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Ahh, yes…back pain. As massage therapists, at least 75% of our clients state they have concerns with their low back. Whether it is pain or tightness, not a soul will complain about taking extra time to work on his/her back.

We never realize how much our back is important to everything we do (sit, bend, stand, etc.) until it causes us pain. Though everything is connected and low back pain can easily be caused by various other conditions, the most commonly involved muscle is the quadratus lumborum, or QL for short.

As you can see in the picture, the QL originates on the iliac crest (top of the posterior part of the pelvic bone) and inserts on the transverse processes of the lumbar vertebrae and the lower border of the last rib. 

When the QL on both the left and the right side work together, its action is extension of the spine (as in straightening up from a bent over position). When only one side is engaged, it allows for lateral flexion (as in side bending). 

It is easy to injure this muscle when performing simple tasks, such as lifting or bending, without using proper form. I’m sure you’ve heard the good ol’ term, “Lift with your legs, not with your back.” That’s not just an old wives’ tale – it truly can save you a lot of suffering and pain!

When this muscle is compromised by either strain or trigger points (aka knots), it can be very painful to turn over in bed, cough or sneeze. Trigger points in the QL can also refer pain into the glutes or the hip area.

Pain in the low back can also be caused by muscle imbalances elsewhere in the body. So when we massage therapists work on other areas other than “just” your low back when you come in for low back pain, please be patient with us. We are palpating other muscles, too, to determine the root cause of your pain. 

To keep your QLs healthy and pain-free, it is always important to keep good posture. Good posture will keep your pelvis in a neutral position, decreasing strain on all the muscles that attach to it, including the QLs. Keeping good posture also makes it easier to breathe (remember the QLs insertion on the lower rib, therefore aiding in exhalation). If you feel as if your QLs are tight, you can perform stretches, such as the cat stretch in yoga, or side stretches. And, of course, if you have any concerns at all, refer to your physician. 

And always remember, we’ve got your back! (And shoulders…and neck…and feet, but you know what I mean.)