Podcast: Episode 176: The Power of Pure Movement: How to Resolve QL Pain

The Quadratus Lumborum (QL) is a crucial muscle in our body that often plays a significant role in compensatory patterns. One of the top five reasons people come to me is to seek relief from QL pain. However, upon closer examination, we realize that the QL itself is not the sole issue, but rather a symptom of an underlying problem.

In the realm of yoga practices, awareness and mindfulness are fundamental principles. These principles are also fundamental to understanding movement, tuning in to the body, and addressing pain. 

I invite you to join me this week as I share the stories of two clients who successfully eliminated their QL pain. Through digging deep, we uncovered a deeper issue—a disconnection with their own bodies. Tune in and discover how these clients resolved their pain through pure movement and the other principles I teach. If you currently have QL pain or are working with clients who do, you don't want to miss this episode.

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What You'll Learn from this Episode:

  • Where the QL is and its role in the body.
  • What symptom chasing is and why it doesn't work.
  • How to resolve disconnection.
  • How mental and emotional states link to the physical body

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 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 back to focus on the quadratus lumborum, which I’ll refer to throughout this episode as the QL.

And it’s really on the top five list for why people come to contact me. Whether they’re a person with QL pain or they are a massage therapist or occupational therapist or yoga teacher who has been integrating therapeutic aspects of yoga with their clients who have QL issues but they’re not getting better.

Most often the message I receive has the elements of I’ve stretched the QL in multiple ways, I’ve strengthened the core, I’ve worked with the pelvis, I’ve done breathing work and still that QL pain is not going away. What is not working, right? They know that something is missing but aren’t quite sure what that is.

Now, I first spoke about issues with the QL in episode 118, and I highlighted the highly compensatory superpower that is the QL. I actually called it like the superhero of compensation. It swoops in with its cape to try and solve the problem that isn’t. And that’s one reason why issues continue to arise. So instead of rehashing that, I’d like to take the conversation a little deeper and in a slightly different direction and talk about three different things.

The first is a key reason that the QL continues to raise a ruckus for so many people. The second is to highlight a concept that I teach my clientele to really help resolve this. And then a third is an invitation to the Power of Pure Movement: The Quadratus Lumborum, so that if you are finding that you would like to have help with applying the concepts I’m teaching. And that program, I’m running at the end of June and I think you’ll really quite like it.

So to begin with, let’s first remember the QL and just where it sits in our body and what its role is. So it’s one thing to engage in an anatomy conversation from our brain from a cognitive perspective and get intellectual. What I’d like to do is add in an embodied somatic experience here. And just quite simply place your hands at your ribs and at your pelvis, and just get a sense of where this quadrant of your body is.

So the top of the pelvis, the bottom of the ribs, and voila, this is the space generally where the QL lives, connecting between that pelvic rim, the iliac crest, and the 12th rib, and also the vertebrae. So when the QL begins to contract, now just imagine your ribs or even do it, bring your ribs down towards your pelvis. That is in part the QL involvement. Now bring the pelvis up toward the ribs. So you’re doing a side bend in both of those circumstances, the QL is involved.

It also fixes the ribs during a forced exhalation. So think like Pilates 100s. And then there’s also conversation around the QL when they’re working bilaterally as being an extensor of the spine. And there’s some talk about it not being that strong of an extensor, but extensor it is, nonetheless. So it does have that role.

And of course, what I mentioned in episode 118 is the superhero of compensation. The QL swoops in to compensate for so many things that aren’t working as well. And thank goodness it does that or we wouldn’t really get around so well. The trouble is, we don’t retrain to support ourselves.

So for example, the QL can really get involved when people are almost at that point of needing hip surgery or knee surgery as an example. And when people get off the table and start the rehab program, they really do need to focus on retraining their gait so that the QL doesn’t maintain that habitual pattern of compensation.

