The Quadratus Lumborum and Spinal Stability

Once your acute low back pain begins to settle it is important to address the underlying causes of your low back problem. One of the most frequent factors which is associated with low back trouble is muscle weakness or ‘deconditioning’. In order to continue the recovery process and take preventive action for serious problems in the future, a few simple safe back exercises have been proven to be safe and effective.

Along with basic postural advice the key to protecting your back is 360° of muscle support. Many programs emphasize only the abdominal muscles which is a big mistake. The side and back muscles are at least as important. What is presented here are a few progressions for training endurance of your side support muscles. These include the oblique abdominals and quadratus lumborum muscles.

Cat/Camel

A: On hands and knees, back sagging down, head up. B: On hands and knees, back rounded up toward the ceiling, head down. — Figure 1. Cat/Camel.

First, begin with a simple warm-up involving the cat/camel exercise on all fours (Figure 1). This should be performed first thing in the morning and then prior to your endurance training exercises. Eight to ten slow repetitions are all that are needed. Think of the cat/camel as a limbering, rather than stretching movement.

Side Bridge

Lying on one side, propped on the forearm, knees bent, hips lifted off the floor, with the top hand on the floor in front for support. — Figure 2. Side-bridge on knees with the top arm supporting.

Propped on one forearm, knees bent, hips lifted so the body forms a straight line from knees to shoulders, top hand on the hip. — Figure 3. Side bridge on knees.

Propped on one forearm, legs straight with the feet stacked, hips lifted so the body forms a straight line from ankles to shoulders, top hand on the hip. — Figure 4. Side bridge on ankles.

After performing the cat/camel you are ready for a simple exercise which will begin to improve the endurance of your abdominal and back muscles. This is called the side bridge and is begun by laying on your side on a carpeted floor or exercise mat. Prop yourself up on your forearm as shown in Figure 2. Bend your knees and hips and raise your side up as high as you can. Use your lower arm and knee for support. You can use your top arm to help. Hold your body up for 5–6 seconds and then slowly lower yourself. Start with 3–4 repetitions and progress until you can perform 10–12 repetitions.

When you feel comfortable enough try to do this without the help of your arm (Figure 3). The next progression is to perform this with your legs straight (Figure 4) using only your lower arm and ankles for support. The final progression of this exercise utilizes the Figure 4 position, but instead of lowering your body in between repetitions simply turn your body by placing your non-supporting forearm under your body and then simply roll onto it as you turn your body around without dropping your hips to the floor. Each of the side bridge exercises can be intensified by tightening your abdominals by drawing your navel in towards your back.

Always, remember if you are experiencing discomfort the cat/camel is your ‘first-aid’ exercise, retreat to it. A little bit of discomfort with the side bridge is all right as hurt does not necessarily equal harm. The road to recovery is through activity. If your back is giving you trouble it is a sign that it is not strong or supple enough to do the work that is required. The cat/camel and side bridge exercises are safe for your back and will help you to recondition the ‘weak link’.

C. Liebenson, “The quadratus lumborum and spinal stability,” Journal of Bodywork and Movement Therapies 4(1):55, 2000. Reproduced with permission.