Steamrolling the QL

   

The tough part of massage therapy long-term back pain is chasing trigger points in the quadratus lumborem.  This is one of those muscles that not only keep clients awake at night; it keeps the therapist up, too.

           

I have done prone QL massage, prone with approximation, prone with stretch.

          

I have massaged the QL sideline with the olecranon. Sideline with directed relaxation. Sideline with directed breathing. Sideline with heat and a tennis ball.

          

It feels sometimes, that I have done everything except roller-skate to get those pesky points.

           

Does some massage therapist, somewhere, have a quick and easy method for releasing the QL?

           

Not to pick on the QL. The multifidus and the longissimuss and iliocostalis contribute to the problems of repeating lumbar pain. I find that if those muscles are skipped, they can recruit the QL back to tension and TrP.

           

And the opposing muscle, the psoas, can be just as equally weak as the QL is knotted. Bilateral weakness of the psoas and I will definitely have to roll my sleeves up. It is going to be a bumpy ride.

           

It is some consolation to know that QL problems tend to fester, painless and subclinical for years. The massages are unwinding years of QL spasticity making up for a lack of core strength.

           

That is a little comforting, I guess. Time to sharpen my elbow.