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