October 14th, 2021

The Quadratus Lumborum (QL) muscle lies deep in the lower back and is one that can make or break your low back health. Read on to learn what the QL muscle is, how to determine if it causes you pain, and how to fix it.

​About Quadratus Lumborum Anatomy: 

Quadratus Lumborum (QL) is a deep low back muscle that connects from the top of the hip to the lowest rib, and also connects to the lumbar vertebrae. The QL muscle is deep, and is sometimes referred to as the deepest abdominal muscle [1].

Function: 

​Quadratus Lumborum is critical to spinal stability and strength. The QL muscle is very active during physically active sports, lifting objects, and carrying weight. When performing all of these activities, Quadratus Lumborum is active with the intention of keeping the lower spine neutral and stable.

In addition, Quadratus Lumborum functions in side bending the spine, as well as in extending the spine. Carrying a heavy object with one arm requires effort from Quadratus Lumborum on the opposite side of the body to keep the torso upright.
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Quadratus Lumborum Pain & Symptoms

The Quadratus Lumborum muscle is susceptible to causing pain in the body when tightness, trigger points, and/or weakness are present. QL muscle pain can be generally described as low back pain, but can also refer pain to the upper glute and outer hip [1]. The image below describes the pain pattern felt by QL trigger points, with the pain areas shown in bright red [1].

In addition to low back pain and pain referred above, Quadratus Lumborum can cause other atypical symptoms:

• A short leg or uneven pelvis [2]
• Non-specific low back pain [1]
• Back pain in unsupported positions requiring balance and stability

Quadratus Lumborum Release 

The first step to eliminating Quadratus Lumborum pain is effective deep tissue massage. Targeted deep tissue massage will break up any knots, trigger points, and tightness contributing to pain. This can be done by the hands or elbows of a physical or massage therapist, or at home with a targeted muscle release tool like QL Claw. QL Claw was designed to release the Quadratus Lumborum and the other 4 muscles that contribute to low back pain when tight, and it is unmatched in at home deep tissue massage.

Effective deep tissue release should eliminate your pain at rest. To know if you released a knot/trigger point, a massage at a higher pressure will feel less painful. You also may feel yourself physically sink deeper into the massage in a therapeutic manner.

Strengthening Quadratus Lumborum

​After effective release of the Quadratus Lumborum, the QL muscle should not be causing pain at rest. However, life is more than rest. We want to build strength and endurance in the QL muscle to be ready for whatever life throws at us, and to avoid falling back into QL muscle pain.
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A few great exercises for improving QL muscle strength and resilience are the side plank, suitcase carry, and overhead paloff press. Check out this video for a walkthrough of each exercise!
 
Sources:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.