Lower Back & Hip
Quick Reference
The quadratus lumborum (QL) is a quadrilateral muscle located deep in the posterior abdominal wall, between the 12th rib and the iliac crest. It connects the pelvis to the lower ribs and lumbar transverse processes. It's a primary lateral flexor of the trunk and stabilizer of the lumbar spine — and when it's unilaterally overloaded, it elevates the hip on that side, contributing to the appearance of a functional leg-length discrepancy.
The QL is one of the most common sources of acute lower back pain and back spasm. Its deep location and multiple functions mean it's recruited for virtually every movement that involves the trunk — lifting, twisting, even sustained standing. Asymmetric loading patterns (carrying a bag on one shoulder, sitting with a wallet in one back pocket, sleeping in certain positions) preferentially overload one side.
Active QL trigger points refer pain in distinctive patterns: deep in the lower back near the SI joint, into the lateral hip and greater trochanter (which is commonly misdiagnosed as trochanteric bursitis), and occasionally into the groin and lower abdomen. The QL is frequently the source of the sharp, acute 'back spasm' that makes it hard to stand up straight.
The QL is not accessible with superficial massage — it lies deep to the erector spinae and requires specific technique to reach. Side-lying positioning allows the best access. In sessions, I address the QL with deep pressure and myofascial release as part of a broader lower back assessment that also includes the iliopsoas, hip rotators, and thoracolumbar fascia. Stretching: lateral side bends and the thread-the-needle stretch target the QL, though they should be held long enough (2+ minutes) to be effective.
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