How to Fix Quadratus Lumborum Pain FOR GOOD

When the quadratus lumborum becomes inflamed, tight, and achy, it produces one-sided deep lower back pain that can run through the pelvis and into the hips.

“When this muscle becomes inflamed, tight, and achy, you can get a lot of one-sided deep lower back pain that runs through the pelvis even into the hips”

Both sides of the body should be stretched with the 90-90 QL opener for balance and symmetry, even if pain is only present on one side.

“from there I do recommend doing it on both sides to keep everything in balance”

The 'ballerina' stretch is a standing exercise performed throughout the day to keep the QL muscle loose, executed by crossing the painful-side leg over the non-painful side, placing the non-painful-side hand on that hip, positioning the painful-side arm overhead bent at 90 degrees, then driving the hip toward the painful side while leaning through the waist toward the non-painful side.

“So here's a really good one that you can do throughout the day to really help keep the QL muscle nice and loose it's known as the ballerina. I'm going to start standing with very good upright posture whatever side that you're having pain let's say it's my right side I'm going to take the painful side's leg put it over the non-painful side my feet and my toes are going to be pointed straight ahead from there I'm going to take the hand on the non-painful side put it on that side's hip so in this case my left hand is on my left hip. I'm going to take the painful side's arm, bend my elbow at 90 degrees, put it overhead. So, for obvious reasons, it looks like a ballerina. The movement from here is pretty easy. What I'm going to do is drive my hip towards the painful side right here while leaning through my waist towards the non-painful side”

The quadratus lumborum is a muscle that originates at the top of the pelvis, connects to the side of the lumbar spine in the lower back, and attaches at the bottom rib.

“it's a muscle that originates at the top of the pelvis, connects to the side of the lumbar spine, the lower back, and attaches at your bottom rib”

For self-massage of the quadratus lumborum, a tennis ball, lacrosse ball, or racquet ball can be used effectively.

“For this one, we just need something round and soft. A tennis ball works perfectly. You can also use a lacrosse ball or a racquet ball”

The quadratus lumborum is located approximately above the hip off to the side of the spine, right below the rib cage, and should not be massaged directly over the spine as this can cause irritation.

“to find it, what you want to do is pretty much go right above the hip off to the side of the spine, don't put this over the spine right here, it can cause irritation, and then right below the rib cage”

An advanced variation of the hip hiker involves not only raising the hip upward but then slowly lowering the hanging leg downward toward the floor without letting it touch, which activates muscles on the opposite side and provides a two-for-one exercise benefit.

“To take this one to the next level, what you can do is not only go up with it like this but then slowly lower that leg and that foot downward towards the floor but don't let the foot touch. Just let it hover slightly above the floor. You'll feel a lot of muscles on the other side activate. So, you kind of get a nice twofer with it”

Proper execution of the 90-90 QL opener produces a deep stretch in the lower back on the painful side extending into the hip, and should be held comfortably for about 30 seconds, repeated up to five times, with progression by building deeper into the stretch with each repetition.

“you know you're doing it right because you're going to feel a deep stretch on the one side of the lower back right here into that hip. Once you feel that, hold this one comfortably for about 30 seconds. You're just going to relax and then you can repeat this one up to five times and with each repetition try to build into it just a little bit more”

The hip hiker exercise is best performed at the edge of a staircase, executed by placing one foot on the stair edge with the other leg hanging off the side, keeping both legs straight at the knees, and driving the hip upward toward the ceiling as much as possible.

“This first one is known as a hip hiker. It's best done at the edge of a staircase. So, every time that you go up and down stairs, throw in a couple reps. It will definitely add up. I'm going to start off by just putting one foot up at the edge of a stair. The other one is going to go off and you can definitely grab off to the side of the wall right here too if you need a little bit more support or if you have balance issues. So, I'm going to keep both of my legs straight at my knees. I'm going to allow one leg to go off the side of the stair right here. I'm going to put my hand on my hip and the movement, I'm driving the hip upward towards the ceiling as much as I can”

The 90-90 QL opener is a stretching exercise performed with one leg straight in front with the knee bent at 90 degrees and the other leg off to the side, also bent at 90 degrees, targeting the side with pain as the back leg.

“This first exercise is known as the 90-90 QL opener. It gets its name because we're going to have one leg straight in front of us, knee bent at 90 degrees, the other leg is going to be off to the side, knee also bent at 90 degrees. Whatever side that you're having pain is going to be this back side”

In the 90-90 QL opener, the back hip should be pressed down toward the floor during the exercise, and the arm on the painful side should be straightened and reached over toward the non-painful side to stretch the bottom ribs away from the hip.

“Take this back hip here and press it down towards the floor as much as you can during this exercise. So, once we're in position, I'm going to take the arm on the painful side, straighten my elbow, and then reach over towards the non-painful side. So, my left arm is reaching over towards the right as much as I can. The goal is to stretch these bottom ribs right here away from the hip as much as possible”

Proper execution of the ballerina stretch focuses on opening the area from the bottom of the rib cage into the lower back into the hip, should be held for about 30 seconds, repeated up to five times, with each repetition building deeper into the stretch, and should be performed on both sides for balance.

