Monday, August 2, 2010

Meet the Quadratus Lumborum

UPDATE: This is an old rambling post, but it is also a very popular one as people try to figure out their quadratus lumborum. Here is a recent ebook by Sean Schniederjan I purchased called Quadratus Lumborum Fixed: For Ultimate Low Back Balance, Strength and Comfort (Simple Strength Book 14). I have used many of Sean's ideas in some of his other ebooks and here he has the first book, that I know of that explains the purpose of the QL as well as gives ideas for controlling it:

Some experts say that as much as 65% of low back pain is quadratus lumborum related. Do you have quadratus lumborum problems? Do you feel tightness on one side of your low back that simply won't go away? This book delivers fast, easy to digest knowledge and fixes to quadratus lumborum imbalances using your natural movement for a healthier and balanced lower back. BONUS - also get enhanced super stretches to increase low back flexibility.

The Quadratus Lumborum is not a math formula or punk rock group! But first, I am happy to have had a great week of running last week totaling 85 miles.
Mon. 5 miles (5k trail race)
Tues. 8 miles
Wed. 12 miles
Thurs. 8 miles
Fri. 22 miles (planned on 16 but felt real good-had plently left in the tank)
Sat. 14 miles (planned 8 but felt pretty good-would have gone longer, but I carried  no $ to get liquids)
Sat. 16 miles (planned 11 to get to 80 for the week but felt pretty good)

Two weeks ago I hit 73 miles and figured that might be the most for a week this summer, but the weather turned cooler on Friday and if the running feels good and fun, I say, "Keep running!"

After finishing the 73 mile week I took a day off, and the next day I felt "off" a bit in the mid back area and right side, like something was twisted wrong. I ran the Mine Falls 5K Trail race and that didn't help. I then ran the Gate City Striders Ultimate Runner track night 4 races (400m, 800m, 1 mile, 5K) and my right side was still bothering me. It wasn't a memorable event, but I made it through. The only fight I had was in the 5k when Karen P. caught up with about 3/4 of a mile to go. I tried to keep in front of her and that helped me pick up the pace and hopefully had her running faster too.



photos Jim Rhoades

Thursday I did a new workout DVD that I had that combines the TRX with Kettlebells. It was a killer workout, but it didn't help my back and neither did the 8 miles I did after the workout.


Then I went to the Cape for a few days and my back and hips were just horrible. It was very uncomfortable to just move and I only pushed through one 5 miler. I did get some sun and surf in with the family. It was a completely horrible week of running, and I was looking forward to my offfice visit with Dr. Baroody on Monday.

During the trip I decided to make sure I was using my abs correctly. I used a tip from Dr. Jolie Bookspan (article here from the book The Ab Revolution Third Edition- No More Crunches No More Back Pain)  and also started doing these exercises from Dr. Stuart McGill.



On Monday, Dr. Baroody worked on the tweak in my back and that started clearing things up, but I had a follow-up visit on Friday and I told Dr. Baroody about my left hip-glutes. This seems to be the major problem now. The left glute gets rather tight and I feel really tight at the top of the left back pelvis. I told him when I run I can't rotate the left hip back and the femur sort of presses into the hip creating the pain and not giving me a  hip rotation. He's a good listener and tried to make sense out of what I was explaining. He did a lot of ART work and finished on the back of the hip. He said it was the quadratus lumborum muscle.

The QR was already a muscle I was quite aware of, but it is a tricky one and one I never found a good stretch that would help it. About 10 years ago when I completed the Falmouth road race, I went direcly to the massage tent where I usually meet a local chiropractor. From years of doing this, he knows a bit about my hip problem. A couple of times, after having an uncomfortable race, he did work on my QL and I would feel great afterwards. In fact, I would feel better running a 5 mile cool-down to my parent's house then I did running the race! However, I never could find a way to stretch, release, or strengthen this muscle.


What is the Quadratus Lumborum?
The quadratus lumborum is a well known muscle that is a primary cause of lower back pain. Its action of bringing the hip up is important for balancing postural distortion. Not only does it refer into the Sacro-Iliac joint, but can cause stress in that joint by pulling the hips out of alignment.
According to this article
The quadratus lumborum muscles, together with the illiopsoas, are a common cause of lower back pain....Because most people sit for 90% of the day, their quadratus lumborum muscles are short, tight, and overused. The quadratus lumborum muscles assist in side bending and in back extension...If you have back pain that is only on one side of your lower back, there’s a good chance it’s the quadratus lumborum on that side...If indeed one of your quadratus lumborum muscles is causing you pain, the quadratus lumborum pain is due to habitual overuse.


With the constant tightness back there (and this is exactly where I used to press 25 year ago to "crack" my own back), I decided to target this area. Dr. Baroody showed me a couple of stretches. One looks like this (you have to go 52 seconds into the video to get the stretch).

Another is a stretch on a swiss ball. This video has a good summary on the quadratus lumborum.



















Here is another QL stretch I found that I am doing.



He also said that doing kettlebell windmills will strengthen this area.


The problem with the stretches is that I don't feel them exactly where I feel tight, however something good must be going on as my hips are feeling a little bit better every run and I did run the equivalent of 2 marathons over the past three days.