It’s really, really, really important because some people think, oh, I’ve gone in for surgery, I should be able to walk fine. But it’s interesting how many people will limp right away because they haven’t retrained that pattern. You have to retrain so that you retrain out of that limp. So that is partly one of the things that contributes to why that QL continues to raise a ruckus.

Many people are so quick to blame things like sitting and sleeping position, and while those do seem likely to be a cause, and you can certainly clear up a lot of pain related to the QL by changing up sitting position and sleeping position, oftentimes just changing the position up provides a temporary fix, but not actually longer term sustainable change because they’re not solving the problem that actually is.

Yep, they’re handling some symptoms, treating some symptoms, yes. And those symptoms are annoying and agitating. And some relief is gained, but not long term. This is often a problem I call symptom chasing. Sometimes I like to call it whack-a-mole, where there’s an annoying symptom that comes up, we find something to relieve it and that lasts for a short period of time. And then something else comes up and we whack that.

When in this state it’s so easy, easy, easy to get tired and resigned and agitated. I’ve seen clients make reference to their age, their work, their sitting or sleeping position, their activity or lack of activity as to why the QL is feeling the way it is. And all of these things have an element of truth and they all play a part, but they’re not the thing that is the thing.

So to illustrate the real reason, I’m going to tell you a story. And it’s a story about a client who came to me with QL pain. He was a basketball player, also had been a football player when he was younger, so he had multiple injuries. And he was doing all the things.

He was a real researcher type of person so he had researched the QL. He was stretching all the ways, core work all the ways. He had even had some injections. And while the exercises had given him some relief and it made him think they were the right ones, they weren’t giving him results consistently.

And this then led him back online where he read about sitting and sleeping and recognizing that some of the positions were often bad for QL, particularly on the position he slept in, which was in a sort of prone on the belly kind of on the side position with the knee coming up toward the belly. So the hip was hiking, so if you remember that movement of that pelvis toward the ribs. And he was figuring that that QL was in a bit of a passive contraction throughout the night or at least through part of the night.

So he tried to change up the way he was sleeping, got a little bit of relief, but the results weren’t any more consistent than what he was already doing. And so he ended up having more questions than answers. And then we meet, and I run a one to one, three months series for my private sessions. And in one visit his pain had come down dramatically. He was symptom free for longer than he had been in years.

And then over the period of time that we worked together, which is three months, the pain disappeared completely at about week six. And he was back to doing all the nimble, agile stuff that he needed to do as a basketball player without more pain.

All right, so let’s take a deeper look at this story. Why was he not getting better? Was it that he was doing the wrong exercise? Was it his sleeping position? And why did he get so much better with what I showed him? On the surface, yes, it appears that the exercises or the sleeping position were not the right ones. Those are apparently what the results seemed to be telling him.

But what was really going on? There are a lot of people who sleep and sit in all sorts of funky positions, and they do their exercises in all sorts of compensatory ways, and they don’t have QL flare ups. They don’t have QL tension or they even resolve their QL tension. So what gives, right? In my clients’ case, he knew a lot. He was doing a lot of the right things and he wasn’t getting better. But why?

The real reason he wasn’t getting better was because he wasn’t actually solving the real problem. The actual problem is that he was disconnected. He was doing all these exercises and he was doing all this intervention, and yet he was doing it in what I like to call like on top of being disconnected. He wasn’t shifting this whole idea of disconnection.

So what do I mean by the word disconnection? Let’s deep dive on this. When you are disconnected, your sensitivity meter is off, your ability to tune into yourself is off. You think you’re paying attention to the sensations that matter, but most of the time you’re actually ping-ponging between fixing the problem and being resigned to the symptoms when they return.

When I’ve spoken to clients who have resolved this, they will say that when they are disconnected they feel unaligned. They’re not connecting to their inner wisdom or their inner authority. They’re mostly in their head either lamenting about the pain, being resigned to the pain or they’re trying like heck to find the person who will do something to them to fix the pain. It’s like they’re looking at their body as being something that is not theirs.

