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3 Steps To Relieving QL Pain

Quadratus Lumborum (QL) pain is the worst. QL pain symptoms can single-handedly ruin your lower back and leave you feeling crippled. In fact, QL pain is so intertwined with lower back pain that the two phrases are sometimes used interchangeably. Read on to learn about QL pain symptoms, referral patterns, and most importantly what to do about it.



QL Pain Pattern Chart

The Quadratus Lumborum pain pattern above, as depicted by Travell and Simons [1], shows the common pain pattern induced directly from QL trigger points and knots. As you can see, QL pain is not only local to the lower back, but it also can cause pain along the tailbone, glutes, and hips [1]. The reason why QL pain can be referred so far from its location in the lower back (pictured in dark red) is due to its strong attachment at the Iliac Crest - also known as the top of the pelvis.

QL Pain Referral Pattern

Quadratus Lumborum (QL) Pain Pattern [1]


QL Pain Symptoms

Quadratus Lumborum pain symptoms are not simply limited to pain felt in the bright red areas above. In fact, the worst of QL pain symptoms have nothing to do with the QL pain referral pattern.

Additional QL pain symptoms include:

  • Lower back weakness
  • Pain lifting any sort of weight
  • Instability in sports and high-impact movements
  • Lower back stiffness
  • A feeling of lower back fragility

QL pain symptoms are fairly characteristic of lower back pain symptoms. If you relieve the QL pain portion of your lower back pain, there may be no pain left. Also - if you optimize your QL muscle into a strong, flexible machine you will not only relieve a lot of lower back pain but your physical capacity and performance may fly through the roof.


QL Pain Relief - The 3 Steps

And now for the dessert - how to actually fix QL pain and bury lower back pain for good.

1. QL Deep Tissue Massage: Step 1 of QL pain relief is to massage and release the living hell out of the QL muscle. The goal here is to physically dig into the QL muscle to break up any trigger points, knots, and tightnesses that are currently wrenching on joints and causing pain. You can do this with your physical or massage therapist, or at home with a deep-tissue massage tool like QL Claw. QL Claw is great for not only QL release but also deep tissue massage of the other main 4 muscles that contribute to lower back pain when tight - check it out below: 


2. QL Stretch: After the QL muscle is sufficiently released from its gnarly knots, trigger points, and pain, it is extremely beneficial to open up the muscles with a QL stretch. This will help sustain the QL release done in step 1 and also increase your mobility so that the lower back can move more without getting angry.


3. QL Strengthening: The final step in Quadratus Lumborum pain relief is strengthening the QL muscle. QL strength is like armor for the lower back - the stronger QL you have the less likely your lower back is to live in pain. However, if you skip to this step without performing 1 and 2 first you may never get out of your current pain, and only prevent worse pain. Get out of pain with steps 1 and 2 then move on to building a bulletproof QL (and lower back) with QL strengthening afterward.


If you would like a whole bundle package with a deep tissue release, stretching, and strengthening program specifically for lower back health and pain relief, check out our Back Muscle Optimization Bundle below:



QL Pain Prevention

Lower back and Quadratus Lumborum pain can be avoided with preventative measures. Preventative exercises are extremely beneficial if you are a) someone who has a fragile lower back, and b) someone who wants to stay safe during higher-impact movements and activities.

Building strength in a few key areas can go a long way in preventing QL pain. Here are a few areas of the body that can pay dividends in your lower back resilience along with exercises you can do to build them:

1. Glutes: Strong glutes help you lift, run, stand, and walk more effectively without stressing the lower back. The weaker the glute muscles, the more stress the lower back (including the QLs) has to take up during daily life.

  • Single Leg Bridges
  • Hip Thrusts
  • Single Leg Deadlifts
  • Fire Hydrants

2. Side Core: The Obliques, QLs, and paraspinal muscles act like armor for your lower back. The stronger these muscles are, the harder it is to trigger lower back and QL pain.

  • Side Planks
  • Suitcase Carries
  • Paloff Press
  • Wood Chop

3. Total Core: The stronger core you have overall, the more pressure your lower back can take. Strong abdominals and bracing power can make QL pain and lower back tweaks obsolete.

  • Hollow Hold
  • Front Planks
  • Bird Dogs
  • Turkish Getups


QL Pain FAQ:

How To Sit With QL Pain:

The important thing for sitting with QL pain is keeping the lower back straight and slightly arched. Slouching and rounding the lower back can strain the QL muscles and bring on more pain.

Use a back support to keep the lower back straight and arched if need be.

What Causes QL Pain?

Quadratus Lumborum pain is often caused by a single high-impact event like lifting a couch or playing a sport, but it can also be caused gradually by poor habits like slouching.

How To Fix QL Pain:

The 3 step process of massage, stretch, strengthen. Start with a QL massage tool like QL Claw for step 1.

How To Sleep With QL Pain:

There is often no comfortable sleeping position with a hot QL muscle - although the side is likely to be the best. If you own a QL Claw or other massage tool, massage before bed to reduce symptoms and a better night's sleep.


Thank you for reading QL Pain! I went through about 4 years of Quadratus Lumborum problems and nagging lower back pain before I figured this out. Shoot me an email at if you have any questions, and best of luck with your back pain relief journey.




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

comment 2 comments

Ben - Author calendar_today

@Karen Miles Thank you for the comment! Yes QL pain is something physical therapists treat frequently. Their hands are the best tool for the job but QL Claw is the best for QL massage at home! I use the kettlebell in the video for suitcase carries to strengthen the QL, but a dumbbell or other weight works just as well.

Karen Miles calendar_today

Right on Target. I finally figured out most all of my injuries where I end up in Physical Therapy are are angry QL. I am using a Lacrosse Ball but the Claw looks like it could get in deeper. Side Planks are helping immensely. I did see a kettle bell briefly in the video but not certain what exercise to do with that.

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