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I Tore My Quadratus Lumborum (QL)

by | Health, health and fitness, injury | 0 comments

I really jacked up my lower back about a month ago. I did a very hard workout, and one of the exercises I did that day was a heavy set of squat rows. I went 30lbs heavier than usual because I normally do a set of pull downs or chin ups prior to doing squat rows. I like squat rows as part of a pre-exhaust sequence when I focus on my upper back. I did it this way for a change of pace (I will not do this again…). Later that day I worked on my motorcycle. I wanted to change the rear tire because it was worn, and I wanted to do the project myself. I like learning new skills to keep challenging myself. Anyway, getting the tire off the rim required a lot of pulling with the crowbars and working in awkward positions that stresses the lower back.

Sure enough. I started having back pain that night. No worries I thought. I get back pain often from manual work, and it usually settles down after a few days. If it is really bad, I do traction to try to take pressure off the sciatic nerve, which works very well.

A little history: I got a herniated disk several years ago from doing plyometric training during my workout. I saw a physical therapist about it to rehab the disk, and it was successful. He taught me how to do traction so I could do it anytime and without fancy machines, and also how to re-engage the Transverse Abdominus (the Transverse Abdominus shuts down from the pain generated by the pressure on the sciatic nerve). He told me that it will take time, maybe several months to fully recover. He was right! I did recover. It did take a long time, but I came back 100%.

So now my default protocol when I start having back pain has been traction, and it always worked…until now. I tried traction for the first couple of weeks, but it did not feel better. It did get a little better before our trip to Washington, so I attempted a light workout the day before our trip. No problems throughout the day, but that night was a different story. I turned over to my side as I was sleeping and felt an unusually sharp pain in my lower back. It felt like I tore my muscle. I knew you could strain a muscle, but actually tear a muscle? I did not know.

Anyway, I did not have time to research it because we were on the road the next day. I just had to deal with the pain and try to sit and lay down as pain free as I could. The first night we stayed at our hotel, I slept on the wrong side for a few minutes and woke up in excruciating pain. I iced my back for 45 minutes before it settled down enough so I could go back to sleep. However, I could not sleep in the bed because the mattress was too soft. I had to sleep on the floor. I am grateful that it worked well enough for me to get a good night’s sleep. I had to do it the next two nights.

Not only did I have to sleep on the floor, but I also had to sit down every time I exerted myself even a little bit. I would get pain radiating from my back around to my front. It felt like I got kicked in my privates.

I finally had some time a couple of days into my vacation to do some research on my back pain. I found out that, yes, you can tear a muscle. You can sprain a muscle, strain a muscle, and tear a muscle. It is simply a matter of degree of damage. No doubt I tore mine. I never felt pain like that from a back strain.

I also discovered what muscle I tore. It was my Quadratus Lumborum, called QL for short. The QL is an fascinating muscle. Unlike the other muscles of the body, the QL looks like a four sided muscle, hence the name Quadratus Lumborum. It sits on both sides of the spine at the base, the origin being the iliac crest and the insertions extend to the transverse processes of the upper lumbar region, and it finally inserts at the 12th rib. More detail than you may have cared to know, but you need to know it to understand function. Because of the location of the origins and insertions of the QL, it can create lateral flexion when one side is contracted. It can also raise the hip when one side is contracted, and it can create lumbar extension when both sides contract. But the most important and yet seemingly misunderstood job of the QL is for stabilization and support of the lumber spine. A healthy and strong QL can minimize lower back pain and provide good protection of the spine.

It was clear to me after my research that I did that I indeed tore my QL. That’s where the pain was coming from. That is what took the brunt the work on that day, and it was simply too much for my QL to handle.

What I learned is that you can heal a muscle tear, juts like a sprain or strain. It just takes longer. The advice was pretty straight forward. Rest, ice, ibuprofen and maybe muscle relaxers. And time. Lots of time. The articles I read said to expect anywhere from three to six months. Basic, but very different from my tried and true protocol of traction.

I opted to not use ibuprofen or muscle relaxers because I wanted to be aware of my pain level at all times. It is very easy to overdo any activity when the back feels better from pain killers and re-injure the body. But I did need some type of relief from the pain. Just enough to be comfortable so I could heel. I chose to use a very aggressive ice regimen coupled with a looot of sitting. Whenever I walked or lifted something, even if it was light, I would get the pain in the groin that I described earlier, so I would sit as soon as I can until it went away. I would also just plain sit a lot longer than I usually do. Laying down really did not give the relief like sitting did. So I sat. A lot.

What was surprising to me was that I would get immediate relief from my back pain when I would apply ice. It never went away completely, but it was always good enough for me to be able to get comfortable again. The example I gave earlier about how I needed to ice my back before going back to bed was a good one. I was in so much pain before I iced my back that I thought I would never feel good enough to go back to bed that night. But it worked. The pain became tolerable. I did an ice regimen every day at least 4 or 5 times each day. More if I needed it. Within a week I was feeling so much better that I even forgot I had my back injury. My pain free range of motion improved quite a bit. I felt so good by the time we came home that I did a moderate workout the next day…and had no pain. Two days later I did a full intensity workout…and no pain!
I don’t believe I am back 100%. It was a doozy of an injury, but I will say that I believe I am back 90 to 95% , which is fantastic! Gratefully, my recovery time was a lot shorter than anticipated.

Conclusion

I will still try traction and spinal decompression first whenever I feel some back pain and tightness coming on. But I know now that a muscle strain or tear could be the problem. If I suspect that, I will immediately start an icing protocol. Now that I am thinking about it, I will simply start using ice more liberally anyway in conjunction with traction. It would help bring down the inflammation, and maybe help me get better a little sooner.

My advice to you from my latest bout of back pain? Certainly explore all options to see what fits your needs, but I suggest you try ice therapy first if you believe you have a strained or torn muscle. It is very inexpensive and there are no long term side effects. Granted, it’s “old school”, but man it works.

Regards,

Gregg Hoffman