Now, what’s important is that none of these states are helping them make sustainable progress. And if they do make progress, there is an element of being prepared for when the symptoms return. And what I mean by being prepared, I mean that waiting and wondering phase. Like is what they’re about to do going to set off symptoms? So while the symptoms are down there waiting and they’re wondering, kind of like they’re bracing against a future that may or may not come.

And in many ways that bracing against, that waiting and wondering has them feeling just as or maybe even more depleted, more strained and perhaps inadequate, as compared to before the symptoms reduced. So the symptoms have reduced, and yet here they are waiting on eggshells or gripping against something that may or may not happen.

When I can teach my clients how to reconnect, they are able to better tune into the signals that tell them that they’ve tuned out. So now they start to be able to notice that their body is their friend, that the symptoms are methods of communication. That it’s not something to fix, but the act of listening to what is going on and being able to discern what that means opens up a whole greater understanding of the pattern that’s contributing to the pain.

And the power for resolving or at least even reducing pain lies in the pattern. So where some people will focus on the QL as a single point of like, “Oh, get rid of this QL pain,” really, you’re only dealing with it at a superficial or a surface level. And the QL, rarely is it just about the QL. Rarely, rarely, rarely. So you need to be able to step back enough to perceive what’s going on, to reconnect to what’s going on.

The bottom line here is, as I mentioned a moment ago, people can sleep in all sorts of dysfunctional ways and sit for seemingly endless hours, compensate like crazy and still resolve their QL issues. The key here is there’s not a perfect sleeping position. There’s not a perfect amount of time to sit, or even a perfect set of exercises that are the key recipe for getting out of QL pain.

I mean, just look on YouTube, there’s a crap ton of things you can do for your QL because there are many, many, many different permutations and combinations for resolving this thing. Now, I realize that for some people listening this might seem downright disappointing. And I’m also hoping that it spawns a new level of hope, because getting away from chasing or seeking the capital T thing that will hopefully solve the surface problem will actually move you closer towards resolving the actual problem.

Remember, QL issues, at least with the circle of people who I work with, they’re in the top five reasons why people seek me out for some support. And every single person except for one in the most recent past has come to me saying please solve this for me.

The one person who didn’t, had already taken the previous edition of the Power of Pure Movement: Quadratus Lumborum program. And he showed up saying, and these are his words, “That program completely reduced my pain. But it seems like what I really need to become aware of is that which I’m not aware of, which is contributing to why the QL is wanting to come back and kind of flare. How do I do that?”

Can you discern the distinction? People coming to me asking for a fix, asking for me to treat the problem, versus someone coming in to ask for help and becoming aware of what the problem could be. This might seem nuanced. And let me tell you, it is so incredibly powerful. Now, here’s what’s fun, even for people who are seeking the fix, I can still work with them. And I do because I start by supporting them and resolving that surface issue of pain, all the while teaching them about their body, teaching them to tune in to what’s contributing to the pain.

This is where this yoga approach to the recovery process is so powerful. Because in a yoga-based approach, awareness is fundamental, mindfulness is fundamental, tuning in is fundamental. We don’t inherently look at the body as being broken, at least that’s not my view of yoga anyway.

So as I help those people seeking the fix grow their awareness, grow their ability to perceive all of the data points that are present that are contributing to the issue at hand, now we have a great chance at resolving it because we see the bigger pattern.

Okay, so now how do I do this? You are going to find the exact process of this inside of the Power of Pure Movement, the Quadratus Lumborum program that I’m beginning at the end of this month. And it’s a process where you can connect to how your body is moving, where it is compensating, where you are gripping and holding and how to connect to the information and know what to do next.

You’ll move past the superficial or surface complaint, and then recognize the overall pattern that’s contributing to your QL responding in the way that it is. And then when you address this pattern, that is where you shift the trajectory of your QL pain.

