Quadratus Lumborum and Mindful Back Health in Yoga

Low back pain is an increasing issue in our society dominated by poor posture, sedentary lifestyles, and chronic sitting patterns. The source of low back pain can vary, but a great deal of these muscular dysfunctions emanate from the quadratus lumborum muscles.

Most of us are quite familiar with the erector spinae muscles that travel from the hip crest/sacrum to various points up the vertebrae and ribs.  These muscles function primarily as extensors of the back. Few people (including yoga teachers) are aware of the all important quadratus lumborum muscles that are located deep to the erector spinae.

Quadratus Lumborum muscleThe quadratus lumborum muscles sit on either side of the vertebrae.  They originate on the iliac crest (hip bone) and insert on the transverse processes of the lumbar vertebrae and the 12th (last) rib.   When both sides contract, they extend the spine (and/or depress the ribcage from behind).  When only one-side contracts, the spine flexes laterally and/or elevates the ilium (hip) on that same side. In forced expiration, the quadratus lumborum will fix the 12 ribs.

Dysfunction and low back pain can settle into the quadratus lumborum under a few conditions:

*if the erector spinae are weak or inhibited (as they often are in chronic seated postures), the quadratus lumborum attempts to take up the slack and loading in back extension and spinal stabilization leading to overall muscle fatigue.

*if muscle imbalances build up across the pelvis (i.e. tight hip flexors), the lower vertebrae can shift into chronic excessive curvature (lordosis), which will shorten and weaken the quadratus lumborum and erector spinae.

*if poor posture and upper body muscle tension forms across the chest and shoulders, rounded-back posture (kyphosis) will pull the rib cage up and away from the hip crest. This places stress and drag on the quadratus lumborum and portions of the erector spinae.

*the deep gluteals (gluteus medius and gluteus minimus) are responsible for hip abduction and pelvic stabilization in walking and other gait patterns. If these deep gluteal muscles are weak and inhibited, the quadratus lumborum and tensor fascia latae have to compensate to stabilize the pelvis.

*some physical experts have also found that tight hip adductor muscles (groin) can inhibit (through reciprocal inhibition) the gluteus medius muscles. As mentioned above, the quadratus lumborum muscle may compensate for the gluteus medius muscle’s lack of activity and pelvic stabilization.

Understanding that the dysfunction residing in the quadratus lumborum is often the result of dysfunction and tension imbalances coming from other muscles, here are some initial approaches to maintaining health of the quadratus lumborum:

*develop a strategy to maintain fluid balance in upper and lower body posture patterns to avoid chronic hip flexor tightness, back extensor tension, and loss of natural vertebral curvature and pelvic placement

*stretch the chest, front of the shoulders, hip flexors, groin, and lower back frequently

*strengthen back extensors and overall core stabilizers

*strengthen and stretch deep gluteals to unload unnecessary engage of the quadratus lumborum

*engage in proper therapeutic treatments when discomfort and pain develop

Here are some basic, accessible stretches readily prescribed to restore and maintain flexibility in the quadratus lumborum muscles:

Child’s Pose

Childs Pose yoga

Seated / Supported Side Bends

 Seated Side Yoga Bend

Lying Bend Knee Twists

Lying Yoga Twist Pose

When aiming to stretch the quadratus lumborum muscles and other lower back musculature, I would personally recommend avoid using forward bends like Uttanasana (Standing Forward Bend), Paschimottasana (Seated Two Leg Forward Bend) and other similar poses.  Due to the nature of intervertebral disc compression in spinal flexion, these types of forward bends should actually involve engagement of the back extensors and transverse abdomen in order to extend the spine, shift the ‘flexion’ into the hips, unload the lower vertebrae and protect against disc compression.

Line of Sight: Mindful Use of Drishtis

Using drishtis (focal points) in yoga offers great benefits including enhanced balance, increased inner awareness and concentration, reduced distractions, and greater connection to breath.  While some styles of practice have specific drishti points, we will look at some basic elements of setting focal points to insure that optimum benefits and quality in postures are being delivered.

