Anatomy of the deep and superficial muscles of the human back. A set of exercises for the lower back - get rid of pain Square muscle syndrome of the lower back treatment

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proximal attachment. Medial half of the XII rib and transverse processes of the lumbar vertebrae LI-L4.

Distal attachment. Superior posterior region of the iliac crest.

Function. Unilateral action: tilts the spine to its side; pulls the XII rib down. Bilateral action: straightens the spine in lumbar; involved in forced exhalation, such as when coughing.

Palpation. The quadratus lumborum is very often the cause of low back pain, but almost as often its role as a source of malaise is overlooked.

To localize the quadratus lumborum muscle, the following structures must be identified:
. XII rib - the lowest and shortest of the ribs. Its free anterior margin is posterior to the midclavicular line at the same level as the L2 lumbar vertebral body.
. Transverse processes of vertebrae LI-L5.
. Iliac crest - lies on the same horizontal line with the articulation of the vertebrae L4-L5.

On palpation of the square muscle of the lower back, the patient should lie on his stomach. Gently palpate the area between the 12th rib and the iliac crest. Pressing should not be directed deep into the body, but obliquely and medially towards the transverse processes of the lumbar vertebrae. Imagine the location of the square muscle of the lower back, and your hand will find its lateral part.

Pain pattern. With a superficial location of trigger points, pain is felt along the lateral border of the iliac crest and up to the greater trochanter of the femur. Deep trigger points cause pain in the sacroiliac joint and deep in the buttocks. Due to deep back pain, the patient may lose the ability to stand with a straight spine or walk. The pain can cause an attempt to turn in bed on the other side. Trigger points can cause a noticeable shortening of the leg.

Causal or supporting factors.

Excessive load when lifting weights with a back bent at the lower back; prolonged and repetitive stress.
satellite trigger points. Small and medium gluteal muscles, piriformis muscle and paravertebral muscles of the thoracic and lumbar regions.

Affected organ system. Urogenital system.

Associated zones, meridians and points.

Dorsal zone. foot meridian Bladder tai yang. BL 21-24, 51, 52.

Stretching exercises.
1. Lying on your back with knees bent and feet flat on the floor, cross the leg of the uninjured side over the other. With the “upper” foot, gently press the lower foot, lowering it to the floor. Fix the pose until the count of 15-20.

2. Stand with your back to the wall, approximately 30 cm from it. Without lifting your feet from the floor, turn upper part body and place your palms against the wall. Fix the pose until the count of 15-20.

3. In a standing position, cross your legs like this. so that the leg of the injured side is in front, transfer the weight of the body to it. Raise both hands in front of your head and grasp the wrist of the injured side. Pull sideways to the unaffected side.

Strengthening exercise. Since the quadratus lumborum is a postural muscle, strengthening exercises are usually not necessary.

D. Finando, C. Finando

Before starting a back workout, do warm-up exercises and warm up all the muscles in your body.

Let's start with the basics basic exercises For quadratus lumborum- exercises with axial load on the spine.

If you have hernias or back protrusions, remove these exercises from your workout. It is allowed to do it carefully with a minimum weight in static dynamics, in the absence of pain in the spine.

We strengthen the back or how to pump up the square muscle of the lower back

A healthy spine is the foundation of a good and correct posture. But how to strengthen the back muscles to avoid the so-called "square muscle syndrome"? In the article we will talk about two training programs with axial and without axial load on the spine. By doing these exercises, you can not only strengthen your back, but also thoroughly pump up the square muscle of the lower back.

Exercises with axial load on the spine

Complex with axial load for the square muscle of the back

Exercises	Sets	Reps/Time
Deadlift with barbell	4	15
Deadlift with dumbbells	4	15
Barbell row with straight legs	3	15
Dumbbell row on straight legs	3	15
	3	15
good morning sitting	3	12
	3	12
Wide squats with dumbbells	3	12

Deadlift with barbell

Technique:

1. Take the bar in your hands.
2. Stand up straight with your back arched. Place your feet parallel at a distance of 10-15 cm from each other.
3. Lower the bar until it touches the floor, inhale.
4. Raise the bar to the starting point as you exhale.

How many: 4 sets of 15 reps.

