Podcast: Episode 118: How to Relieve and Resolve Quadratus Lumborum Pain

The Quadratus Lumborum – also known as the QL – is one of the top 5 muscle groups that people seek my help with. These people have stretched their QL in all the ways, done all the bridges, and retrained their core, but have not been able to crack the code on how to detrain it.

I have helped so many people get rid of QL pain, and I’m bringing you this episode as a way to jog your mind and thinking process to help you tune in and listen to what your body is saying to you.

Join me this week as I show you how to listen to your body and allow it to guide you to whatever your next step is. I’m covering the biomechanics of the QL, a key function of it that nobody ever talks about, and some step-by-step things to consider when working with your body.

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What You'll Learn from this Episode:

  • Why it is important to understand the anatomy of the QL.
  • The 4 key functions of the quadratus lumborum.
  • How the QL is an extraordinary way of compensating.
  • Some of ways that issues with the QL might limit your capability.
  • What to do if you want to get out of a compensatory pattern.

Featured on the Show:

  • If you want more detail, you will love a course I recorded on this topic. Click here to access the course or email us at [email protected] to join me for a 3-month private session series.

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. With this episode I want to dig into the quadratus lumborum, also known as the QL. The QL is probably one of the top five muscle groups that people seek my help about. And these are people who have stretched their QL 12 different ways, they've done all the bridges, they’ve retrained their core.

They are starting to recognize there's a relationship between their QL and their breathing, but they haven't quite been able to crack the code for how to de-train their QL. Like how to get their QL to stop doing what it's doing, whatever that might be. And just to stop experiencing the tension and limitation that it has.

It's getting to the point where it's hampering their ability to climb stairs, to run, to get down on the floor and play with their kids or their grandkids. And they're starting to wonder if this is something that they're going to have to live with, and that they're super, super frustrated.

Now, innately inside of them they know that there's an answer, but they're starting to feel like they're hitting their head up against the wall. So I want to dig into this in a podcast version. Of course I can't get into all of the detail inside of a podcast episode, which is why I want to offer you the course that I recorded on the quadratus lumborum, so that if what I'm saying here really resonates, then I encourage you, if you want to do the do it yourself version to go and access the QL course.

Where you can find it is at functionalsynergy.com/the-quadratus-lumborum/. And that link is in the show notes so you can find that course there. It's a two hour course. And it will really help you discover what's contributing to why you still have issues inside of that muscle group.

And then if you want more of a handhold and someone to really work through this with you, then I encourage you to join me for private sessions. I run a three month private session series and I have helped so many people with their QL.

People who are power lifters, CrossFitters, runners, grandmas, granddads, desk workers, hikers, elite athletes, so many different kinds of people really tackle this issue around their QL and really make friends with their QL and really see the beauty and amazingness in their body.

The bottom line really is a key bumper sticker that I like to share around almost everything that I do, which is where the pain is, is not the problem. The problem is, is you can't find it. And the big reason you can't find it is because it resides in a place that I call under your awareness, right?

If you were aware of what was going on, you'd fix it, you'd sort it out, right? You would make change. And the reason why you can't do it is because you're trying to solve the problem that doesn't actually exist. It might appear to exist because it's feeling like it's a pain in the butt, a pain in the back, a pain in the rump, a pain in the, you know, fill in the blank. And it's actually not where the pain is because if you were giving yourself the right intervention, you would have already cleared this thing up.

So I want you to utilize this episode as a way to really jog your mind and your thinking process, to really tune in and listen to what your body is saying to you and allow it to guide you to whatever your next step is. Whether it's the two hour course, whether it's to noodle through, I like to say noodling through and really sorting through how your body is moving. Or whether it's working with me directly in my three month practice private series.

Okay, so how I want to work through this is I want to, first of all, briefly go through the anatomy of the quadratus lumborum, some of the biomechanics to think about. And then a key function of the quadratus lumborum that no anatomy book talks about. And then I want to go through a few things step by step for you to consider when you're working with your body.

And then if you're a healthcare professional or a teacher and you're listening to this for your own client base, really consider this and start to train your eye for things to look at. Because again, much like the person who's got pain, a lot of health care professionals, it's just where their bias lies, they're looking to like, oh, QL problems? Fix the core. QL problems? Fix the glutes, do lots of bridges. But they're missing, they're missing a key part, and that's this. This episode I hope to kind of open your eyes a little bit.

Now, I really want to emphasize this is a podcast episode. I'm going to be talking for maybe 18 to 20 minutes if that, and so you're going to get bullet points here. And to really dig into more of this, then I encourage you to see the other resources that I'm sharing. Okay, so let's get going.