Retaining Postural Lines

In classic standing balances like Tree Pose, it is beneficial to place the gaze at one point to bring greater steadiness.  I usually recommend in balancing postures where the head is vertical (ie Tree Pose) to set the gaze in a horizontal line to the earth to retain harmony through the neck and shoulders.  However, if you are in a class with people in front of you, it may be more suitable to shift the gaze where there is less ‘distractions’ (ie looking down).  Take note of where the eyes flow and insure that head retains its’ vertical alignment over the skull.  Often, where the eyes flow, the head follows.  If you shift the gaze down to a place more free of distractions, emphasize keeping the head balanced and level over the body versus flexing head and neck forward.

Keep Attention Inwards as You Look Away

Although our superficial gaze maybe set outwards, keep your attention always on the internal sensations and core alignment.  Classic example is seated twists.  As we rotate and look past our shoulder, we can readily lose attention to the various aspects of the pose.  I often see people gradually collapse the spine in the twist as the eyes (and mind wanders) behind them.  In Half Twist (extended leg), it is very common to see a great number of students drift attention away from the forward leg losing the benefits of engagement through the heel and toes.  As the eyes gaze far off from the body, remain engaged and sensitive.

The Eyes Should Observe, Not Guide

Our visual senses are a primary proprioceptive mechanism that many people become overly reliant upon.  We readily lead with our eyes as seen in postures like chaturanga (yoga plank to push up).  As people descend in chaturanga, the eyes will grab onto the floor causing the head to fall into forward head placement ahead of the rest of the body.  This causes a loss of spinal integrity adding potential strain and negative habitual postural patterns to the neck and shoulder girdle.  Retain fluid head and neck alignment especially when the head is placed more against gravity and out of vertical alignment (Mountain Pose).

Bend and Fold Mindfully with the Gaze

As we flow into a forward bend, the eyes are typically encouraged to move to a focal point that enhances those spinal and hip flexion movements.  For forward bends like Janu Sirsasana (seated 1 leg), gazing forward over the toes may take the neck into slight extension, but this action of setting your focal beyond the toes can further facilitate elongating the spine, engaging the transverse abdominals, extending the lumbar, and isolating the flexion from the hips.

The Drishti Should Invite Vertebral Space

The eyes reflect much of the state of the mind and the physical manifestations emanating from the nervous system.  It is common when the mind is cluttered and jumbling with thoughts, unmindful tension will circulate and be reflected in where the eyes inherently settle.  Example:  I often see students in Standing Forward Bend (Uttanasana) and Downward Facing Dog holding mental tension in their necks and allowing their gaze to shift into their mats.  By holding a drishti on the mat, neck muscles contract (with particular concern of the suboccipital muscles).  This adds unnecessary layers of stimulation to postures that are meant to be grounding (not to mention encouraging poor posture habits).  Clear the wandering mind, calm the external eyes, and bring awareness to where unnecessary resistance may be lingering.  In the case of Standing Forward Bend and Downward Facing Dog, I invite people to place their focus through the legs versus anywhere on the mat so the neck enjoys length and freedom with the action of gravity and release.

In case of back arches like Cobra Pose, before sending the gaze up and extending into the neck, take time to add space through the base of the skull.  Simply tilting the gaze and nose up, pushes the neck arch aggressively into the upper cervical spine leading to compression.  For many people with chronic sitting postures, they often already have issues with overactive, tense suboccipital muscles.  Unmindful tilting of the head up adds further firing of these deep neck muscles promoting increased postural problems including impingement of cranial nerves and tension headaches.  The simply action of setting a light amount of lift and space through the base of the skull and upper neck, AND THEN arching the whole neck with equal distribution can significantly reduce upper cervical congestion.

Our drishtis are meant to keep us engaged and aware.  Looking at a specific spot is only part of the tool in focusing.  How has your focal point positioned your mind, breath, and body?  Train the practice to be less dominant on the outer gaze and use the inner gaze to service the greater benefits of the practice.  With proper use of drishtis, we can shift into the deeper layers of practice where we become more connected to our necessary alignment principles, and ultimately are directed to a place of more fluid energy and inherent freedom.