Advice. The exercise can be started from different starting positions, when the crossbar is on the floor or when it is held in the hands. If the weight is heavy, lift the bar off the floor. If you are working with low weight for the number of repetitions, do the starting position with a barbell in your hands.

Option - deadlift with dumbbells

It is performed similarly to the dumbbell squat exercise, the only difference is that the dumbbells are lowered in front of you, and not to the sides.

Exercise "Barbell row on straight legs"

Technique:

1. Hold the bar in your hands.
2. Place your feet with your feet parallel at a distance of 15 cm. Keep your back straight.
3. Lower the bar as low as possible, trying to keep a minimal bend in the knees and a straight back throughout the movement.
4. Inhale and lift the bar back.
5. On the rise, exhale.

How many: 3 sets of 15 reps.

Advice. Avoid back arching and strong bending of the knee joints.

Another option: straight-legged dumbbell row

It is performed similarly to traction with a barbell.

Technique:

1. Place the bar on your shoulders and hold with your hands.
2. Stand shoulder-width apart. Make a bend in the lower back.
3. Lower the bar down while bending into hip joints. Take your hips back, and the body forward. Keep your back straight.
4. Feeling the tension in the muscles of the back of the thigh, rise to the starting position.

How many: 3 sets of 15 reps.

It is aimed exclusively at working out the square muscle of the lower back.

Sumo barbell row for the quadratus dorsi

Technique:

1. Stand near the bar on the floor with a wide setting of the legs, turn the socks and knees to the sides.
2. Hold the bar with your hands with a grip at a distance of 30-50 cm. Keep your back straight.
3. Raise the bar at the expense of the hips and back, exhaling.
4. Hold for one second and lower back. Take a breath.

How many: 3-4 sets of 10 reps.

Option: Sumo style dumbbell row or dumbbell wide squat

It is performed, as with a barbell. Instead of a barbell, hold a dumbbell in front of you.

Exercises to strengthen the square muscle of the back without axial load on the spine

Fulfill the following exercises considered safe for people with back problems.

Complex without axial load for the square muscle of the lower back

Technique:

Initial position: Lie on the table with your stomach so that the pelvis protrudes beyond the base. Use a gym mat placed on top of a table. Hold on to the ends of the tabletop. Legs are on weight.

1. Raise your legs, exhaling as high as possible. The load can be adjusted by bending the legs at the knees. The more they are bent, the easier the exercise.
2. Lower your legs. Breathe in the air.

How many: 3 sets of 10 reps.

Technique:

Initial position:
Find a flat surface. For example, a sofa, bed or table. It would be nice to do the exercise with a partner who will hold your legs. If you don't have a partner, a heavy rucksack for counterweight will do.
Lie on your stomach on the bed with your pelvis slightly forward. Put a counterweight on your feet or sit a partner. Keep the body horizontal to the floor, fold your arms in front of you.

1. Lower the upper body down to the floor, exhale.
2. As you exhale, rise to the starting position.

Number of repetitions: 3 sets of 12 reps.

Exercise "Boat" for the square muscle of the back

Technique:

1. Lie on the floor with your stomach on a gym mat.
2. Bend at the spine as much as possible, stretching your arms and legs up. Keep limbs straight.
3. Hold for 2 seconds and lower yourself to the starting position.

Number of repetitions: 2 sets of 15 lifts.

Another version of the exercise

There is another option for doing the exercise. WITH alternate cross raising arms and legs. You can do by analogy with the previous boat.

"Plank" for the square muscle of the lower back

Technique:

1. Get on the floor, rest on your elbows and toes. Keep your spine straight.
2. Hold this body position for 1 minute.

Perform 3 sets with an interval of 1 minute in the plank stance and 1 minute rest.

The quadratus lumborum is a paired postural muscle that is responsible for lateral stability and tilt of the spine and chest, hip elevation, and may also be involved in the process of exhalation. It begins at the iliac crest and attaches to the 12th rib and the transverse processes of the lumbar vertebrae I-IV. Roughly speaking, it connects the lower ribs and the pelvis. Often this muscle acts as a source of pain in the lower back. If the gluteal muscles are weakened, the quadratus lumborum partly takes over their function of stabilizing the pelvis and, accordingly, is subjected to unintended overstrain. the site will tell you how to get rid of pain caused by quadratus lumborum overexertion.

