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Quadratus Lumborum Stretch

Directions

1. Lie on a flat, elevated surface.  If it's a bed, remove the covers first for a firmer surface.
2. Place a pillow on the edge of the long side of the bed.
3. Lie on the edge long side of the bed, facing the inside of the bed, with your waist on the pillow.
4. Dangle your top leg behind and below you.
5. Reach up over your head with your top arm.
6. Reach straight out on the bed with your bottom arm to keep you from falling backwards off the bed.
7. You should feel a stretch in your quadratus lumborum ("QL") and/or oblique on the top side.  Alternatively, you may feel a stretch in your ITB and/or intercostals on the top side.

Tips

1. Vary the angle with which you lie on the bed.
2. Vary the degree you allow your hip to rotate backwards.

Background

The quadratus lumborum muscles, together with the illiopsoas, are a common cause of lower back pain. Before you convince yourself that the quadratus lumborum is the source of your back pain and commit to stretching your quadratus lumborum every day, you should consider whether your psoas muscle might be causing your lower back pain. Read the floota.com articles on (1) testing your psoas for dysfunction (2) stretching out your psoas and (3) "desk jockeys" (detailing the negative effects on your body of sitting for 16 hours a day 365 days a year).

Because most people sit for 90% of the day, their quadratus lumborum muscles are short, tight, and overused.  The quadratus lumborum muscles assist in side bending and in back extension.  The quadratus lumborum muscles are constantly working if you are sitting without lower back support (which is not to imply that lower back support is necessarily desirable). 

If you have back pain that is only on one side of your lower back, there’s a good chance it’s the quadratus lumborum on that side.  If, for some reason, you like to cross your legs when you sit, and you frequently only cross them one way (e.g. always right over left), this means there are unequal forces on your back.  To keep your back straight, one of your quadratus lumborum muscles is then engaged.  Some people have a tendency, when they cross their legs while sitting, to shift their weight onto the butt cheek of the uncrossed leg.  For example, crossing your left leg over your right means you lean slightly to the right, with, say, 70% of your weight on your right sit-bone, 30% on your left.  This isn’t a problem, unless you do it for 12-14 hours a day, every day (like most of us do when we’re sitting).  If this is habitual, that means one of your quadratus lumborum muscles is doing most of the work all day while you sit.

So what do you do if you have quadratus lumborum pain?  First of all, lie down and have someone rub your lower back on one side and then the other, to check for tenderness.  The problem is, there are several structures down there, and the quadratus lumborum is the deepest (it’s below other muscles, like the erector spinae).  To rub it, you have to kind of come in from the side, rubbing up and down relative to the spine (i.e. parallel to the spine).

If indeed one of your quadratus lumborum muscles is causing you pain, the quadratus lumborum pain is due to habitual overuse (unless you actually injured it during a fall or sport or whatever, which is highly unlikely).  You need to address the habitual overuse first.  Get a little lumbar support pillow and use it until your quadratus lumborum is better.  Next, use a heating pad on your quadratus lumborum.  You can get an electric heating pad for $15 USD, and most of them come with a felt pad nowadays that can be soaked in water and placed in the satchel to provide moist heat, which is much more conductive.  One of my physical therapists said that just using a heating pad without a wet towel is essentially useless in that it “only heats the skin.”  I don’t know if I agree with her, but take it for what you will. 

Next, stretch your quadratus lumborum to get it supple again.  Recovery could take weeks of daily quadratus lumborum stretching.  If, after stretching the quadratus lumborum for weeks, the quadratus lumborum is still tender and sore, either you didn’t correct the habitual misuse of it and are reinjuring it daily, or you have some sort of myofascial problem with it (i.e. “knots” or “adhesions”).  In this case, you need to go to someone who can do “stressage” or ART (active release technique) before stretching will be much good.  Once the quadratus lumborum pain is gone, the quadratus lumborum pain will return unless you (A) stop sitting all day or (B) strengthen your quadratus lumborum such that it can handle the demands you place on it.  This means doing anaerobic exercise specifically for the quadratus lumborum muscles.

References

1. Quadratus Lumborum Muscle @ Wikipedia
2. Quadratus Lumborum Muscle @ Exrx