Tips for working the QL

[KROQFAN]

I have not taken any formal trigger point or deep tissue classes, although it's become clear I really should!

Is there a gentle way to address the Quadratus Lumborum muscle without positioning the client sidelying?

I have a client who recently had some major surgery involving removal of adrenal glands. Everything I do with her is very gentle. She is experiencing lower back pain, and while it may be a complication of the surgery (yikes!) it is likely muscular. I was reading up on the role the QL plays in lower back pain, and would like to help this client in any way I can. The incisions are located on her lateral abdomin, so I don't want to melt into her sides directly.

Also, her lats are very tender, especially the area around where her bra digs into her back/sides. Will I be able to get past those lats to access the deeper QL? Working that area while she was prone, her arm up out of the way, I was hoping I was getting close to that QL, but no it was definitely still over her ribs.

 

[IReallyDunno]

You can work it while she is prone.
First, the QL is at a bit of a diagonal from the lowest rib and spine (superiorly) to the mid to lateral iliac crest.

You can do a gentle stretch by placing both hands in the middle of the QL (I do this with forearms or the ulner edge of the hand sometimes- or knuckles, but that is a bit "deeper"). Slowly slide the hands away from each other along the QL with your footward hand ending on the iliac crest and the headward hand at the spine/rib attachment.

Look at an anatomy book, and this move may make more sense. It is fairly gentle, and shouldn't bother her incision site- depending on exactly where it is.

Good luck- and take a couple of DT classes

 

[Pompal 09.]

One of my favourite techniques for accessing the QL is to position myself on the opposite side of the QL I wish to work on with my client prone. I then reach across the back and hook my hand into my clients side. I then slowly pull my hand medially towards the spine until I hook onto the lateral fibres of the QL. Then depending on the client and the tension in the QL I drop my weight down and bow the QL towards the spine... it generally is a pretty sensitive area so always make sure you're within the client's comfort zone. If a TrP is present the client will register a jump sign so just hold pressure for a bit until you feel a relaxing in the muscle. Hope that helps.

 

[RAWR!]

anyone else?

 

[Cracker]

'Twas my question, but since then I've been on the look-out for techniques, and watched a nice one for chair massage clients: one fore-arm anchoring the lower back on one side at the sacrum, the other fore-arm parallel just above it slowly moving upward and stretching out the QL area. (Did that make sense in writing?)

 

[AnaBabyBunny]

'Twas my question, but since then I've been on the look-out for techniques, and watched a nice one for chair massage clients: one fore-arm anchoring the lower back on one side at the sacrum, the other fore-arm parallel just above it slowly moving upward and stretching out the QL area. (Did that make sense in writing?)

That is what I do when the client is in my chair and has LBP. They are always impressed with how that one stretch helps immediately! On the table, the cross-armed stretch works well - to stretch the right QL, standing on the client's right, place your right hand on the right hip. Cross the left arm over and place it just below the last rib. Sink in gently, then move the hands apart until you feel good resistance, and hold there.