Trigger Points in the muscles are often the cause of localized and referred pain throughout the body. Trigger Points in the Quadratus Lumborum (QL) muscles of the low back are often the source of low back pain, but they can also cause pain in the sacral and buttock region.
A trigger point is a hyperirritable taut band of skeletal muscle tissue, also known as a “knot” in the muscle. They are often painful to touch. They can also cause radicular pain or pain in another location than the actual trigger point location.
A trigger point can be caused by an acute trauma or strain on a muscle or from repetitive stress and strain on the muscle. They often are the result of gripping or clenching of the muscle, and poor posture. They can be the cause of pain throughout the entire body from headaches to foot pain.
The quadratus lumborum is often a site of low back pain.
It runs from the bottom of the last rib (12th rib) to the top of the pelvis (iliac crest). Along the way, it attaches on the side to the lumbar vertebrae (L1-L4). It functions to:
When a trigger point occurs in this muscle deep, you may experience pain in the sacral and buttock region, even though the actual cause of the pain is much higher in the muscle. This is called referred pain. The actual trigger points themselves may also be painful.
Often, its your posture that causes the QL muscle to tighten up. When standing, we often tend to jut one hip out the side, this can shorten the QL on that side, making it more prone to trigger points. In sitting, we may lean onto an arm rest on one side doing the same thing. And during sleeping, often we lay in the “fetal position”, but if that top leg is hiked up pretty high, that will put more stress on the QL.
Being mindful of your posture and correcting postural alignment issues can make all the difference in pain and trigger points developing in the QL and causing low back pain.
Trigger points often respond well to different myofascial release techniques – including “trigger point release” where you put deep pressure into the trigger point, hold it for a minimum of one minute and then let go which will help blood and cells rush to the area to help heal the knotted up tissue. The QL can be very hard to release yourself, but you can use a tennis ball to release the more superficial trigger points. The deep points may require more of a skilled hand (see your physical therapist).
Stretching can be helpful in some instances, but overstretching can actually cause the muscle to tighten up even more.
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