I am sure the QL stretches are helping some. I'll give it a couple of weeks. In addition, I have started doing resistance stretching of my hamstrings in particular again. My quads and hammies are stating to loosen up some. I wrote tons on resistance stretching a couple of years ago (good place to start) and it still is a unique stetching program that works. I also had a massage a week ago and two weeks ago. That started the loosening process.

UPDATE
I just found this book and am reading it slowly. It has a great section on the quadratus lumburom with stretches and trigger point areas for releasing the QL. I have had other books on trigger points, but this one seems very comprehensive with loads of information. I will report on this book later, after I have read and tried some of the ideas in it more thoroughly.



To see a hamstring resistance stretch find the 4:00 mark. This comes from the Resistance Stretching With Dara Torres DVD.



Bob Cooley, author of The Genius of Flexibility: The Smart Way to Stretch and Strengthen Your Body,shows a partner resistance stretch here.



Finally, I noticed that one of my posts on functional hallux limitis got mentioned on a forum for Aikido (OK he did say my post might be like "watching paint drying" to some readers!). Josh mentions my posts on the stiff big toe and learning body wisdom. I know nothing about Aikido but read through the thread and wanted to find out more about what they were talking about. I do like the phrase "wisdom of the body"  as that is what I am trying to figure out. The links sent me here, where I wanted to learn what Kua was. I found this video and found the movements interesting. My femurs often seem stuck and this actually helped me feel them rotate better.



Anyhow, it has been a successful and busy week!

12 comments:

Bob Prichard said...

One of the problems I can see in your stride is that you are running too upright. Most successful elite runners tilt their trunk forward 13 degrees. You can see an example at http://www.somaxsports.com/osborneN.htm

Also, you have accumulated microfibers over the years from running, which then alter your mechanics, leading to the chronic problems you are experiencing. You can read more about microfibers and running at http://www.somaxsports.com/running.htm

Jim Hansen said...

Bob,
You are right on both accounts. The core stuff I am trying is to get rid of the backwards lean. You have to write a book or something to make you ideas and techniques more available to regular runners!
Jim

Matt Metzgar said...

Jim,

I know you've read Gray Cook's book, but have you ever put yourself through the Functional Movement screen?

It might be something else to try.

Jim Hansen said...

Hi Matt,
No I have not done that yet, but it is something I have thought about.
Jim

Anonymous said...

hi, Josh here!
Nice little feedback loop we have. I love your site dude, awesome posts and topics..i have learned a lot.

I echo the movement screen mentioned above..

also; i had run across this; and thought of you; and the types of problems you mention ...

see this link
http://www.momentummedia.com/articles/tc/tc1308/nbaknee.htm

This was the key part for me:
Some injuries, however, are so deeply rooted in larger neuro-physio-anatomical problems that traditional rehab protocols only touch the surface. Athletes with these injuries return to their sport but don't recover fully. They require a more in-depth assessment and whole-body rehabilitation.


it is tough working restoring the central equilibrium of the body once it is lost. Fixing first of all coarse length-tension imbalances, then tuning the body/neural system... things that were literally childs' play.
but i also have hope that it can be done; and you will find a way.
Good Luck.
Josh

Anonymous said...

Hi -
this stretch was great. for your collection..
http://perfectpointe.blogspot.com/2007/02/quadratus-lumborum-stretch.html

Josh

Jim Hansen said...

Thanks Josh,
I am currently awaiting an MRI to see if I have a torn labrum. A FMS is definitely something I'd like to try, if I could find the right person and can afford it. I went back to the QL post and recalled the KUA exercise. My hip has been pretty bad this week, but the exercise felt good when I did it again. I have to explore this type of movement more. I like that phrase "central equilibrium of the body" and will have to read that article carefully.
Jim

Anonymous said...

I've been reading a bunch of Dan John stuff lately. He's pretty versatile for a big time weightlifter. He is a big fan of somatics. He is also a big fan of farmer's walks and other forms of loaded carries to develop QL strength.

http://www.youtube.com/watch?v=P5yZJoHC01I

http://www.t-nation.com/free_online_article/most_recent/the_secret_of_loaded_carries

What I like about Farmer's walks is how basic yet effective it is. You can totally see how it is a movement that humans have been doing forever.

Mike

Jim Hansen said...

Thanks Mike,
I have one of Dan John's ebooks, but have not read it yet. I have seen him interacting on Martha Peterson's Somatics blog. Martha has a great somatic movement for the QL. I will check out the loaded carries and the Farmer's walk.

Daniel said...

Hi Jim,

What happened with your injury? i am having similar symptoms along with right lower rib cage tightness. been doing pt for 3 months now but no help

Jim Hansen said...

Daniel, I had a torn labrum and arthroscopic hip surgery in 2011 and am working out all the muscle compensations I had accumulated through the years. You should check out Martha Peterson's Somatics site. She has a lot of good gentle exercises. I still use these a lot. One that might help is the side bend shown here, but there are others if you search around: http://essentialsomatics.wordpress.com/2011/02/06/what-to-do-about-hip-pain/

Jim Hansen said...

Here is a kettlebell move I have been doing recently that loosens up that area: http://recoveryourstride.blogspot.com/2013/11/the-half-kneeling-kettlebell-windmill.html