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The Quadratus Lumborum – An MSR Approach

Updated: Apr 1


Working the Quadratus Lumborum

The Quadratus Lumborum (QL), a key stabilizer of the lumbar spine and pelvis, is integral to postural alignment and mechanical efficiency. This article dissects the QL's anatomy and biomechanical roles within the Motion Specific Release (MSR) framework, highlighting its significance in spinal stabilization, pelvic orientation, and load transfer during movement.


Our MSR perspective focuses on the QL's contributions to lateral stability and axial rotation, examining the implications of its dysfunction in musculoskeletal pathology. We will elucidate MSR procedures to optimize QL function, aiming to enhance therapeutic outcomes in the management of lower back pain.


Article Index:


 

Quadratus Lumborum - Anatomy & Biomechanics


Image of the Quadratus Lumborum

The Quadratus Lumborum (QL), often overshadowed by the more prominent muscles of the core, plays a pivotal role in the biomechanics of the lumbar spine and the pelvis. A key muscle in spinal stabilization and pelvic tilt, is essential for functional movements and load-bearing activities.


Origin and Insertion:

  • The QL originates at the posterior iliac crest and inserts into the transverse processes of the upper lumbar vertebrae and the lower margin of the twelfth rib.

Innervation:

  • It is innervated by the anterior rami of the T12 to L4 nerve roots, which is crucial for its motor and proprioceptive functions.

Biomechanical Role:

  • The QL engages in lateral flexion of the vertebral column, aids in extension, and assists with forced expiration. In a bilateral action, it fixes the 12th rib during deep inspiration, aiding in respiratory mechanics.


From an MSR standpoint, the QL's ability to influence pelvic stability and lumbar spine alignment is critical. Its mechanical advantage is leveraged during therapeutic interventions to alleviate lower back pain and restore functional mobility.


 

Motion Specific Release (MSR) Treatment


Initial Setup:


  • Patient Positioning: The patient is positioned in side posture position, this allows for relaxation of the surrounding musculature while still providing adequate access to the QL.

  • Practitioner Stance: To ensure effective delivery of the MSR procedures, the practitioner takes a stance that balances stability with the ability to maneuver.


Basic Technique:

  • Treatment: The practitioner applies precise pressure with the forearm, targeting the soft tissue between the iliac crest and the lower ribs.

  • Support Hand: The opposing hand stabilizes the patient’s upper arm/shoulder, enhancing the practitioner’s ability to create bilateral tension.

  • Synchronization: Treatment requires synchronized movement and pressure, targeting the QL’s attachments from the iliac crest to the transverse processes of the lumbar vertebrae.

  • Pressure Application: Gradual pressure is increased in a controlled manner, ensuring comfort while engaging the QL.


Force generation:

  • Bilateral Traction: The amount of force generated can be increased or reduced by tractioning the patient's arm in a superior direction and the patient's QL in an inferior lateral direction with the practitioner's forearm. The application of forearm pronation and supination can also be used to increase and decrease tension.

  • Multidirectional Engagement: Besides the forearm position, the patient's body can be rolled forward and back to increase tension and vary the direction of treatment related to the specific orientation of the QL fibers.


MSR Demonstration Video:

In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for releasing the Quadratus Lumborum Muscle.





Best Practices:

  • Time Factor: Sufficient time should be allocated for the MSR session, allowing for a methodical approach to releasing the QL.

  • Kinetic Chains: The interconnectedness of the QL is considered, recognizing their impact on both local and systemic musculoskeletal health.


Precautions:

  • Prioritize patient safety by considering contraindications and ensuring informed consent.

  • Avoid exacerbating any existing conditions by using gentle, informed techniques.

  • Be aware of the patient's comfort and response to pressure throughout the MSR session.


 



Functional Kinetic Chain Image

Quadratus Lumborum Functional Kinetic Chains


Understanding the kinetic chains associated with the Quadratus Lumborum (QL) is vital for a comprehensive approach to musculoskeletal health and the application of Motion Specific Release (MSR). This perspective allows us to recognize:


Direct Myofascial Connections:

The QL is intricately connected to the lumbar fascia and interacts with abdominal and spinal muscles, forming a myofascial continuum that affects posture and spinal stability. Dysfunction in the QL can lead to imbalances and compensations throughout this network, impacting overall body mechanics.


  • Thoracolumbar Fascia: The QL's connection to the thoracolumbar fascia is critical in transmitting forces across the lower back, influencing both spinal stability and mobility.