So how do I do this? What I’m going to teach you now is one part of the process. And I’m going to share it with you in the form of a story with my client who saw the relationship between his QL, ribcage and SI joint, okay? Now, again, a client who was doing all of the things. He works at the airline, working both the front desk where you come in and you check your luggage, as well as at the gate helping people get onto the plane and then helping people come off the plane.

So there’s a lot of standing that’s going on, there can be quite a bit of moving parts, sometimes quite a bit of stress. And then depending on the customers that are coming up to the desk and the various, just all the various things that can be occurring, and they need to get the plane off on time or any number of things can occur.

And so sometimes it’s a breath holding kind of needing to follow a step-by-step process in a very particular way. And when something goes off the rails a little bit, like people being late, or pilots being late or any number of other things that aren’t expected that can happen, it can create a little bit of extra load of stress.

So this client of mine has had a QL spasm for a little bit. And so when he came in because of the consistency and the kind of work that he does, we were able to track what he was experiencing through his body when he was in the act of bringing people onto the plane or when he was at the desk checking people in at the front of the airport, versus when he was not in those scenarios.

And it was really easy to name something like lifting luggage or doing things that were extra load physically to his body. So the first thing that I was asking him to become aware of is to simply notice what were the various activities he was doing while he was doing his work. And then he was able to tune in. And what he started to recognize is that there was more standing as opposed to doing any sort of lifting or putting his body into awkward positions.

Then the next part of the conversation was all right, well then how is the standing position? So it became obvious to look at this from an anatomical standpoint, but then it started to open up. It wasn’t so much the standing position that was contributing, but rather how he was holding his body when there was sort of this rat a tat, tat, tat, tat pace to what was going on, whether he was at the gate or whether he was at the front of the airport.

So it was how he was in the situation, as opposed to what he was doing with his posture. So how he was mentally and emotionally working with the situation versus what he was doing with his posture. What ended up happening though, is he started to recognize how his posture responded to his mental state, and then how his mental state responded to his posture.

So he started to get greater and greater and greater understanding of what was contributing to why his QL was what it was. Now, what was interesting with this as well, is how he started to also notice that he thought he held most of his stress up in his ribcage. Like he would stop breathing or he would start to feel emotions of anxiety during certain parts of the workday.

Then he had the understanding of like, wait a second, that’s not really stress that I’m responding to. I’m responding to the heldness down in my pelvis and in my ribcage, and that’s creating the tension up higher around the breastbone area.

As soon he was able to recognize that and he started to do a few different movements, he started to shift up his breath from the perspective of supporting what he was realizing down lower in his torso, the ribcage freed up. His jaw freed up. His QL freed up and he found himself standing on his feet.

So it’s interesting in this circumstance that he was relating it all to an emotional state and he could feel his posture change as a result, as opposed to needing to go in there and fix his posture. So not that fixing the posture is a bad or wrong thing, it was just he was starting to get a greater understanding of what was contributing to his situation.

Okay, now, how does this relate to you or to your clients? The reason my client was able to do this was because while I was working with him, he was experiencing reductions of pain related to his QL. When I was working with him he did not yet see the correlation to his ribcage. He discovered that when he was at work, but he did recognize pain reduction while I was working with him.

So he had tuned into what the feelings felt like when he had less pain. He felt lighter, he felt taller, he felt more on his feet. So when he was at work and he started to recognize the yellow lights or the whispers of the tension arising, he then went, “Huh, I wonder what else I’m feeling.”

He didn’t feel lighter. He didn’t feel taller. And he certainly didn’t feel grounded or even in his feet. So he was able to relate what he was experiencing from the session to when he was at work. And then he was able to start to incorporate, all right, how now can I support myself at work so that I can have longer and extended periods of time feeling lighter and taller and more on the feet?

