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.