  • Psoas Major: Works synergistically with the QL to maintain lumbar lordosis and contributes to spinal stabilization.


Synergists:

The QL collaborates with other muscles to ensure the stability and movement of the lumbar spine and pelvis.


  • Erector Spinae: Supports the QL in maintaining upright posture and assists in spinal extension and rotation.

  • Abdominal Muscles: Particularly the obliques, work in opposition to the QL, helping in trunk rotation and lateral flexion.


Stabilizers:

These muscles provide structural support and are crucial for the effective functioning of the QL.


  • Transversus Abdominis: Acts as a stabilizer for the lower back and pelvis, working in concert with the QL to provide trunk stability.

  • Multifidus: This deep spinal muscle supports the vertebral segments and works closely with the QL for lumbar spine stability.


Antagonists:

Muscles that counteract the actions of the QL are essential for balanced lumbar and pelvic mechanics.


  • Rectus Abdominis and Lower Abdominals: Oppose the lumbar extension and lateral flexion actions of the QL, important in movements like forward bending and trunk rotation.


This integrated understanding of the QL within lumbar and pelvic kinetic chains is crucial for devising targeted MSR treatment and rehabilitation strategies. It underscores the importance of addressing the interconnected nature of the lower back's musculoskeletal system for effective clinical outcomes.


 

Exercises


Exercise is a key element in myofascial treatment, focusing on enhancing mobility, fortifying strength, and cultivating balance. Specific exercises are selected based on individual needs.


Stretching


5 Minute Low Back Pain Relief

If you're experiencing discomfort in your lower back after prolonged sitting in front of your computer, it's essential to address it promptly. In the case of the QL the stretch at time stamp 04:10 is extremely effective, especially if you perform this several times per day.



Myofascial Release


Quadratus Lumborum Back Pain Release

The QL muscle is considered a postural muscle group and part of the core muscles. The QL tends to be tight and overactive and is commonly related to low back pain.



Strengthening


The 3 Minute Plank Routine

Beginner Level" is a great way to start working on your core. Each set only lasts for just over a minute so repeat the sequence 3 to 5 times with one minute in between.



Balance


Improve Your Balance

Exercises for Beginners: Balancing exercises are crucial components in both Rehabilitation and Sports Performance training. These exercises should not be overlooked, as they can bolster one's capacity to stabilize the body during functional movements. By incorporating straightforward balance exercises into a progressive training program, you can enhance balance and avert injuries.


 

Conclusion


In conclusion, the Quadratus Lumborum (QL) stands as a fundamental muscle in maintaining lumbar and pelvic stability, vital for postural integrity and movement efficiency. Through tailored MSR procedures and carefully selected exercises, clinicians can optimize QL function, which is essential for mitigating lower back pain and enhancing the functional movement of patients. The nuanced understanding of the QL's anatomy, combined with targeted interventions and exercise regimens, serves as a cornerstone for effective therapeutic strategies and underscores the muscle's significant role in the musculoskeletal system's dynamic interplay.


 

DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

Dr. Abelson's approach to musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the Motion Specific Release (MSR) Treatment Systems developer, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.


 


MSR Instructor Mike Burton Smiling

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Integrating MSR into your practice can significantly enhance your clinical practice. The benefits we mentioned are only a few reasons for joining our MSR team.


 

References 

  1. Abelson, B., Abelson, K., & Mylonas, E. (2018, February). A Practitioner's Guide to Motion Specific Release, Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries (1st edition). Rowan Tree Books.

  2. Neumann, D.A. (2013). "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." St. Louis, MO: Mosby.

  3. Hides, J.A., Stanton, W.R., McMahon, S., Sims, K., & Richardson, C.A. (2008). "Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain." Journal of Orthopaedic & Sports Physical Therapy, 38(3), 101-108.

  4. McGill, S.M. (2007). "Low back disorders: Evidence-based prevention and rehabilitation." Champaign, IL: Human Kinetics.

  5. Panjabi, M.M. (1992). "The Stabilizing System of the Spine. Part I. Function, Dysfunction, Adaptation, and Enhancement." Journal of Spinal Disorders, 5(4), 383-389.

  6. Cholewicki, J., & McGill, S.M. (1996). "Mechanical stability of the in vivo lumbar spine: Implications for injury and chronic low back pain." Clinical Biomechanics, 11(1), 1-15.


 
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