Name: Quadratus Lumborum SA Static Release and Stretch
Uploaded: 2023-04-26T01:00:03.000Z
Duration: 7 min 54 s

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https://stream.mux.com/ffHRWD3T1ZEawW1icikkaJPM01EvGwlHBVx8J1c01aMvE.m3u8

Learn how to properly perform a quadratus lumborum self-administered static release and stretch in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and technique (including progressions and regressions). Safely reduce quadratus lumborum hypertonicity, improve trunk mobility, and decrease lower back discomfort while supporting optimal lumbopelvic alignment and movement mechanics. Suitable for all fitness levels. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to reduce pain, improve mobility, and restore optimal movement mechanics while reducing injury risk.

Understanding the Quadratus Lumborum (QL) and Its Role in Lumbo-Pelvic Dysfunction

Anatomy and Location of the Quadratus Lumborum

Using Tennis Balls for QL Release: Techniques and Precautions

Risks of Improper Techniques: Lumbar Stability Concerns

Stretching the Quadratus Lumborum: Effective Positions and Techniques

Quadratus Lumborum SA Static Release and Stretch

This is Brent coming at you with another release and stretch video. In this video, we're going to do the often forgotten muscle, the quadratus lumborum, commonly known as the QL. Now the QL has a propensity to get overactive and short in those individuals with an asymmetrical weight shift, and those individuals with lumbo-pelvic hip complex dysfunction, specifically an anterior pelvic tilt, may have shortness and overactivity in this muscle, especially if they have a history of low back pain. I'm going to have my friend Yvette come out and help me demonstrate this exercise. Now this muscle is a little deeper. This muscles a little different than some of the other muscles that we've talked about with self-administered release techniques, so I want to take a second to discuss anatomy here, show you guys a little bit of a palpation activity, something you can practice so you get a good idea of where this muscle is. If you find the back of somebody's pelvis, go to their posterior ilium and find the rim. Right, the top edge. You then put your hand on the last rib that you can feel. I want you guys to stick your thumbs on the lumbar spine. You can feel the spinous processes. Then use your index fingers to go to the posterior ilium, the edge of that last rib, that little square you just made with your fingers outlines the quadratus lumborum. You can then take your index fingers, move them inward towards each other and then bring them down into the lumbar spine. All right so immediately, this way, and you should be able to feel the edge of the quadratus lumborum. It's definitely a pretty distinct border. Now what that'll do is it'll give you an idea that this muscle is not superficial. It actually lies just lateral to the lumbar spine underneath the thoracolumbar fascia, underneath the external and internal obliques, as well as underneath the transverse abdominis. This is a very deep muscle. We're not going to be able to hit this with a foam roll across the low back. Not that it would be a good idea, anyway. So I'm gonna have Yvette go ahead and flip over. Now what I've done guys is when I was walking my ginormous chihuahua this morning; I know some of you guys are going to laugh at me for having a chihuahua, but he's 22 pounds and is the biggest chihuahua you've ever seen. You guys can look that up on Facebook. We were at Petco, and at Petco they had a big bin of tennis balls, right, because dogs love to play with tennis balls. The nice thing about that is I could kind of play with these tennis balls to find different densities, right, so some of these--like this one-- super, super, soft and this one is a little bit more dense. Why is that important? Well, if I'm dealing with Yvette here her tissue depth is really not that much, and I just want to get to her quadratus lumborum. I don't want to push past it to the point where we end up with this huge lumbar lordosis. Now somebody like me, with a little bit more tissue depth, I would need a little bit firmer tennis ball.  So, I just picked out three with different densities. We're going to use the softer one for Yvette. It's actually a pretty fairly easy technique to show. All you're going to have them do is find the top of the pelvis. They can use their hands. So find the top of your pelvis back there, you got that, now I want you to put this tennis ball underneath your back there, just on top of your pelvis and then what you'll have them do is actually slide sideways in one piece. All right, make sure that they don't do this squirmy pelvis thing because that will actually contract the QL and then relax the QL and make it harder for them to find any sort of trigger point that may exist there. But if they kind of bridge and use their arms and slide in one piece, what they'll end up doing is slide that tennis ball right into the QL and then slide a little further until they find the most tender spot, and then you guys know what the release protocols are. It's 30 seconds to 2 minutes, until we get a significant, significant decrease in discomfort or we see an actual release, right, where we feel that the muscle is letting go. Now one thing I do not want to see is you guys know I'm very fond of the training softball, right, that's a softball with a soft outside. If Yvette tries to do a softball on her QL, let's look at what happens. So she's going to go through the same motions and then I'm going to go ahead and tell her to relax, right, we can't have her all tensed up or we'll never get a release. Well, as soon as she relaxed and she puts her backside on the floor, we get this lumbar lordosis. We get a little bit of rotation in her pelvis. Probably the scariest thing for me thinking long-term is we get this huge posterior to anterior force on the lumbar spine. Now I'm not worried about one session. What I'm more worried about is if I give this to her for homework, if I put this in her routine to do every day, because I'm trying to correct whatever dysfunction exists that includes the QL, and she starts doing this every day. Is there a chance that posterior to anterior force is going to create adaptive changes in the connective tissue around the lumbar spine, setting up an instability and potentially injury? I'm not so worried with the tennis ball, right, her lumbar spine was flat on the floor. There was no reason for me to think that there was really that much of a posterior to anterior force that I might cause those changes, but something huge like this, that could be a problem. The same could be said about using a foam roll on the low back. It's not so much one session. One session is probably not going to hurt you, but if you did it every day, could you create those changes that eventually set up injuries such as like, a herniated disc. Now once I get this muscle released, now I need to start thinking how do I lengthen it, right, I want to return it to optimal length, so I'm going to have that get into Child's Pose position, which you guys have seen. We actually use the Child's Pose for a latissimus dorsi stretch. The nice thing about this position is it posteriorly tilts the pelvis, which the quadratus lumborum is a very weak lumbar extensor, will actually be lengthened just slightly by posteriorly tilting the pelvis, because it's the same as lumbar flexion. We can then side creep as we did and the progression of that latissimus dorsi stretch, the only thing we need to worry about now, is there a potential that the lat is going to be the restricting structure and I've never actually going to get to the QL? Well that's easy enough to fix. All I have to do is have Yvette relax her arms a little bit, bring them in, she can actually use them to kind of pillow her head. She can go a little bit more into lateral flexion until she feels it at the QL. I do have to know guys, that this particular stretch, unless somebody is really, really, geared up, they're probably not going to feel this QL stretch. It's so deep and it's so medial, so proximal to the lumbar spine, that actually takes a fair amount of tightness before lateral flexion is going to lengthen it enough for the individual to feel, going back to the regular Child's Pose stretch in that case, is probably your best bet. So that, at least you're affecting the other lateral flexors, the spine, being the latissimus dorsi, and the erector spinae on that side. Do you feel this? Yvette actually feels this and she has been having a little bit of SI joint dysfunction and does have an asymmetrical weight shift, so this is probably a good stretch for her. She's going to use the release technique using the tennis ball at the appropriate density. Make sure you guys are very careful at calculating which tennis ball you should be using. I hope you guys get great outcomes from this technique and anybody who has been having some of these problems gets great results. Talk with you soon. 

