Podcast: Episode 177: The Power Of Pure Movement: A Key Issue Related To Quadratus Lumborum Pain

Join me for week two of my three-week series exploring the QL, Quadratus Lumborum. This week we explore the connection between the ribs and the pelvis. This is where the QL lives and often is the first place people expect to make movement changes when in pain.

Have you noticed that cues to release your persistent QL pain don’t hit the spot? Have no fear because I share how strain in one area can resolve itself by working with Pure Movement. By breaking down and easing tensions outside of the pain point, my clients often find the area of trouble has space to right itself.

This is why when I address QL pain, I look at the whole body. Join me as I unpack the anatomy and methods I use to identify areas of the body to work to eradicate QL pain. Discover more about Pure Movement and how it can help you reduce the pain in a way that traditional methods can't.

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What You'll Learn from this Episode:

  • How to imagine the rib cage and pelvis connection.
  • Why traditional cuing may not provide release for the QL.
  • The power of tuning in to the whole system.

Featured on the Show:

Full Episode Transcript:

Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.

Welcome and welcome back to From Pain to Possibility, a podcast that helps you reduce and eradicate physical pain for yourself and your clients. I’m your host, Susi Hately and I’m so happy that you’re here today because I’m going to continue my conversation on the QL.

I first spoke about the QL in Episode 118, where I described the QL as the superhero of compensation that comes in swoops in when we have this other anatomical and functional issues that occur. And it can really help us out in situations that are important for it to help out in that way.

Then again, last week I got into the QL and spoke more specifically about why it is. What contributes to the QL raising its ruckus? Why does it keep doing that? And how that leads to so many people falling into the trap of symptom chasing, something I like to call Whack-a-Mole where there’s relief initially, and then the symptoms come back and then whack, and then there’s relief and then the symptoms come back and then whack.

And sometimes it feels quite random in terms of where all these symptoms are arising from. And so it is the whacking of them, sometimes it can feel circular, but overall it feels annoying and agitating. I explained one key reason why symptom chasing continues and how it’s actually a bigger indicator of being disconnected.

I explained what I meant by disconnected and how essentially it is that your sensitivity meter is off and your ability to tune into your body is off. And it’s really important to reconnect so that you can make significant gains. And I explained how you can do that. So that’s last week’s episode.

This week I’m going to continue this conversation on connection from a slightly different perspective where I’m going to dig into just a specific area of the body, the ribcage to the pelvis. After all, this is where the QL lives and when the ribs and pelvis aren’t well connected, the QL can become agitated and annoyed. It’s a really great messenger that things aren’t totally on.

So today we’ll explore connection in this context, explore some common cues that are often used with the intent for more connection, yet can actually lead to more gripping and bracing and then that good old game of Whack-a-Mole, and then a suggestion for how we can integrate for better connection. So let’s dive in.

So what do I mean by connection of the ribs and pelvis? To gain a more embodied or a somatic experience of this, let’s step away from anatomy for just a moment and consider something I learned from one of my trainees years ago, Ann Woods. She’s an OT and an incredible artist and also a yoga therapist. And she would like to share how the ribcage is a cylinder. And I thought, oh, that is so great.

Now, since her comment about the ribcage like a cylinder, I’ve also heard other artists who teach anatomy drawing to other artists describe the ribcage sort of like the shape of an egg. I thought that was sort of curious too. So think about it like a cylinder or egg. And then Ann talked about the pelvis being like a bowl or even a box.

So just for a moment consider those as shapes, those as segments. So now I’ll bring the anatomy back in. So think about the cylinder and the bowl connecting and they are connecting via groups of tissue. So groups of muscles that include the quadratus lumborum, all four layers of the abdominals, the latissimus dorsi, breathing diaphragm, pelvic floor, as well as the thoracolumbar fascia.

So collectively this connection provides an important role in providing support and stability to how the loads and forces are moved, dissipated, and absorbed through our bodies. So functionally how this tissue responds is vital to how the cylinder and bowl interact. And in turn, how the cylinder and bowl interact will directly impact how the tissue responds.

So it really is this feedback and feed-forward relationship. How the tissue responds is vital to how the cylinder and bowl interact and connect. And in turn, that connection between the cylinder and bowl impacts how the tissue responds.