Overstrain of the square muscle of the lower back: the most common causes

The causes of pain in the back, namely in its lower part (lumbar) can be:

• protrusion or hernia of the vertebral disc;
• trauma;
• pinched nerves;
• inflammation of the nerves;
• diseases internal organs(referencing pain);
• infections;
• rachiocampsis;
• diseases of the spine;
• leg length difference
• joint displacement;
• muscle strain or strain.

It is possible to assume an overstrain of the square muscle of the lower back only after passing a complete examination and excluding other causes that led to the appearance of pain.

A characteristic feature of problems with the square muscle of the lower back is pain, as well as a noticeable inclination to the “sore” side. Possible causes of overexertion of this muscle:

• the habit of sleeping on one side with a raised hip;
• carrying weights on one side;
• weakened muscles of the buttocks;
• bad posture, etc.

How to relieve tension in the square muscle of the lower back

To relieve lower back pain, it is enough to perform the following exercises aimed at relieving tension in the square muscle of the back.

Massage will also be useful, but it is better to contact a qualified specialist who knows exactly the technique of performing massage movements.

We suggest you try the following exercises and poses.

1. We reach for the fetus (up to 10 repetitions)

• stand straight, raising straight arms up;
• now raise one hand higher as if you were about to pick a ripe fruit from a tree;
• bend the opposite leg at the knee and lift the thigh up;
• inhale and feel the contraction of the square muscle of the lower back;
• exhale and relax;
• repeat on the other side.

2. Gentle twisting while lying down

• lie on your side;
• attach a roller to the left thigh;
• turn the body in the direction of the roller;
• hands lie on the sides of the roller (as shown above);
• turn your head in any direction (as you prefer);
• you will have to look for the most successful position yourself, adjusting the bend of the hips and knees, pulling the thigh away from the lower ribs;
• stay in the selected position for a couple of minutes;
• exhaling slowly, return to the starting position;
• repeat on the other side.

3. Graceful tree pose

• lie on your back;
• bend the spine so that the body leans to the right side;
• keep your hips and shoulders on the floor;
• grab your right wrist with your left hand;
• move your feet to the right;
• so that the legs do not move apart, it is fashionable to cross them at the ankles;
• feel the entire left side stretch;
• after a few minutes, return to the starting position and repeat the pose on the other side.

4. Sitting side stretch

• get down on all fours;
• put your hands exactly under your shoulders;
• knees and inner thighs should touch and be aligned under the pelvic bone;
• move your hips to your left side, rolling onto the outside of your left leg ( right leg should be located on the left);
• look over your right shoulder;
• inhale as you stretch the left lower back and left thigh;
• exhale to return to the center position;
• repeat on the other side.

5. Child's pose

• get on your knees;
• sit with your buttocks on your heels;
• bend forward with arms outstretched;
• put your chest on your hips;
• move your hands to the position of the arrow, which points to 10 o'clock, so that the body bends to the left;
• stay in this position for a minute;
• repeat on the other side (arms at 2 o'clock).

the site hopes that the above poses will help relieve the tension of the square muscle of the lower back, and with it - the pain in the lower back.

Due to the fact that in our time a sedentary lifestyle is becoming more common, most people have back problems in one way or another and are worried about back pain, especially in the lower back. Lower back pain may be due to poor posture, poor posture, low physical activity or other factors, and may be in the form of discomfort or quite strong. One of the most common causes of low back pain is quadratus lumborum syndrome. The quadratus lumborum is located in the lower back. It connects the ribs, spine, and pelvic bones, and when it contracts too much or too often, it causes hip elevation, and pain in the back, hips, and buttocks. The quadratus lumborum is responsible for tilting the torso, straightening the torso, and stability of the lower back. Since the quadratus lumborum is part of the muscles responsible for the movement of the spine, damage to this muscle can lead to limited mobility and pain when performing various movements.

It is often difficult to determine when a muscle strain has occurred. Sometimes, the pain can be sharp and quite severe, and in such cases, the patient notes a clear connection with a specific injury. In other cases, there may be persistent pain for several days, with no apparent external cause. In cases where there is tension in the square muscle of the lower back, patients may have spasms or cramps and, despite the fact that these are unpleasant sensations, they indicate that the body turns on self-regulatory mechanisms.