So it's first of all important to understand the anatomy and how the QL attaches and where it attaches and how it works. So the first piece of it is that it's a muscle that sits between your ribs and your pelvis and attaches to the bottom rib, which is the 12th rib and the top of your pelvis, and to the vertebrae of your spine.

It has four functions described in an anatomy book and the first two are related to side bending. So just think about that for a moment, when you side bend, your ribs come towards your pelvis or your pelvis can move up towards your ribs. That is the job of your QL, in part, right? And so it will pull the rib, let’s think about the right side QL, it will pull the right ribs to the right pelvis, or it will hike the right pelvis up to the right ribs.

It will also fix the 12th rib in forced exhalation. And if both sides, because there's two QLs, one on either side of the spine, if both sides bilaterally contract it will extend the spine. So those are the four key functions that you will read about in anatomy books.

Now there is a fifth, and this is the one that is not in anatomy books anywhere. I call it the superhero of compensation. So when your patience has been overwhelmed or overridden by your ambition, or when you need an alternative muscle strategy, a compensation pattern in order to get a job or a movement done, oftentimes the QL will swoop in, yep, think about the QL with a big old cape, and save the day.

Think about it, let's say that you are walking, or standing, or climbing stairs and that leg bone does not swing through very easily. Now you probably won't even realize this is happening, but if it's not swinging through and you still need to get from point A to point B, then the QL will hike your hip. Think about that side bending action.

It will hike the hip up towards the ribs and that will help clear the foot from the floor, essentially swinging that foot through. So you're kind of doing a hip hike. Now the hip hike is often not really, really noticeable. So you probably won't even notice it in your conscious mind that you're doing it. But over a period of time, this then becomes the neuromuscular pattern that is utilized when you move your leg through.

So then your brain starts thinking, oh, this is what a gait pattern is, hike the hip. And you begin to de-train the muscles in and around the hip that are actually designed to move the leg bone in the hip socket and your gait pattern.

I mean, think about it, think about how you are meant to move your foot from back to front, that hip, that leg bone, the femur is supposed to move in the hip socket, moving forward and then back. But if it doesn't have the mobility, if the stability is lacking, something's up, then partly what can happen is that QL will lift the pelvis in order to swing that leg through.

So if you do that enough, then you're going to start to de-train in and around the hip, right? And then that QL, because the QL is not designed to do that job, then it will start to get fatigued. And then what will happen? Well, then you're going to find another pattern to then compensate for the original compensation of the QL.

So do you see how then you stack patterns on top of patterns and that’s why people's ribs get tight, and then upper traps get tight, and then tension develops around the head, and maybe you get plantar fasciitis, and a hypertonic pelvic floor. I mean, lots of different patterns can then arise and can create a big old mess.

So when you've got a long standing QL issue, it's not surprising to have long standing other issues residing in your body, which then need to be sorted out. So it makes a lot of sense, right? So it's a great thing that our bodies compensate, but then what begins to happen is that you keep compensating a compensation, which is a big reason why you get more and more fatigued and that having QL issues can also feel super exhausting.

Because not only are you trying to sort out why the QL is behaving in the way it's behaving, all these layers of compensation are inefficient movement patterns. And anytime we have inefficiencies, we have opportunities for exhaustion because there's an energetic drain because we're not moving as well as we could.

So that's a big piece. It's a great practice in our bodies, in our body mind really if we’re having compensation patterns, right? We need them because we need them. There are times when we need to compensate, it's effective. And if we continue to compensate it becomes problematic.

Which is why when it comes to the rehabilitative process for QL, when people are learning to do lots of bridges, when they're doing lots of core work, when they're doing a lot of like rolling out with their ball, that's all good. But it's not actually addressing the problem that is, it’s only addressing part of the problem.

So they're getting stronger, they're gaining more awareness, but they're not actually integrating to make better change. And it's not the QL’s fault, that's a big piece of this too. The QL didn't wake up one day and decided to give you a run for your money. The QL is simply responding to forces at play.

So the way that your body and your mind is initiating or engaging with movement, the QL is just responding and it's being supportive. It's really trying to help out. Now, you might be listening to that and shrugging your shoulders and saying, “Well, that's great help.” Yeah, well, at least you're able to move.

So this next part of the episode, I want to give you some ideas to think about. And I'm also going to direct you to a video that's on YouTube where I talk more about the QL, as well as give you access to some movement videos that you can explore this with because me audio-ing this will only take you so far. Okay? So you can find that in the show notes as well.

I want you to think about your leg bone movement in your pelvis. And I'm saying that really, really specifically. Your leg bone movement in your pelvis. So your leg moves in six different ways: flexion, extension, forward and back, abduction, adduction, out to the side and back towards the middle, and then rotation.

