The Not so Daily Privateer

Self treatment of trigger points

Ahhh.  And I located the tennis balls!  Thank you Kealani!

Good article on trigger points specifically for QL

The main trigger points

 

Ergonomics and lordosis

This is the not fun part.  Overall stability.

Lordosis

 

Getting to mobility

Lower back stretch

Instructions for a helpful masseur

This maneuver is the goal.  Before the QL gets this help, here is what is suggested:

Myofascial Stand perpendicular to your side-lying client. Thoroughly warm and release the oblique musculature with kneading, friction and light compressions. Utilize the olecranon (that's the use of the forearm and elbow) process at a 45 degree angle of entry between the iliac crest and the 12th rib. Coordinate your depth with your client’s respiration, gradually engaging the lateral border of quadratus lumborum. Slowly angle your elbow superiorly toward the 12th rib, lingering on areas of tension and hardening. Explore the lower attachment by gently shifting your pressure toward the iliac crest. Allow your client’s breath to lift and lower your point of contact. Be certain not to press straight down, potentially bruising soft tissue against the lumbar transverse processes. Spend 5 to 7 minutes thoroughly melting troublesome areas. Performed with accuracy and slow, conscious engagement, this method of myofascial release can generate tremendous physical relief from chronic low back pain.

Easy quick location of THE SPOT

If time is of the essence, there seems to be general agreement that trigger point release should be done every day, as the ossification of the tendons in the QL muscle is the cause of the deeper pain.

The order of muscles (several people say this) for mobility massage:

1. quadriceps
2. iliopsoas
3. tensor fascia lata (hip)
4. piriformis (butt)
5. quadratus lumborum (low back)
6. quads again

And here's a video of a more general massage of the same area.

Detailed pix of back exercises

Now - I have to realize that I have to REVERSE this because my problem is on the other side.  Since I have some kind of dyslexia of body sides, that means the LEFT leg is the one on the floor, and and RIGHT leg is the one that is bent.  The right leg is the one ON the bed (bent).  Put in simple terms - I do this by reversing the way I usually lie on the bed.  It will be my LEFT arm that is up over my head.

Day One of Self-care for Back Pain

 

See that red thing?  That's the muscle that's sick.  Only on my LEFT side.

So much for writing about other things first!  After a rough night of trying to figure out why the pain is worse at night, and reading through textbooks on kinesthiology and physical therapy (and two years of going to doctors, etc.), the back is getting better.  However, it still hurts.  Trigger point therapy, yoga and strengthening are all recommended - but it's complicated.  Stretching on the side where the quadratus lumborum is contracted and spasming is recommended.  Strengthening the QL on the other side.  Strengthening the muscles around the QL on both sides.

The order of the yoga poses is crucial.  This is an area where yoga masters and physical therapists are in agreement - and they are almost in agreement about which postures, exactly, need to be done.  Two kinds of stretches are important to do first are listed as 1 and 2.  Organization:  standing poses first.

0.  General (no one can be harmed by any of these!)

Mountain Pose  Tadasana

1.  Stretching the quads

Yoga postures that do this (that I'm sort of capable of doing):

Chair pose Utkatasana 

Bound Angle Pose

Child pose   Balasana

Stretches and other exercises that do this:

2.  Stretching the side muscles (including the QL)

Yoga postures that do this: 

Staff Pose  Dandasana

Revolved Head to Knee Pose  (for some reason an't get it to link:  http://www.yogajournal.com/poses/2496)  Parivrtta Janu Sirsasana

Stretches and other exercises that do this:

This is the that helped in the night

Bed-based stretch

Same stretch with low quality video

Stretch that needs help

Now, there is some disagreement in the literature about which of these two to do first, so I have to pay attention.  This morning, it came naturally to me, when I started my first pose to do 2 first, but I had already, earlier, attempted the child pose (about an hour earlier).  The goal is to be able to stretch and strengthen (both alternately and simultaneously) and to do some yoga postures in a seamless manner for several minutes at a time.  However, I already know if I overdo it, in the least, I'll pay for it with days of decreased functioning.

It's Spring Break and I have an opportunity to sort out the above problem.

It is very important (crucial) to keep in mind that some muscles are TIGHT and need to be stretched:

QL, Erector spinae

Hip flexors (iliopsoas of course)

and others are WEAK and need to be STRENGTHENED:

Abdominals in general

Hamstrings and gluts (for me, especially gluts).  Hamstrings will need lengthening - but entire literature says wait for that.