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Quadratus Lumborum Static Release and Stretch:

Note: Stretching the Quadratus Lumborum will be discussed below under "Child's Pose Stretch…." and the sub-heading "Modifications"

Have your patient/client assume a hook lying position (supine with legs bent and feet flat on the floor).

Explain to your patient/client where they should be applying pressure with a flat tennis ball or soft tennis ball-sized release tool (lateral to the spine, not on it). It is often beneficial to palpate the quadratus lumborum (QL), with the intent of demonstrating what the patient/client should feel during this technique.

It is important to find a ball that is the right size and density: The ball should be able to penetrate the various levels of muscle and adipose tissue superficial to the deeper QL, but without pushing the lumbar spine into extension.

Have the client search for "tender points" by placing the ball under their obliques, between their posterior ilium and 12th rib, and have them gently roll the ball into their QL (slide laterally into the ball).

As a tennis ball is fairly broad it may not be necessary to do much "searching" for tender spots. Simply centering the ball over the QL or against the lateral border of the QL is often sufficient to get a release.

Once a tender spot is located, have your patient/client relax on that spot.

Wait for the discomfort to subside or for a “release” (generally 30 – 120 seconds).

Move on to another tender point or the next muscle to be released.

Rolling the lumbar spine: Again the lumbar spine is not well designed for resisting posterior to anterior forces. Keep the ball lateral to the spine to avoid any potential risks.

Rolling the 12th rib: Although the 12th rib is denser and often tender upon palpation, you cannot release a bone. Make sure you double-check the position of the ball while administering this technique, and quiz your clients/patients often if this is given as a home exercise.

Don't chase pain! This is not a technique to be used on any patient/client that complains of low back pain. It is important that a thorough movement assessment (and subjective evaluation) is performed before using this technique as part of a comprehensive routine to optimize movement or treat low back pain.

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