Now, since the focus this week is on the QL, this relationship between these parts, cylinder and bowl, and how the tissue that connects them, this relationship very specifically impacts the way the QL behaves and responds. If this tissue becomes grippy, if it pulls the cylinder or pelvis one way or the other, if it contributes to poor interaction, then that QL can also become strained. So rather than connection and ease, what results is not only disconnection but ineffective bracing and sometimes a hardness and possible spasming.

Now let’s explore some cueing that contributes to this. Now, oftentimes in the yoga world and the Pilates world and the fitness world cueing is created or offered based off of what is seen. And in context of the ribs in the pelvis, when we see poor alignment between the ribs and the pelvis, between the cylinder and the bowl, the teacher wants to bring about a better position, a better alignment.

So if the ribs are not stacked over the pelvis, that teacher or that trainer might use the cues of, well, pull the ribs in. If the ribs are sort of appearing to stick out, pull those ribs in. Or another common one is weave the ribs into the upper abdomen. It might be that we need to tuck the pelvis, right? If the pelvis is in an anterior tilt and it’s losing connection with the ribs, then the cue might be to tuck in the pelvis, or it could also be pulling the navel toward the spine.

Now, from these cues better alignment may occur. But the question becomes does that better alignment mean better connection? What I can say is that the group of people that I work with, the ones that I’m helping to reduce and eradicate persistent pain, what I see is that these cues do not work for these folks.

What happens is their breath often becomes more shallow as those ribs get pulled in. Or as they pull that navel to the spine their obliques can overly engage and the upper abdominal muscles can become overly tense. And it can impact the way that the diaphragm moves or the access to the ribcage as we breathe.

The pelvic floor can, according to some pelvic health therapists that I know, the pelvic floor can become more hypertonic and the abdomen more tense. And when you consider the common dysfunctions that the QL is compensating for, these cueings can lead to greater core muscle weakness, right? Those deep core muscles, like the transverse abdominis or the multifidus, might not be properly activated.

So then the QL might come in and try harder to stabilize the spine and to maintain posture. That cueing, that tension that can be resultant from that type of cueing can generate or contribute to or continue gluteal muscle weakness, particularly through the glute med and the glute max. They can sometimes continue to be weak or functioning not as optimally as what’s possible. And then the QL makes them come in, become overactive and attempt to provide stability and support to the hips and the pelvis.

That cueing might also contribute to hip mobility restrictions. It can impact hip flexion or extension rotation. That QL may come in and compensate by assisting hip movements by moving that pelvis toward the ribs, as an example. So this just leads to poor moving mechanics. More overworking of that QL, leading to more fatigue, strain and injury. So while this cueing is really common and all very well intentioned, it’s not actually solving the actual problem that needs to be addressed.

So I’ve talked about the kind of client that I typically see because pretty much everybody that I see has had persistent issues of pain for a period of time where they’ve had some gain, they’ve had some relief. They might be playing the game of Whack-a-Mole and they’re kind of annoyed and they want things to change. And they know that I’m someone who can support them in reducing and eradicating physical pain.

Now, you might not be that kind of person. You might be doing okay. So how do you tell if that cueing is working or not working? Well, let’s first consider, is there more ease being generated? Is there less tension being generated? Is there more of a floating, light, tall kind of experience being had? Do you feel more in your legs, or lighter on your feet? Those are all just examples of how it will feel if we are moving in a way that is deeply congruent and connected in ourselves.

So then, what’s the alternative? If what I’m offering here is that cueing might not work, certainly for the folks that I tend to see, then what would? And then how does this relate to better QL? Well, let me share this in the form of a story.

I recently had a client who had QL issues, very persistent QL issues. And initially what we discovered is that the way that her leg bone moved in her pelvis, so the way the leg bone moved in the bowl wasn’t terrific. So the bowl of her pelvis was moving all over the place while she was attempting to do some basic hip mobility work.

So that was the first thing we did. We helped her gain a better connection between the leg and the pelvis and just helped her settle in through that abdomen. The abdominal tissue connects the cylinder to that pelvis, the cylinder to the bowl. And then as she gained more awareness of what was connecting and what was contributing to the way that leg bone moved better in her pelvis, she then was able to tune in to some of the straining patterns between the cylinder and the bowl, or the ribcage and the pelvis.

