Back Pain: Quadratus Lumborum

How do you evaluate the quadratus lumborum?

What tests do you use to distinguish between psoas, iliacus, obliques and quadratus lumborum [QL]?

These muscles are all involved in flexion, extension, rotation and lateral flexion.

How can we single out the QL from the rest of the muscles that directly affect the lumbar spine?

Side bends test the function of the obliques and QLs. [mobility]

 

Unilateral hip elevation also evaluate the obliques and QLs. [strength]

 

Prone/supine eccentric break testing evaluate both obliques and QLs. [strength]

 

Palpation directly addresses the QL muscles.

 

Combine range of motion, palpation and muscle testing to evaluate the degree of success obtained from your treatment.

 

Correcting the QL.

Insertion points – press directly into the osteo-tendinous junction at the site and angle of most sensitivity and tenderness. [See arrows]

Use a tolerable force. [2-3 on a 1-10 scale]

Apply thumb pressure with 3 to 4 gentle nudges into the most tender insertion

or…

press and hold the tender point for 3 to 5 seconds.

Immediately retest mobility and strength to track progress.

 

 

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