles, and you overwork them, they can soon develop painful muscle knots, known as myofascial trigger points. These knots in over stressed muscles cause local pain, stiffness, and refer pain to other regions, such as in your buttock, hip or down your leg. Myofascial trigger points cause muscles to shorten and weaken and interrupt the normal motion and function of your vertebra. They fire pain signals into your spinal cord, causing your back to become hypersensitive and irritated by almost any activity. When the spine does not function properly the joints and discs of the spine wear out prematurely. There are 3 very important muscles in the posterior abdominal wall. They are the

  1. Psoas major
  2. Iliacus and the
  3. Quadratus lumborum which is what my talk is based on today


Location and Description

One of the most frequent causes of chronic myofascial pain of the low back is the quadratus lumborum muscle. The quadratus lumborum muscle is a flat sheet muscle in the lower back. It sits deep in the back waist, one on each side, attaching to the top of the pelvis and travelling up to the last rib (12th) and the sides of the lumbar vertebrae and works hard to stabilize your spine. The quadratus lumborum refers pain down over the sacroiliac joint area, (the area under the big dimples on each side of the bottom of your low back) and to your buttock. Once you press on the quadratus lumborum, it's like scratching an itch you can't reach and didn't even know you had. Pressure produces a deep, satisfying, almost paralysing ache. As it fades, there is great relief.

Actions

The quadratus lumborum muscle has three major jobs, which is why it often needs work. It acts as

  • a prime mover
  • a postural muscle, and
  • a respiratory muscle


Its action of bringing the hip up is important for balancing postural distortion. It provides lumbar spine stabilisation and assists with lateral flexion of the spine. When both muscles act together, either from below or above, they flex the trunk. Not only does it refer into the Sacro Iliac joint, but can cause stress in that joint by pulling the hips out of alignment. When the quadratus lumborum contracts, it pulls the pelvis and rib cage on the same side closer together. It laterally flexes (sidebends) the trunk, and elevates the hip. It also helps to stabilize the low back, and is, therefore, usually involved when low back pain is present. It has fibres that run vertically and in two diagonals.

Treatment

You can't treat this spot on yourself, but it's not hard to find on someone else. Simply locate the bottom rib, and then work your way inwards towards the spine.
Between the bottom rib and about an inch away from the spine is a corner or pocket where you can almost push underneath the rib.
Use thumbs or fingertips, or even a gentle elbow, to slowly dive into that pocket. Press inwards and upwards.
Your partner will probably tell you when you've found it.

 

 

 

Written by Frank Panetta

Bodhi Health Centre - Melbourne - Coburg

Shiatsu Melbourne - Quit Smoking Hypnosis Melbourne - Corporate Massage Melbourne - Sports Massage Melbourne