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QL And Psoas Muscles | Why They Cause Lower Back Pain

QL (Quadratus Lumborum) and Psoas are two of the most deadly lower back pain perpetrators. Both muscles can develop a ton of constant tension from sitting, and they wrench on the poor lower back when they are tight. This is on what the QL and Psoas are, why they hurt your back, and how to fix them from causing your pain.

QL and Psoas Muscles - QL QL and Psoas Muscles - Psoas

QL (left/top) and Psoas (right/bottom) Muscles


What Are The QL And Psoas Muscles?

QL and Psoas are two muscles that are crucial in human movement and lower back health. Both muscles refer a ton of pain to the lower back when tight, and here is what they are (pictured above) [1].

QL Muscle

Anatomy: The QL muscle, or the "Quadratus Lumborum", is a deep lower back muscle that connects from the bottom of the ribcage to the top of the hip. The QL also connects to the lumbar vertebrae, and it is four-sided in shape (the reason for the "quad" in the name).

Function: QL is critical in lower back stability. Without the QLs, you would be as flimsy as a flower on a stem [2]. Both QLs help keep your lower back strong, sturdy, and neutral to protect the spine from harm.

The QLs also function in side bending when one lone QL contracts at a time. Both QLs contracting together create high spinal stability as well as spinal extension [1].

Psoas Muscle

Anatomy: Psoas is a hip flexor muscle that connects from the lumbar vertebrae to the top of the femur on each side of the body. Psoas gets chronically tight from sitting - if you picture where the Psoas is while sitting, you can observe it is in a highly shortened position.

Function: As a hip flexor muscle, Psoas functions in bringing the knee towards to chest. In addition, Psoas is a spinal and pelvic stabilizer that helps keep the pelvis in alignment [1].


QL And Psoas Lower Back Pain

Both QL and Psoas muscles are relentless when it comes to lower back pain. If you have been in the pain cave or treatment long enough, chances are you know these two by name and pain.

QL Pain Pattern

QL Muscle Pain Pattern [1]

The QL muscle tends to refer the pain pattern above. Pain from QL trigger points and tension can be felt in the tailbone, top of buttock, outer buttock, lower buttock, and lower back (essentially all over the backside).

QL Pain Symptoms:

Additional QL pain symptoms can include:

  • Lower back fragility & weakness
  • Nagging, constant pain regardless of laying/sitting/standing
  • Inability to bend forward
  • Difficulty lifting or carrying objects

Psoas Pain Pattern

Psoas Pain Pattern [1]

The Psoas muscle and Psoas trigger points tend to refer pain in the pattern above. Psoas pain is typically described as general, non-specific lower back pain, but it can also be felt on the upper thigh. Psoas pain is typically caused by sitting, and made more comfortable by sitting - it is the transition from sitting to standing (which causes Psoas to lengthen) that is difficult with Psoas pain.

Psoas Pain Symptoms:

Additional Psoas pain symptoms include:

  • Pain standing after sitting a while
  • Pain extending the hips (arching the lower back)
  • Stiffness in the hips
  • Difficulty running with full strides


How To Release QL And Psoas

The QL and Psoas muscles have the same pain relief concepts and order of relief plan. The pain relief process follows 1) massage 2) stretch and 3) strengthening.

QL & Psoas Relief Step 1: Massage

The goal of step 1 is to eliminate all of the knots, trigger points, and rigid tissue that currently hold constant tension in QL and Psoas. This rigid muscle fiber is often painful and impossible to stretch, so we need to physically work it out with deep tissue massage.

Deep tissue massage can be done by the hands of a professional, or at home with specifically made tools like QL Claw (for QL) and Pso-Rite (for Psoas).  

QL Claw On QL Muscle
QL Claw On QL Muscle

QL & Psoas Relief Step 2: Stretch

After step 1, we want to create length in the muscles to stop them from pulling on joints and impinging nerves. This is especially important for the Psoas because it is longer and has a greater capacity to shorten its connections.

Here is a great Psoas stretch video for reference, as well as a QL stretch below:

Psoas/Iliacus Stretch:

QL Stretch: 

QL & Psoas Relief Step 3: Strengthen

The last step of bulletproofing the lower back from QL and Psoas muscle problems is strengthening. Without strength work, you will likely re-trigger your pain eventually and land yourself right back at step 1.

There are a few key areas to strengthen for QL and Psoas resilience. These areas include the obliques, QLs, upper glutes, paraspinal muscles, and more. Here are a few exercises to get started, as well as our own Back Of Steel program designed to bulletproof the lower back completely:

Thank you for reading QL and Psoas! Check out the links in the article for more on lower back pain relief and mastering the muscles to get you there.

[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.

[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.

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