Feb 272011

Quadratus Lumborum muscle highlighted on diagram

What pain and symptoms are associated with the quadratus lumborum?

  • Pain in the low back, constant deep aching even at rest
  • Pain in the hips and buttocks
  • Groin pain
  • Pelvic pain
  • Pain down the front of the thigh
  • Low abdominal pain

Where is the Quadratus Lumborum muscle?

The quadratus lumborum is a low back muscle that connects the hip bone and lower back vertebrae to the 12th rib.

What movements does the quadratus lumborum muscle control?

  • Side bending the trunk
  • Straightening of the spine (standing straight)
  • Stabilizes  low back

Quadratus Lumborum Trigger Point Pain Pattern

Activities that cause quadratus lumborum pain and symptoms:

  • Lifting heavy objects
  • Twisting while lifting
  • Leg length discrepancy – one leg shorter than other. This can be the way you were born or due to injury. It is often seen after a leg has been in a cast or splint.

How Can Massage Therapy Relieve Pain and Symptoms Caused By The Quadratus Lumborum?

The quadratus lumborum can cause debilitating pain when shortened or trigger points are present. Therapeutic massage can release trigger points and soften the muscle to coax it back to normal length. Anytime the quadratus lumborum is the primary source of low back pain, all other muscles of the low back, pelvis and upper leg muscles must be examined and treated.

Interesting facts about the quadratus lumborum:

  • Pain from the quadratus lumborum can be paralyzing. It brings sharp knife like pain to the lower back area. Turning over in bed and trying to stand from a sitting position can almost bring tears to the eyes.
  • People who have one hip noticeably higher than the other are usually experiencing problems with the quadratus lumborum.

Clinical diagnoses to which this muscle symptoms may contribute: Trochanteric bursitis, S1 nerve compression, Sciatica, Osteoarthritis, Rheumatoid Arthritis, Sprain/Strain low back, Weakened Abdominal Muscles

Other muscles that should be considered and examined in conjunction with the quadratus lumborum:

  • Iliopsoas
  • Lumbar paraspinal muscles
  • Gluteal muscles
  • Piriformis
  • Rectus Abdominis

Origin: Transverse processes of  L1 – L4, the ilolumbar ligament, posterior third of the iliac crest
Insertion: Inferior border of the 12th rib
Action: Alone, lateral flexion of vertebral column; Together, depression of thoracic rib cage
Innervation: Ventral primary rami of T12 – L3

Primary Actions:

1. Lateral rotation of the lumbar spine when acting unilaterally

  • Agonists: Iliocostalis lumborum,  Longissimus thoracis,  Psoas major, External Oblique, Internal Oblique
  • Antagonists: Same muscles on opposite side (Iliocostalis lumborum,  Longissimus thoracis,  Psoas major, External Oblique, Internal Oblique)

Secondary Actions:

1. Elevation of the pelvis when acting unilaterally

  • Agonists: Rectus abdominis, Internal Oblique, External Oblique
  • Antagonists: None – assisted by gravity

Satellite Trigger Points: Gluteus minimus, Gluteus medius, Thoracolumbar paraspinals, Piriformis

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