The quadratus lumborum (QL) is a deep muscle in the lower back frequently linked to pain and stiffness. This muscle can become a significant source of discomfort when overworked or held in a shortened position for extended periods. Tension often manifests as an ache near the top of the hip bone or lower rib cage, making simple movements like bending or twisting painful. This article provides instructions for safely stretching the QL and movements to help stabilize the area for long-term relief.
Understanding the Quadratus Lumborum
The QL is a four-sided muscle located on either side of the lumbar spine, sitting deep beneath other back muscles. It forms a muscular bridge connecting the lowest rib, specifically the 12th rib, to the iliac crest, which is the very top of the hip bone. The QL also attaches to the transverse processes of the first four lumbar vertebrae (L1-L4), establishing it as a primary stabilizer of the spine and pelvis.
Its primary functions include lateral flexion of the trunk, which is the motion of bending sideways, and extension of the lower spine when both sides contract simultaneously. When a person stands on one leg, the QL on the opposite side contracts to prevent the pelvis from dropping, a motion known as hip hiking. The muscle’s attachment to the 12th rib also means it plays a role in respiration, helping to stabilize or depress the rib cage during forced expiration.
The QL often becomes tight or painful due to lifestyle factors that cause it to overwork. Prolonged sitting with poor posture, uneven weight bearing, or weakness in surrounding core and gluteal muscles forces the QL to compensate. When this muscle becomes chronically strained, it can cause referred pain that radiates to the hips, buttocks, or even the abdomen, making targeted stretching an important part of a relief strategy.
Essential QL Stretching Techniques
Targeted stretching encourages muscle fibers to lengthen, releasing strain and discomfort. When performing any QL stretch, breathe deeply: inhale to prepare and exhale as you move into the stretch, holding for 20 to 30 seconds. Never stretch into sharp or shooting pain, as this indicates overstretching the tissue.
Seated QL Side Bend
Begin by sitting on the floor with your legs crossed or in a comfortable hip position. Place the hand on the side you wish to stretch a few inches away from your hip on the floor. Inhale, then as you exhale, reach the opposite arm up and over your head, bending your torso to the side of the supporting hand.
Focus on creating length along the side of your body, from your hip bone all the way up to your armpit. Use your breath to gently deepen the stretch, imagining the air expanding into the side of your rib cage. You can slightly rotate your torso upward toward the ceiling to ensure the stretch targets the deep QL muscle. Return to the center slowly and repeat the movement two to three times on each side.
Standing Doorframe Lean
Stand next to a doorframe or a sturdy vertical pole. Cross the leg closest to the wall behind the outer leg. Place the hand closest to the wall high on the frame or reach it up and over your head to grasp the doorframe.
Gently lean your hip away from the wall until you feel a pull along the side of your back, keeping your feet planted and your pelvis stable. The cross-legged stance helps to anchor the stretch at the hip, isolating the pull on the QL. Hold this position, breathing steadily, and then slowly step out of the stretch before switching the position of your feet and repeating on the other side.
Supine Spinal Twist
Lie on your back with your arms extended out to the sides in a ‘T’ shape, palms facing up. Bend your knees with your feet flat on the floor. Inhale deeply, then as you exhale, slowly let both knees drop to one side while keeping your shoulders pressed against the floor.
If your knees do not reach the floor, place a pillow or blanket beneath them for support. To increase the stretch on the QL, turn your head to look in the direction opposite to your knees. This movement gently introduces a rotational element that can help release tension in the muscle’s attachments to the lumbar vertebrae. Hold the twist, focusing on slow, complete exhales, and then bring your knees back to the center before repeating on the other side.
Complementary Movements and Strengthening
Stretching provides immediate relief, but strengthening the surrounding musculature is necessary to prevent the QL from becoming overworked again. The QL often compensates for weakness in the core and glutes, so integrating stability exercises is a long-term preventative measure. These movements should be performed after the QL is warmed up or on separate days from stretching.
Bird-Dog
The bird-dog exercise is an excellent low-impact way to improve core stability and coordination, which directly supports the QL. Start on your hands and knees, then simultaneously extend one arm straight forward and the opposite leg straight back, keeping your back flat and your hips level. The goal is to maintain a stable torso without letting your lower back arch or your hips rotate, which teaches the QL and deep core muscles to work together efficiently.
Modified Side Plank
Another foundational movement is a modified side plank, which builds endurance in the lateral core muscles, including the QL. Begin by lying on your side, propped up on your elbow, with your knees bent at a 90-degree angle for a supported variation. Lift your hips off the floor, forming a straight line from your head to your knees. Hold this position for 20 to 30 seconds, or as long as you can maintain perfect form.
Suitcase Carry
The QL is highly involved in stabilizing the trunk during unilateral loading, such as carrying heavy objects on one side. Incorporating exercises like the suitcase carry, which involves walking while holding a moderate to heavy weight in one hand, can significantly improve the QL’s capacity for endurance. This type of movement forces the QL on the opposite side to powerfully contract to maintain an upright posture and prevent lateral bending.