Low Back Pain, Breath, and The Quadratus Lumborum

No single muscle (or pair of muscles like the Quadratus Lumborum – QL) should be held accountable for low back pain. Never the less, if you do have low back pain, the QL muscle is likely to be tight. QL is the deepest supporter in your lumbar spine (L1-L5, AKA ‘low back’). As such, it is generally grumpy on the side of the lumbar spine where there is pain. Additionally, as a muscle of respiration, the QL can restrict breathing.

Even though this video brings in Mr. Bones for specific, though certainly not scientific anatomy of the Quadratus Lumborum (as noted by my ‘cut to QL shape’ terrycloth towels!), please know that my policy is that you cannot look at muscle dysfunction in isolation. Furthermore, deep, long term healing is more likely to occur when you look beyond the bugger muscles to the respiratory system. Back pain is a team effort. It includes weak core muscles, gluteal muscles, and other contributors like the grumpy P’s: psoas and piriformis. These naughty muscles can be working overtime or on sabbatical. Of equal consequence, low back pain, or any bodily pain, is also a function of our breath.

Quadratus Lumborum And Respiration

In my world of embodied movement as medicine, breath is an amazingly accurate diagnostic tool as well as the underutilized superpower in healing. This is especially true of low back pain and the QL. When practical experience and anatomical knowledge collide, I would argue that the main role of the QL is to be a starting team player in respiration. The QL is connected to the 12th rib along with the diaphragm (engine of the breath); it is the base of support for the diaphragm when it contracts during inspiration. The QL can also be used voluntarily in active expiration of breath as it pulls the ribs down to expel air from the lungs as the diaphragm relaxes. When the QL is tight, it inhibits our breathing. 😮‍💨

Pain And Respiration

When we are in pain, the instinctive response of the nervous system is to breathe faster and shallower. Flip this around. What happens when our breathing rate is voluntarily reduced to a slower speed and the breathing depth increases? Clinical studies confirm that slow deep breathing can reduce or positively impact pain. Chronic back pain leads to long term breathing problems. Breathing inefficiently lends itself to an increase in pain. It is a literal tug of war. With dysfunctional QL, the physical issues may go beyond the back and breath. The QL’s intimate relationship with the respiratory diaphragm and lumbopelvic region means it connects movement between the hips and lungs. Pain in the pelvis can benefit from releasing and relaxing the QL with intention, gentle movement, myofacial release and breathing.

In the yoga therapy field, we are skillfully taught different fancy and sometimes convoluted pranayamas (breathing techniques). Pranayama can specifically benefit our physical, mental/emotional and energetic Be-ing. In its simplest form, a breathing technique is any voluntary change in breathing behavior; this includes the frequency (how often), rate (how fast), depth (how much we take in), as well as the airway used for breathing (nose or mouth). A pranayama that is a pain healer for some people can be toxic for others. This is a good time to mention that Dr. Google has seen an explosion in searches that contain the word “breathing”. Unfortunately, many of the search results include trendy and difficult breathing techniques that can actually lead to an increase in anxiety, (which increases pain at the nervous system level).

Breathing To Change Pain

If you have low back pain (or any other physical or emotional pain), before you do this video, I invite you to start with a basic breathing experiment. Locate yourself in or near the area of pain. Set a positive intention, or at least be curious, and try pursed lip breathing: breathe in the nose and out mouth with pursed lips, like you are blowing a candle out out…or blowing the pain away. This is an available, adaptable breathing exercise that can help control pain on both a physical and mental level. There is no goal of length of inhale, exhale or holding the breath. You are simply and organically reducing your breathing rate (slow it down) and increasing you breathing depth (make it deeper).

This class will teach you the imagery of anatomy so you can visualize your QL muscle, and breathe to it while inviting it to relax. In addition to understandable anatomy, it incorporates somatic yoga, yoga therapy and myofacial release. Please have a thick blanket, a few tennis sized balls or smaller (and softer!), a heavy bolster or even a book to place on your back, and a slo-mo ball if you have it.

Breath Is Life, Megan

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