Working on Back Pain by Working the QL – Quadratus Lumborum
Gang, know we are on the “7 ELEMENTS” of achieving high levels of training and performance. But wanted to hit on something this week that has been “popping up” with a number of folks I’ve been working with, consulting with and just talking with through emails and on facebook.
Back injuries are at the top of the list for problems with folks anymore – even for those who endured accidents, according to Creve-Coeur auto accident lawyer, and for many professions, it’s the number-one injury they have to deal with. Take example in the profession of First Responders; most EMT’s, firefighters, and police suffer from some type of lower back pain. Too often, we self-diagnose the problem as a slipped disk or sciatic pain. The funny thing is, back experts find that MOST folks have slipped disks, in some form or fashion, so could it be something else causing the pain?
Your quadratus lumborum (QL) muscle might be the problem, and you may not even know it. The QL plays a prominent role in chronic lower back pain as well, becoming a key player in the subsequent onset of sciatica symptoms and hip pain. Many times these trigger points can cause “referred pain”, or problems in the psoas, piriformis, and glutes. Keep in mind that the QL muscle’s role is to stabilize your torso in the frontal plane. For example, if you hold a bag of groceries in your right hand, the left QL contracts, preventing you from leaning to the right. If you have paralysis in the QL muscle, it would be impossible to walk.
Another important role that the QL muscle plays is in side bending. When you lean to the side, the QL must lengthen and then contract to pull you back up. However, it is not recommended to train that way (e.g., side bends) because of the stress placed on the disks. According to Dr. Stuart McGill, the QL muscle needs endurance strength and should be trained in a static position, such as side planks. The overall goal of the QL is to provide lumbar stability. You could try some White Maeng Da to feel better.
Over the years, I have seen the QL muscle become problematic to many folks – and the more we sit, the more problems we have. Not moving enough, or not properly, causes the QL to not work like it should. When this happens, it can have detrimental effects on us physically. When you are walking with some type of load in your right hand, the left QL muscle is firing to help maintain posture, while your right glute medius (part of your butt!) is working to maintain proper gait. If those muscles become weak, that excessive load can affect other areas of your body such as your knee (patellar tendonitis) because the hips and core cannot stabilize throughout the movement pattern.
So when my athletes, runners or folks that are working to move pain free, has right knee pain, we find that the right glute medius is usually weak. And since the right glute medius works with the left QL, there’s usually weakness or “trigger points” in the left QL. In other words, if you have right knee pain, strengthen your left QL; as a result, your right glute medius will take stress off the knee.
So, how do you know if you have a weak QL Muscle? Perform a side plank and see how long you can hold it. Then, compare it to the other side. If you perform 60 seconds on the right side plank and 30 seconds on the left side plank, the left is weak and you need to strengthen it. Make sure to check back with Coach Rozy Blog over the next few Wednesdays, for our WEDNESDAY EXERCISE OF THE WEAK, on what exercises and stretches to do for the QL Muscle. Next Friday we’ll be back on track and hitting #3 for our “7 ELEMENTS” of achieving high levels of training and performance.
JYOTI IYER
December 29, 2019 at 6:43 pm
Hi this is very helpful. So if I have pain on my left side- knee and hips, I need to fire up my right QL, so carrying a weight on my left arm while walking should help? I also have a injured right rotator cuff, so I can’t do planks to help build up the right QL. Would you be able to suggest other exercises as well. Thanks!
Mark Roozen
December 29, 2019 at 8:14 pm
Jyoti Iyer –
You can do a number of carries with variations; walk with DB/resistance in both hands by the sides, one arm overhead – one by the side – also by doing one arm carries – by side – arm at 90 degrees – arm overhead changes the carry and the load as you move. One great exercise to activate the QL is to just stand and hold HEAVY dumbbells with the shoulders back, weight by the sides. Controlled breathing is great. I also will send you our rotator cuff program – 12 exercises that you can do. Start off with very light weight – and do 6-8 reps per movement. You can also do band work – such as the Palloff Press. We do lateral press – and also standing lateral and do overhead press work – if your should can handle that work. Look at some of the other shoulder mobility and stability exercises we have on the blog – even the ones that give you T-Spine mobility.
One other area to look at is to make sure the IT band isn’t the problem with the knee and hip pain – not sure if you are a running; but something to look at!
Lets work together to get this figured out! Help you get pain free!
All the best – make 2020 your year.
Coach Rozy
Jason Burnstin
June 14, 2021 at 5:08 pm
Hi Coach – If I sleep on my left side and have a weak right QL, could my sleep position be making things worse for my right QL? Thanks. Jason
Mark Roozen
June 14, 2021 at 6:28 pm
Jason,
Most the time, pain that involves the QL is more from it working overtime because the muscles supporting the spine is weak and the QL kicks in to help out – which really isn’t it’s main function. Pain in the quadratus lumborum can be due to overuse, stress, and strain. Sometimes muscles cause pain and stiffness when they’re weak or too tight. Activities such as sitting for long periods of time can reduce blood flow to an area, especially in the QL and surrounding areas. Sleeping on one side and having pain “MIGHT” be brought on by QL being weak; I would think it could be with the posture issue. You might try to sleep with a pillow between your legs to keep your back in line, or work to sleep in another posting if possible.
From there work to develop the QL muscles – keep things balanced; and work on the back stabilizers as well! Please let me know if you have other questions or need more info!
Coach Rozy
Nick
May 21, 2022 at 12:58 am
Hi,
When I lie down my left QL cramps up to the point it starts twisting my spine. I have got a ton of symptoms all the way up to my shoulders as a result, my left shoulder hikes up too. I dont understand why it would do so. Any exercises I can do to build up my right QL to balance things out, or is my left QL compensating for anything else?
Mark Roozen
June 24, 2022 at 9:32 am
Nick –
Sorry for the late response. Without seeing you – just general thoughts. It might be something more related to the hips and glutes. Also, how is your “lateral” strength; doing a side plank; do you notice a signigicant difference between the right and left side?! That can lead to back/QL issues.
One of our GO TO exercises for strengthening is to just do simple Farmer Walks with load. You can go moderate to heavy with the load – keep good posture and go for a walk!! Keep neutral spine – and start off short build up distance and weight as you go. Those side planks are good – once you get up to 90 sec. on each side – can add mobility to it; leg raise / front and back foot taps / arm reaches, etc.