Pacific NW Pilates blog

Melanie Makes Anatomy Meaningful—Quadratus Lumborum

by Melanie Byford-Young on August 31, 2016

PNWP Owner Melanie Byford-Young, an expert in addressing biomechanical issues with movement-based therapies, consults daily in the studio. Melanie’s approach brings clarity to the complexity of human movement. She transforms theories into relevant, practical and meaningful information that can be used to help clients and patients in a Pilates studio or clinical setting.

Here, she shares her insights about the quadratus lumborum (QL) muscle.

quadraus_lumborum_yoga_anatomy

 

Anatomy Made Simple

 

1 The quadratus lumborum originates on the top of the pelvis (posterior iliac crest), inserts in the last rib (12th rib) and the bony projections off of each of the lower back vertebrae (transverse process of L1-L5). Every person’s trunk has two quadratus lumborum—one on the right and one on the left.

2 Look at the shape of the muscle. It’s rectangular. Anatomists combined the Latin words quadrus and lumbus to describe the shape and location of the muscle. It means “square loin.”

3  It’s commonly referred to as a back muscle. Did you know the QL is really the deepest muscle of the posterior abdominal wall?

4  The QL has five main jobs. When activated on one side, it side bends (laterally flexes) the spine to that same side, the right and left sides work together to arch (extend) the lower back (lumbar spine), it keeps the 12th rib anchored during inhalation and exhalation and it lifts the pelvic bone (ilium) on one side toward the ribs on the same side (like a hip hike). The QL is also an important stabilizer of the ribs, pelvis and spine. For example, when moving the arms and legs, the QL assists in keeping the spine, ribs and pelvis stable and centered.

The best way to understand anatomy is to move and feel it in your own body. Take a moment. Can you feel how the QL assists in each of these movements?

back-man

The quadratus lumborum muscle often gets blamed for pain.

Blame or Brainstorm?

 

If you teach movement or work with patients, you’ve seen people express back pain. “It hurts here,” they say and clutch their back with a grimace on their face. The person is suffering, and you want to help. I recommend using the presence of pain as an opportunity to brainstorm and problem-solve—a chance to avoid further irritation. In my experience, too often the site of pain falls prey to criticism and unfair blame.

Here are three things to consider about the quadratus lumborum when it is irritated, tight and inflamed:

1 Is it a localized issue?

2 Is it reacting to imbalance or poor alignment elsewhere in the body?

3 Is it responding or compensating for poor muscular recruitment patterns in another parts of the body?

Remember, pain is a warning. A muscle that is irritated will frequently respond negatively to being stretched. Instead, go back to principles of balance and stabilization.

Posture

Take a Deeper Look

 

When the lower back is irritable, take a step back. Look at the whole body and around the area of pain. Consider what you know about the anatomy of the QL— it attaches to the lower ribcage and pelvis, so it will be affected by imbalances in these regions.

Check for these things:

1 The placement and symmetry of the ribcage—the QL will have to overwork to counterbalance a shift in this area.

2 The placement and symmetry of the pelvis.

3 The alignment and symmetry of the legs. Check for visual imbalances between the musculature of the gluteals and adductors.

4 The alignment of the scapulae. The QL can respond negatively to an upwardly rotated and tipped scapula.

Pilates instructors are movement detectives. Use your “spidey” senses to detect tension or lack of ease in the body.

Side Bend

Movement Matters

 

How we move affects the health and happiness of our muscles. When one muscle group is working poorly, another will compensate for its lack. A few simple tests may help you identify if the QL is responding to movement imbalances and poor recruitment of other muscles.

Observe the following:

1 Side bending (lateral flexion of the spine) in a standing position. Check to see if the curves of the spine are even and balanced. Look for asymmetries between the two sides.

2 Rotation of the spine in a standing position. Notice if the rotation is even and fluid or if one segment of the spine is rotating too much or not enough. Pay attention to the position of the ribs and hips—the ribs may shift during rotation. Look for asymmetries between the two sides.

3 Standing on one leg. There should be a small amount of weight transference. The ribs and hips should stay level and balanced.

 

Side Leg Lifts

Side Leg Lift is an excellent initial exercise to help a client learn how to stabilize the hips and ribs during a leg lift to the side (hip abduction). This exercise helps to strengthen the same muscles (gluteus medius) needed to stand on one leg well. Modify with springs or theraband to assist with the weight of the leg.

Tips for Pilates Programming

 

Exercises that are good for an irritated lower back will restore control, slowly progress to increase range of motion and challenge postural endurance.

Five important tips to follow:

1 Apply what you’ve learned from your postural and movement assessments to Pilates exercises you know. Program exercises for success. If a client is unable to rotate in a smooth and balanced way during an assessment, you can expect that the same movement pattern will appear in a Pilates exercise that rotates the spine.

2 Change your approach. Move beyond stretching and strengthening the QL. Teach exercises that re-educate your client to restore alignment of the ribs and hips and stabilize the spine. Pay special attention to the QL to ensure it’s not gripping or responding to movement by bracing. Side Leg Lift Series on the mat, Footwork on the reformer and Lat Pull sitting on the cadillac are good examples of exercises that help during this phase.

3 Monitor the QL in closed and open kinetic chain exercises. For example, Side Kick on the mat versus Side Lying One Leg Pull with a strap on the foot on the reformer may result in a different response from the QL. Students should be able to remain stable in their spine and avoid gripping QL during both exercises.

4 Move your client through dynamic range. The ribs and hips should be well aligned through every exercise. During exercises that rotate or side bend the spine, cue students to create smooth, even and articulate movement. When sitting, ensure the spine is in a neutral alignment—use props as needed. Pilates exercises as Saw, Spine Stretch Forward and Mermaid are recommended.

5 Add exercises that require power and endurance. Watch for perfect integration of the abdominals, back muscles, gluteals and QL. Side Bends on the Pilates barrels and Swan Dive are good exercise examples.

Use pain as your guide. If it hurts, don’t do it. Return to earlier steps and work to refine a client’s technique before progressing.

The science of anatomy and biomechanics and the art of programming and teaching for special conditions takes time, education and mentoring. Pacific NW Pilates offers annual courses and workshops in functional anatomy, rehabilitation and therapeutic Pilates.

I invite you to learn more.

-Melanie Byford-Young

 

Pacific NW Pilates is studio, school and fitness family under one roof. Click to learn more about our education courses and workshops, private studio sessions and group classes. Or call Brette for details: (503) 292-4409.

 

 

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