As with any muscle injury, when the square muscle of the lower back is damaged, inflammation and a feeling of warmth in the muscle area appear. This is explained by the fact that when the muscle is tense, the body reacts by increasing blood flow, thereby accelerating the healing process.

Swelling in the area of ​​the muscle is a sign that there is a buildup of fluid in the tissues surrounding the muscle, which further exposes the muscle to damage, and therefore any muscle injury that is accompanied by swelling requires a careful approach to treatment.

Causes

The cause of square muscle syndrome can be acute injuries such as heavy lifting, twisting of the torso when lifting. Pain can also appear when the back is in a bent position for a long time (for example, when working in the garden). The cause of the syndrome can also be a difference in the length of the limbs (when one leg is shorter than the other), which can be either congenital or acquired. But most often, square muscle syndrome occurs as a result of prolonged static loads. It is very typical in this case that this syndrome develops in people who spend most of their time at the computer, since the square muscle of the lower back is one of several muscles that are overloaded during normal sitting.

Symptoms

Pain due to the square muscle of the lower back is usually felt in the iliac crest and sacroiliac joints, as well as deep in the upper buttocks. Pain may also radiate to lower part buttocks and in the region of the greater trochanter. The pain may worsen after sleep when the patient gets up and begins to walk. Painful muscle spasm when the body takes a vertical position is characteristic of acute overexertion. In such cases, coughing or sneezing can also be painful, as can turning in bed during sleep. Often the increase occurs in the morning hours, even with small movements, after the tense muscles have been in a contracted state all night. Patients often report that the painful spasm occurred after they got out of the shower and reached for a towel, or when they twisted, twisted, leaned over something in the kitchen during breakfast. A less acute onset, with a gradual increase in pain, occurs in patients who sit for a long time at work without getting up or moving around. Postural tension of the square muscle due to incorrect position during sleep can also be an important factor exacerbating pain symptoms. The pain associated with the square muscle syndrome may also be in the lower back, the pain may be in the thighs and buttocks, in the groin, in the pelvic region, in the lower front of the thigh.

There are symptoms that may indicate that there is a more serious cause of pain:

• Numbness, tingling in the legs or feet.
• Constant pain that does not improve with rest.
• Gradually increasing pain.
• Bladder or bowel dysfunction.
• Pain that gets worse during sleep.
• Numbness in the perineum.
• Morning stiffness lasting more than half an hour after rising.
• Weight loss, night sweats, or fever

If you have these symptoms, you should definitely seek medical help.

Diagnostics

There are a number of diseases that can lead to muscle spasms.

According to the symptoms, similar to those in the syndrome of the square muscle of the lower back are:

• Trochanteric bursitis
• Spine compression at S1 level
• Stenosis of the intervertebral foramina
• sciatica
• Cauda equina syndrome
• Bechterew's disease
• arthrosis
• Rheumatoid arthritis
• Weakened abdominal muscles
• Diverticulosis
• endometriosis
• uterine fibroids
• Uterine prolapse
• Pelvic inflammatory disease
• Kidney infections
• Urolithiasis disease
• Urinary tract infections

Due to similar symptoms, it is necessary, first of all, to exclude these diseases using instrumental (radiography, MRI or CT, ultrasound of the pelvic organs) and laboratory research methods. After the exclusion of another possible genesis of the pain syndrome, the presence of the square muscle syndrome can be assumed. As a rule, a physical examination is enough to diagnose this syndrome. There is pain on palpation of the affected muscle and increased pain when turning the body and the presence of pain trigger points, especially in the area of ​​​​attachment to the 12th rib (palpation of this area causes pain in the square muscle). In addition, the presence of lateral paravertebral spasm is characteristic.

Treatment

In cases where there is a clear connection with a certain overload of the muscle, rest and application of cold to the muscle are sufficient. However, other treatments are often needed.

Physiotherapy. Modern physiotherapeutic methods, such as cryotherapy or HILT therapy, help to quickly remove muscle spasm, muscle inflammation.

Massage and manual therapy allow you to remove muscle blocks and improve blood circulation in the muscle

exercise therapy. Physiotherapy allows you to restore normal muscle tone and muscle elasticity and is especially effective when it comes to the syndrome that occurs due to static loads.

Medical treatment. It is possible to take NSAIDs for a short time.

Trigger point injections are also widely used in the treatment of quadratus muscle syndrome.