All right, so how we got here is what I now offer to you. Whenever you’re doing the exercises that you’ve been given or that you have found on YouTube or however you have come to those things, whether it’s exercises, or whether it’s breathing technique, or whether it’s sleeping position, or whatever it is, that has given you some level of relief, notice what that relief actually is.

So is it that you’re taller or lighter? Is it that your pelvic floor feels different? Can you name this experience? And here’s why this is important. It’s so easy, and our culture is one that spends lots of time here, and that is there’s QL pain, you do something to relieve it and then now you don’t have QL pain. End of story, off you go dealing with your life. But you don’t have something to notice when the QL pain starts to come back.

And that’s where the mistake lies, what’s this state of relief feeling like? Because whatever is contributing to the QL pain existing has been a habit that’s been around for a little while, especially if you have persistent issues of pain. So when you get the relief, that relief is not a pattern that’s got legs yet, is how I like to say. It doesn’t have endurance yet.

So in order to get some endurance and stamina, you’ve got to pay attention to what it is. What’s the state that we’re trying to now have, like remember. And if you can name it something other than, well, I’ve just got relief. But what? What are the qualities of that relief? And different people call it different things.

So it can be grounded, in the pelvis, in the feet, taller, whatever it is. Try not to use the word “not pain,” though, because you’re still focusing on pain. But if you can name it something other than not pain, or pain relief, or less pain, now you’re creating a new state. Whether it’s lightness, or tall, or grounded, or in the legs, or I can feel my pelvic floor or whatever that is.

So here’s the thing, when you’re doing that, and what my client demonstrated when he was at work is this ability to engage and to connect. The exercises, yes. Do they provide relief? For sure. But how I really want you to see the exercises that you’re doing, whatever they are, is how are they helping you create connection?

Let the exercises be the doorway in. Let them be the start of the conversation. The exercise is not being done to you. When you’re mindfully aware of what is happening, you will see more of the pattern that contributes.

See, so many people think that pain comes back for no apparent reason. And it’s simply not the case. When you can recognize what’s contributing to the pain relief and you spend some time just connecting to yourself and to your system, you will start to recognize what is contributing to the pain coming back. The idea here is that you’re focused on you.

Now, as I mentioned earlier in this episode, you recognize your body as your friend. That there’s some significant messages that it’s providing you so you can be curious. You can approach with more trust, care and tenderness.

There is a collaboration between you and your body. There is a collaboration between you and me, yeah? You’re bringing your expertise. I’m bringing my biomechanical understanding, my ability to see movement, my ability to see the patterns and then teach you concepts so that you can become clearly connected.

That’s what I did with my client, the one that worked at the airport and also the one I was referring to earlier who was a basketball player and a football player. You see how connection can give you a clarity that is also giving you peace? The more you get this clarity and this peace, the greater your foundation for having less and less and less pain arises.

You don’t have to cycle around and around and around and around. Rather, you gain more and more functional movement patterns so that the QL does what it’s only meant to do. And the other joints, they do what they’re meant to do.

And the relief that comes is a relief that helps you come home to yourself, tuning in and connecting. And it’s that which brings quality range of motion, coordinated strength and that, quality range and coordinated strength, that is what brings greater and greater sustainable results.

So the conclusion here is that connection is the key to your success. Getting out of QL pain is a process of connection. It doesn’t matter the exercises you do, really. Can they be a doorway into reconnecting with your body, with the whispers so that you don’t have to hear the screams?

All right, so now, what to do next. If this is resonating with you and you want my help in applying the concepts to your own body, and if you are a health professional with your clients. If you want to move beyond treating your clients and really help teach them how to get into this place of connection, then go to learn.functionalsynergy.com/QL.

We begin June 27th. It’s live but it’s also recorded, so if you can’t make the time it’s all good. And you’ll have access to the program forever. I would love, love, love to work with you. And, of course, please join me next time for another episode of From Pain to Possibility. I look forward to connecting with you. Thank you again for being here today. Take good care and happy exploring.

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