Dr. Salman Akbar
The quadratus lumborum can cause significant discomfort in your back, buttocks, hips, and groin, but with proper management, exercises, and self-care, you can be pain-free in the long run.
Where does quadratus lumborum pain occur?
The pain referral patterns for the QL muscle’s deep (near to the spine) and superficial fibres are shown below. Because of this diverse referral pattern, referral from the quadratus lumborum can vary greatly across individuals; for some, it can be a literal ache in the buttock, while for others, it can be the side of the back, hip, or groin.
Quick anatomy
When the quadratus lumborum becomes tight, it can pull on your lower ribs, vertebrae, or pelvis. If this occurs on one side more frequently than the other, it can create some serious asymmetry and result in a variety of other issues in addition to back pain.
How can a tight quadratus lumborum affect you?
Besides being uncomfortable, it can also put additional strain on a variety of other components. As one side of your body contracts, it might elevate that side of your pelvis slightly, making you feel out of position or out of alignment (even if your back cannot move). It can also drag on your ribs, leaning you to the side and limiting your reach and breathing. Last but not least, if the QL is tight on both sides, your spine is compressed.
The QL can also:
- Result in a strong stabbing pain in the lower back.
- While attempting to turn in bed or stand from a seated position, this causes discomfort and restriction.
- Make one leg appear shorter than the other by raising one side of your pelvis.
- Asymmetrical tension causes a variety of additional problems, including patellofemoral discomfort, trochanteric bursitis, and scoliosis.
So how do we fix it?
In three steps:
- Reduce discomfort by releasing muscular tension (stretching frequently does not help).
- Restore your normalcy by recovering the complete range of motion in your back and hips.
- Next, tackle the cause by strengthening the QL so that it can withstand everything you throw at it.
1. Ease pain
We need the muscles to relax for this, so the most essential thing is to reduce irritating activities and provide heat. Heat can be applied with a wheat bag
, hot water bottle, heat rub, or anything similar; it will make a big difference. Of course, follow the guidelines carefully to avoid overheating or injuring yourself.
In addition, rather than stretching, you can directly release the quadratus lumborum.
2. Regain the normal range.
We must now restore normalcy to all of the muscles that have been altered as a result of the asymmetry induced by the quadratus lumborum. The stretch below is ideal for this; just remember to relax into it and that no pain is no gain.
Gluteal Stretch: This will help you balance out and recover hip range.
3. Strengthen
Make your quadratus lumborum stronger so it can tackle what you wish to achieve. A stronger QL implies less discomfort and greater control and power, without the need to continuously avoid things.
To load the QL, we need to load the side of your body, and the side planks and one-sided farmers carry are the finest ways to accomplish so:
Side plank Level 1
Hold for one minute. If you’ve mastered that, move on to level 2 below.
Level 2 side plank:
Raise your upper leg up and down 10 times in a side plank. Replicate 3 times on each side.
Farmers who are one-sided carry:
Do some laps while holding a dumbbell, kettlebell, or other weighted object in one hand (e.g., 10 x 10m laps on each side).
When you carry a weight on one side, the QL and obliques on the opposing side have to work extra hard to hold you upright.
Don’t do two-sided carrying like in the image! Bringing in on the right, for example, requires the left torso to work hard to keep your upper body from tipping over, and vice versa. This exercise can help you strengthen not just your quadratus lumborum but also your lateral hip and obliques.
Tip: Try to keep your balance!
FAQS
What is the quadratus lumborum and why does it hurt?
The quadratus lumborum (QL) is a muscle located in the lower back on both sides of the spine. It plays a crucial role in stabilizing the spine and assisting with various movements, including bending, twisting, and lifting. QL pain can be caused by muscle strain, overuse, poor posture, muscle imbalances, or injury. It may also be associated with conditions such as muscle spasms, sciatica, or kidney problems.
What are the common symptoms of quadratus lumborum pain?
When the quadratus lumborum is affected, you may experience symptoms such as lower back pain on one or both sides, pain that radiates into the hips or buttocks, stiffness, muscle spasms, difficulty standing upright, pain worsened by certain movements (e.g., bending, twisting), and pain that is relieved by rest.
How can I relieve quadratus lumborum pain at home?
There are several home remedies you can try to alleviate QL pain. These include:
- Applying ice or heat packs to the affected area.
- Taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
- Practicing gentle stretching exercises that target the lower back and hips.
- Maintaining good posture and avoiding prolonged sitting or standing in one position.
- Using a supportive pillow or cushion while sitting or sleeping.
- Engaging in low-impact exercises like swimming or walking to promote blood circulation and relieve muscle tension.
Can exercises help in strengthening and stretching the quadratus lumborum?
Yes, specific exercises can help strengthen and stretch the quadratus lumborum. Some examples include:
Quadratus lumborum stretch: Stand with your feet shoulder-width apart, cross your right leg behind your left, raise your right arm overhead, and lean towards the left until you feel a stretch on the right side of your lower back. Hold for 30 seconds and repeat on the other side.
Side plank: Lie on your side, with your forearm on the ground and your elbow aligned with your shoulder. Lift your hips off the ground, forming a straight line from your head to your feet. Hold for 30 seconds and repeat on the other side.
Superman exercise: Lie face down with your arms extended overhead and legs straight. Lift your arms, chest, and legs off the ground simultaneously, squeezing your lower back muscles. Hold for a few seconds and then lower down. Repeat for several repetitions.
When should I seek medical attention for quadratus lumborum pain?
While most cases of quadratus lumborum pain can be managed at home, you should consider seeking medical attention if:
- The pain persists or worsens over time.
- The pain is severe and debilitating, affecting your daily activities.
- You experience numbness, tingling, or weakness in the legs.
- The pain is accompanied by fever, unexplained weight loss, or urinary/bowel changes.
- You have a history of trauma or injury to the lower back.
Can a massage or physical therapy help with quadratus lumborum pain?
Yes, massage therapy and physical therapy can be beneficial for quadratus lumborum pain. A skilled massage therapist can help relax and release tension in the muscle, while physical therapy can provide targeted exercises and techniques to strengthen the quadratus lumborum, improve posture, and enhance overall back health.
Are there any preventive measures to avoid quadratus lumborum pain?
To prevent quadratus lumborum pain, you can:
- Practice good posture while sitting, standing, and lifting.
- Avoid prolonged periods of sitting or standing in the same position.