Charity Workshop and Masterclass at Naada Yoga

I am excited to be presenting a yoga anatomy workshop and masterclass at Naada Yoga to support the Paper Kite Foundation.

Steady and Powerful Knees

Sunday, March 2  4:30-7

Explore fundamental anatomy and alignment principles that will enhance the strength, balance, and care of your knees in classic standing postures. This yoga anatomy workshop will include an invigorating all-levels hatha fusion practice.

logo_CF_tag_colorEvent proceeds to go to the Paper Kite Foundation a non-profit charity working to ensure that basic necessities are available to orphanages in the state of Bihar, India.

WHERE: Naada Yoga, 5540 Casgrain Ave, Montreal QC

NaadaYogaLogoCOST: by donation

PREREGISTER: reserve online www.naada.ca under ‘workshops’

There will be exciting giveaways from our generous sponsors:

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Montreal Yoga Festival 2013  Samastah Yoga Jewelry

The Disadvantage of Our Internal Rotators

Poor posture is often a combination of cascading, dysfunctional elements acting on our musculoskeletal system.  This dysfunction is not helped by the fact we have a strong tendency towards a dominance of our internal rotators of the humerus (upper arm bone).  As muscle tension imbalances set in across the shoulders and upper arms, the dominance of internal rotation places dragging tension onto the shoulder blades.  This ultimately draws the shoulder blades forward that leads to inhibition and weakening of the musculature needed to counter dominant internal shoulder rotation.  Let’s look at all the various internal rotators to gain a better sense of these tension imbalances.

pectoralis majorPectoralis Major – this power house chest muscle runs from the collar bone, chest bone, and ribs to connect into the top, front aspect of the upper arm bone (humerus).  Besides pulling the arm bone into the body (adduction), the pectoralis major has a significant internal rotation action on the humerus.

anterior-deltoidAnterior Deltoid – traveling from the collar bone and partly from the shoulder blade (acromion process), the anterior deltoid is responsible for flexing the shoulder (lifting the arm bone forward) and abduction (IF the arm bone is externally rotated), but also has a strong internal rotation component.

latissimus_dorsiLatissimus Dorsi (and Teres Major) – another powerhouse muscle running from the hip crest, spinous processes of the vertebra, and ribs, this large back muscle comes from inside the arm to attach on the front, inside aspect of the upper arm (similar location to the Pectoralis Major).  Coming just off the shoulder blade and attaching very close to the same insertion as the Latissimus Dorsi (at the upper arm) is the Teres Major.  Both of these muscles play a major role in extending the shoulder (or bringing the arm bone back down into anatomical position from a flexed state).  Because of their line of insertion at the upper arm, these muscles also contribute to internal rotation of the humerus.

subscapularisSubscapularis – one of our 4 rotator cuff muscles responsible for stabilizing and supporting the head of the arm bone in the shoulder socket, the Subscapularis runs from the inside (anterior) aspect of the shoulder blade and connects onto the anterior aspect of the arm bone.  Besides shoulder socket stabilization, the line of pull from its’ contraction facilitates adduction of the arm bone and clearly also internal rotation.

Our body has a set of external rotators of the humerus: Posterior Deltoid, Infraspinatus, Teres Minor.  When we compare the internal rotators to the external rotators, it appears that the external rotators are at a disadvantage in creating a balanced muscle tension relationship against the internal rotators.  Compound this structural disadvantage with postural imbalances from work, home, physical activity, health, and injuries, and we clearly see how the internal rotators can overwhelm the external rotators.  How much of our day is chronically spent with the arms forward (shoulder flexion), arm bones internal rotating, and shoulder blades being drawn forward?

By acknowledging these tendencies towards tension imbalances and structural disadvantages, we can integrate more mindful approaches to our exercise and yoga practices as well as bring more awareness to the need to avoid poor habitual lifestyle patterns throughout the day.  How can we change the design and sequencing of our yoga flows to more effectively restore tension balance and a harmonious relationship across our musculoskeletal system?  What changes and additions to our work and home life can we make to prevent the body from settling into a dysfunctional adaption state and instead help the body memorize postures that retain fluid space?