A major cause of back ache. The quadratus lumborum.

Posted by & filed under Exercise and Training, Health and Fitness.

A constant problem I run into with clients is the assumption that all ab work hurts and is hard work.  In the early sessions, people hold their breath, turn red and generally grip their way through the simplest exercise.  This shows they are using their superficial abdominals and not the deep corset like muscle called the transversus abdominis or TVA.  When ab work is done with a grip, people are also using over using their back muscles which include the quadratus lumborum, a particularly troublesome muscle.

The quadratus lumborum (QL) is pictured in red to the left of this text.  In this picture it is viewed from behind.  It can be seen that it runs from the top of the hip bone up to the low ribs, attaching onto all the lumbar verterbrae.  There is a QL on either side of the spine and it is extremely common that one side is tighter than the other.  The QL does indeed help stabilise the spine, but when the deep abdominal muscle, the TVA, is inactive the QL becomes over active as a spinal stabiliser and with one side contracting harder than the other, this can ultimately cause the verterbral bodies to get stuck together – the facet joints lock up – and this hurts.  It is a major cause of backache.

Although this is an X-ray of the cervical (neck) spine, the facet joints can be seen as a line of near vertical rings at the back of the neck.  The facet joints allow the spine to move forwards and backwards but resist excessive rotation, so if one QL is tighter than the other, the spine is pulled into a side bend, leaving the short side prone to locking up when we are twisting.

A tight QL one sided or both sides also pulls the back of the ribs and the hips towards each other, working in concert with another troublesome muscle group, the hip flexors, the group responsible for lifting the knees.  This leads to an excessive lumbar curve, called a lordosis.  When this happens the belly sticks out and it is harder to engage the abs properly.

What I have also found is that as the belly sticks out it is usually accompanied by the upper back rounding, with the net result that people are shorter than they should be.  It is very common for clients of mine to gain an inch or so in height as their spine lengthens and their abs regain their true strength.

A poor diet with excessive consumption of wheat – or any single foodstuff, come to that – plus unhealthy gut function will turn the TVA off. The upper back rounds, the belly sticks out and this all leaves the QL in charge of lumbar stabilisation. Then it is only a matter of time before the back aches when standing for a while, for example.  And only a matter of time before that back ache becomes critical.

So if the abs are working well, ab exercises like the plank are done with the ability to be able to sing away heartily. The ab crunch becomes properly hard and can be performed with good form, with the low back relaxed on the floor throughout the movement.  As a result, the belly flattens most satisfyingly, back ache is a distant memory and we stand taller for as long as we like.


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