When I'm working with clients, those six movement patterns are often somewhat limited. They have some of those patterns, yes. And how they do them is often limited. And they often use breath holding practices, they often use their QL, they often use their shoulders, they often clench their jaw when they're doing them. And while that might sound like what's the big deal, so what if I'm clenching my jaw when I move my leg bone?

That's the point. You don't need to use your jaw to move your leg bone. You don't need to hold your breath to move your leg bone. And you don't need to use your QL to move your leg bone. So part one of the process is to move your leg bone. And that's it, just move your leg bone.

And a lot of people will become initially frustrated at that because they'll recognize how limited they are in that movement pattern, to which I very lovingly and kindly raise the pom poms and say, hey, isn't this awesome that you're noticing where your true limitation is? So now you're actually seeing what's really going on here.

And that can be a big contributor to why the QL is swooping in. So then if we’re giving the QL an opportunity to see that it doesn't have to swoop in because you're actually improving this limitation, then that, because the QL is responding, that is the thing that can help de-train and down regulate that QL, if I can put it that way.

We often find something similar up in the arm bones and the shoulder sockets. And that when we move the arm bone, whether it's flexion, or extension, or abduction, or adduction, or rotation, oftentimes we’ll find things going on with other parts of the body. Again, like the jaw, or the neck, or the ribcage, or breathing patterns, or the pelvis, or even the toes. Those other areas will often jump in and try and support the movement of the arm bones in the sockets.

And again, someone might say, well, what's the big deal? So what if my toes contract? Well, that's the big deal, your toes are not needed to move your arm bone. And when you actually refine and simplify the way you're moving so that the arm bone truly is the thing that is moving in your shoulder socket, then you release a whole bunch of extra tension holding patterns that aren't needed. And then pain starts to go away, the QL doesn't need to swoop in, and all becomes better in the world.

So those are two really key areas. And there's other areas for you to explore it. If you just start with the hips and the shoulders, then you'll start to notice other areas in your own body, which will start making sense as to like why your QL wants to kick in so much. Because again, it's being responsive.

I think it's a big thing, I hear a lot from people about why can't my body get back on board? Like why is there such fight with my body? My body is responding in these ways to my brain. And yes and no. Your body is responding yes, and your body and your brain, your brain is in your body.

So when we can tune into how your body is moving and then move it actually in the way that it’s designed to move, that's when tissue starts to change. And when tissue starts to change, different sensations start to arise. You feel differently, you feel lighter, you feel more buoyant, you feel more grounded, you feel more at ease because now there's way more efficiency in your body. There's way more effectiveness in your body.

And when you have those experiences, your brain starts to interpret them differently. You start to feel safer inside of yourself. You start to feel more connected to yourself. And when you have those experiences, those are experiences of safety and security. And so now your body mind system doesn't feel the need to protect you because you have innate protection.

You can be responsive. You don't need to brace against the world or brace against something happening because you're tuned into the way that you’re responding to things. You're able to listen to the whispers so that you don't have to hear the screams.

And then when you're tuning in in that way, now you start to understand the smaller and quieter aspects of your body movement systems and how they contribute to escalation of symptoms. So you become more in the driver's seat because you're listening to what's going on inside of you. And you really begin to see that the answers truly reside in there.

So the key bullet points that I want you to consider then is that the anatomy of the QL is that it sits between the ribcage and the pelvis with attachments to the spine. Part of its job is to side bend. Part of its job is to fix the lower rib. When working with the other side it moves you into extension. It does a great job at hip hiking when you need to get a leg through. And when you continue to utilize it as a compensatory pattern, then that starts to become the normalized pattern, which is actually an inefficient pattern.

You can strengthen on top of that inefficient pattern, but you aren't actually resolving the pattern. So you continue to basically build strength on top of the house of cards, the foundation is unsteady. Which is why you cycle around in patterns where you get these spasms and levels of tightness that can really throw you off your rock.

So keep in mind that the QL is a really extraordinary way of compensating. And if you want to get out of that compensating pattern, you need to re-train the primary areas that are not moving as well as they could be. And when you connect with those, that's when you really can make your gains.

If you want to dig into this further I highly encourage you to look into the two hour course, which you can find at functionalsynergy.com/the-quadratus-lumborum. You can do it yourself.

Or if you want my help, you can email us at [email protected] and I'd be happy, happy, happy to help you to be one of the many people that I have helped getting rid of quadratus lumborum pain. It will take you three months. It would be an honor to support you in being one of those grads. All right? Looking forward to hearing from you, have a great, great time exploring. See you next time.

If this episode has resonated and you're looking to deepen this idea of getting your body back on board, of listening deeply to your symptoms, of listening to the whispers so you don't have to hear the screams and you're looking for one to one support or professional training, then reach out to us at [email protected] where we can customize your learning path. That's [email protected]. Looking forward to hearing from you.

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