The next muscle that can be stretched easily to reduce lower back pain is the Quadratus Lumborum or commonly known as the QL. It is a muscle of the posterior abdominal wall. It is the deepest abdominal muscle and commonly referred to as a back muscle. The quadratus lumborum can perform four actions:
- Lateral flexion of vertebral column, with ipsilateral contraction
- Extension of lumbar vertebral column, with bilateral contraction
- Fixes the 12th rib during forced expiration.
- The quadratus lumborum assists the diaphragm in inhalation
- Elevates the ilium bone, with ipsilateral contraction
The QL is a common source of lower back pain. It connects the pelvis to the spine and is capable of extending the lower back when contracting bilaterally. The two QLs pick up the slack when the lower fibers of the erector spinae are weak or inhibited.
This is very common in today’s society as more people are spending their time during an average day seated. It is fair to say that most people’s routine would include quite a significant amount of sedentary seating in their day to day, whether it be sitting to eat breakfast, drive to work, sit at your desk at work for the day, drive home, eat dinner and watch television.
If the chair’s that people are sitting in do not have a lower back support then the chance of weak or inhibited lower erector spinae fibres, causing an over use and reliance on the QL is highly apparent. Given their comparable mechanical disadvantage, constant contraction while seated can overuse the QLs, resulting in muscle fatigue. A constantly contracted QL, like any other muscle, will experience decreased blood flow, and, in time, adhesions in the muscle and fascia may develop, the end point of which is muscle spasm.
Further to poor posture whilst sitting, the QL can be over used and overworked in other ways you don’t even realise. Hip abduction is performed primarily by the hip abductors (gluteus medius and minimus). Hip abduction is the movement of the leg away from the midline of the body. We use this action every day when we step to the side, get out of bed, and get out of the car. When the gluteus medius/minimus are weak or inhibited, the TFL [Tensor Fasciae Latae] or QL will compensate by becoming the prime mover. The most impaired movement pattern of hip abduction is when the QL initiates the movement, which results in hip hiking during swing phase of gait. Hip hiking places excessive side-bending compressive stresses on the lumbar segments.
Acute hypertonicity (abnormally high tension) and spasms of the QL may be associated with pain during menstruation. Stretching, applying pressure to trigger points, massage or dry needling in the muscle belly may relieve symptoms.
Theres heaps of different stretches that can be implemented to relieve lower back pain. The best idea is to keep trying different positions until you find one that relieves you best.