And then we are able to better connect those two segments in twisting and in side bending and back bending. We were then able to create a better connection between those movements and the mobility and stability work she was doing between the leg and the pelvis.

So we started with one component, helping to improve how that bowl and the leg bone were working, because that’s such a common pattern with QL issues. There’s something usually amiss between that leg bone and pelvis. Then there’s often something that needs to be retrained between the ribs and the pelvis because that’s where the QL lives.

Then what was really interesting is we continued to move up the body. What we noticed is that in the cylinder the shoulder blades and the upper part of the spine and the neck and the tissue around the jaw was now having its opportunity to speak, if I could put it that way. With the patterns further down the chain settled out, she could feel the strain further up the chain and how that was actually contributing to what was going on between the ribs and the pelvis.

Now, what was curious about this is that that area, and this is so common for so many of my clients, is that area, she’s like, well, you know what, that’s just the way it is. And I offered up, well imagine if this was resolved, how might the connection be between the ribs and the pelvis? You’ve already gained connection here. You’ve already gained connection to the hip, so how might that deepen the connection, lengthen the amount of time you have that connection, and give you greater bandwidth and greater energy?

I was providing her different movements, different mobility exercises, different strengthening exercises that were connecting how her leg bone moved in the pelvis, how her pelvis and her ribcage moved relative to each other, and then how her shoulder blades moved on her ribcage and how her neck area moved relative to her blades, her ribcage and her pelvis. It was allowing each component of that to improve its movement pattern.

The motor control and coordination between the brain and the tissue surrounding that joint. Each joint area became a better mover. And then we were able to continue to connect them all. Starting with the hip, adding in the space between the pelvis and the ribs, the bowl and that cylinder, and then further up the chain to the blades and the neck and then connected the whole.

So we didn’t have to pull ribs in, or tuck pelvis, or pull navel to the spine. Because as connection became more fluid and consistent, better alignment organically and naturally arose. Now what do I mean by organic and natural? So rather than putting the ribcage or the pelvis in a certain position relative to each other, like pulling those ribs in or tucking the pelvis, the position of the ribs and pelvis naturally improved, the relationship between those naturally improved because the whole system was working better together.

So rarely is the QL speaking up in agitation and annoyance because of it. It’s responding because of other forces at play. And we can start in the area, but we often have to move much further beyond.

In the program that I’m running beginning on June the 20th, Power of Pure Movement: Stronger and Happier QL, this is what we are focusing on. And in fact, I got an email just prior to recording this episode where someone asked me, you know, I actually have a lot of QL problems and I’m a little concerned about working the QL itself. Am I going to be okay for this program?

And my response was yes, because we’re likely going to be spending more time away from the QL to show the QL how when you work in areas away from it, it actually settles out. And as a result of that, the nervous system can calm down, the breathing can calm down and more ease can arise. Connection, rib cage to pelvis, cylinder to bowl, helping your system functionally work better so that you don’t have to pull parts in together.

We’re a dynamic living, breathing human being. We aren’t Lego pieces, we’re not blocks that we just kind of push one here and push one there and make that alignment happen. We’re 3D structures that have energy pulsing through us. And we have to honor that 3D-ness and we have to honor that pulsation of energy.

So a simple thing that you can try on your own is when you move into whatever movements you’re doing, so if you’re someone who’s working with QL or you’re a professional who’s providing QL stretches to your clients, just notice the way their parts are moving without having to utilize those cues. And see how those parts naturally connect when you move more purely, when you move with more ease, and see the results that arise from that.

If you’re resonating with what I’m sharing today and you’d like my help in supporting yourself and improving your QL, or if you’re a practitioner who wants to hone your skill, with the approach that I utilize to help people reduce and eradicate pain rather than just manage it, then check out learn.functionalsynergy.com/QL. I would so love to work with you.

The QL is such a source of agitation for so many people and it doesn’t have to be. And of course if there’s any questions, fire them off to me. You can find me at [email protected] Have a great time exploring. Thank you for being here today. I look forward to connecting with you next week.

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