<b>What is the Quadratus Lumborum?</b>

<span style="font-weight: 400;">It is a deep muscle that provides stabilisation and movement of the pelvis and spine.</span>

<span style="font-weight: 400;">In fact we have 2 of them!</span>

&nbsp;

<b>Where are they?</b>

<span style="font-weight: 400;">They are at the back of the spine close to the midline and attach to the 12th rib and the iliac crest. The medial fibres also insert into the transverse processes of the lumbar spine.</span>

&nbsp;

<b>What do they do?</b>

<span style="font-weight: 400;">Primarily, if there is a bilateral contraction of both QL, the spine will extend. However individually they produce lateral flexion of the spine or hip hitching.</span>

&nbsp;

<b>What problem can arise?</b>

<span style="font-weight: 400;">Due to our sedentary lifestyles we are spending more time sitting in some degree of lumbar flexion.</span>

<span style="font-weight: 400;">QL is commonly found to be in a state of subclinical spasm </span><span style="font-weight: 400;">and can cause limitations in movement. </span>

&nbsp;

<b>How does this affect movement?</b>

<span style="font-weight: 400;">If the QL muscle/s are in spasm they can limit the spine’s ability to laterally flex.</span>

&nbsp;

<span style="font-weight: 400;">For example, bending over to pick up shopping bags or even things like turning to reverse in your car, could become much more difficult if your QL is in spasm.</span>

&nbsp;

<span style="font-weight: 400;">Imagine activities like running, or maybe rock climbing, where you need to hitch your hip/leg up. The QL muscle  contributes to the hip hitching up, but when in subclinical spasm, this function and control of it may be inhibited.</span>

&nbsp;

<span style="font-weight: 400;">Also QL spasm could even create a descending mechanical compensation in the body like a functional leg length discrepancy. The subclinical spasm can cause a hitch of the ilium lifting it up on that side, which in turn could then affect your pelvic function and even the load being transferred down into your knee and foot!</span>

&nbsp;

<b>What can we do?</b>

<span style="font-weight: 400;">When we laterally flex or side bend we should see a nice smooth curve in the spine. So we can test QL by asking our client to sit (to limit movement from the pelvis) and watch their spines movement and shape as the lean from one side, to the other. If you see what a ‘hinge’ in the lumbar area instead of a smooth curve this would indicate QL spasm.</span>

&nbsp;

<span style="font-weight: 400;">This video shows a few QL tests in action:</span>

&nbsp;

<iframe src="https://www.youtube.com/embed/xWlGWanUOPE" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

&nbsp;

<b>Solution </b>

<span style="font-weight: 400;">A wonderful accessory technique called Wall Glides that acts as an anti spasm on the QL muscle and can be a great way to iron out hinges. It is important to recognise this is not a joint mobilisation exercise but is a muscle energy technique. </span>

&nbsp;

<span style="font-weight: 400;">This specific movement below is a VERY slow subtle gliding action of the vertebrae which 'proprioceptively desensitises' the subclinical spasm in QL when done super slowly for reps.</span>

&nbsp;

<img class="aligncenter size-large wp-image-2787" src="https://www.biomechanicseducation.com/wp-content/uploads/2017/05/MG_9964-683x1024.jpg" alt="_mg_9964" width="683" height="1024" />

&nbsp;
<ol>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Standing side on to the wall ask your client to measure their foot distance from the wall. Resting the whole upper arm against the wall, fix the ribs to the inside of the arm as if you are holding a newspaper there.</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Now bend the elbow to 90 degrees</span><span style="font-weight: 400;"> </span><span style="font-weight: 400;">at the waist, keeping the body straight.</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Keeping the ribs </span><b>fixed </b><span style="font-weight: 400;">above the elbow, gently glide the hips underneath the elbow, towards the wall, by just an inch or 2 and return to original position.</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Repeat slowly for 8 reps both sides 2 x daily. </span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">If it feels tender reduce the range no matter how small.</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Anyone with any clinical conditions that affect the lower back should consult their Biomechanics Coach&#x2122; first.</span></li>
</ol>
&nbsp;

<b>Considerations</b>

<span style="font-weight: 400;">Just as QL spasm can cause descending compensations, as described above, any ascending compensations could result in QL spasm!  </span><span style="font-weight: 400;">The Body is a Master of Compensation &amp; Works As An Integrated System!</span>

&nbsp;
<p style="text-align: center;"><b>Would you like to learn more?</b></p>
<p style="text-align: center;">rachel@biomechanicseducation.com</p>