“When you do this, you're going to feel a deep stretch forming on that painful side. What we want to focus on doing is opening up that area from the bottom of the rib cage going into the lower back into the hip. So, tilt as much as you can until you start to feel that. It usually feels really really good. I try to hold this one for about 30 seconds. I just relax and then I can repeat this one up to five times and with each repetition, try to build into it just a little bit more and again, I do recommend doing this on both sides to keep them imbalance”

The hip hiker should be performed by holding the upward hip drive for about 5 seconds, relaxing, and repeating 10-15 times at a slow pace, with optional additional sets, and can be easily integrated into daily stairs usage.

“I like to hold this one for about 5 seconds. I just relax and then I repeat this one 10 to fifteen times, just nice and slowly. Build into it as much as you can. From there, if you have a little bit more energy, throw in another set or two”

The advanced hip hiker variation should be performed for 10-15 repetitions and then alternated to the other side to maintain balance.

“but again, try to do this one for about 10 to 15 repetitions and then from there, switch to the other side to keep them both in balance”

The 'butt walk' exercise effectively targets the glutes and quadratus lumborum, executed by starting in a seated position on the floor, lifting one glute and hip off the floor until muscles fire, driving the body forward by placing the heel down, and then alternating sides to walk forward using the glutes.

“So, here's a strengthening exercise fittingly called the butt walk. This one is really going to target the glutes and that quadratus lumbarum. I'm going to start seated on a floor. The movement is pretty easy. What I want to do is take one glute right here and lift my hip and that glute off the floor as much as we can until you feel those muscles start to fire on that side. From there, we're going to drive our body forward, so kind of like taking our foot forward as much as possible, putting our heel down and then you're just going to do the same thing on the other side. As you do this, you're going to notice that you're going to start to walk with your butt”

The butt walk should be performed slowly for 10-15 repetitions on both sides, with optional additional sets, and can be reversed by walking backward to activate muscles differently.

“But I try to do this one nice and slowly for about 10 to 15 repetitions on both sides to take this one to the next level just simply go in reverse you're going to notice the muscles get hit just a little bit differently so try to do this again for 10 to 15 repetitions in both directions if you feel like you have a little bit more energy throw in another set or two”

In the hip hiker exercise, movement should occur exclusively through the hip and pelvis in the upward direction, not through knee bending, and practitioners should feel a ton of muscles firing including the glutes and quadratus lumborum.

“So, I'm not really trying to bend my leg at all. All the movement needs to be through the hip through the pelvis and lower back going upward as much as you can. You're really going to feel a ton of muscles start to fire including the glutes and that quadratus lumborum”

The most advanced self-massage variation involves combining hip pressing, chest lift, knee-to-chest movement, and toe-reaching movements while rolling on the ball, holding each position for 1-2 seconds, repeating 10-15 times, which 'floss' the muscle.

“So, what I'm going to do is roll over, press down, lift up like this, and then I'm going to take my leg up like this, almost like a knee to the chest. You'll feel that muscle start to activate. We're going to hold this for about a second or two and then we're going to straighten our leg and then turn our foot inward and try to reach away from our body as much as we can with our toes. Hold this for a couple of seconds and then you're just going to repeat this process. Essentialy, what we're doing is flossing the muscle and it usually feels really really good but try to do this for about 10 to 15 repetitions”

Self-massage of the QL muscle should be performed by lying on the affected side with the ball pressed into the muscle, lifting hips up and down, rolling forward, and exploring the area with circular motions for about 10 seconds per repetition, repeated multiple times with increasing pressure.

“you can control this by rolling up on it and then lifting your hips up and down. So, what I would do is press into that muscle just until you find that comfortable amount of self massage once you feel that what you want to do is use your body to roll forward a couple times do this for about 10 seconds relax and then repeat this a couple more times and with each repetition press into it just a little bit more to target that muscle you can also go up and down do circular motions really explore the area”

An advanced variation of the self-massage technique involves rolling to press down with the hip while lifting the chest upward, focusing on moving the bottom ribs away from the hip to create deeper activation of the quadratus lumborum.

“If you want to take this one to the next level, let's focus on activating that quadratus lumborum muscle. So, what I'm going to do is roll over, press down with my hip as much as I can and then I'm going to lift my chest upward. What we're focusing on doing is trying to take the bottom of the ribs here away from the hip by coming up like this and you'll feel a deep activation of that QL muscle”

An advanced variation of the 90-90 QL opener involves rotating the chest downward toward the floor while holding the stretch, which produces a much deeper activation of the QL muscle, held for 30 seconds and repeated 3-5 times with progressive deepening.

“if you want to take this one to the next level what we can do is then rotate our chest downward towards the floor as we do this you'll feel a much deeper activation of that QL muscle. Again, a 30 second hold, just relax, and then try to build into it for about three to five repetitions”

All exercises in this protocol can be done at home and may provide quick pain relief within 30 seconds.

“As a bonus, all of these exercises can be done at home and you may find get quick pain relief even within 30 seconds”