Quadratus Lumborum — MET
One question matters more than the name of this variation: will the patient notice a useful change in Lumbar side-bending, standing trunk shift and the functional movement that originally reproduced symptoms.? The careful re-test gets the final word.
The change we are looking for
Improve painful side-bending restriction or lumbopelvic guarding when QL involvement is supported by examination.
Primary target
Quadratus lumborum
The movement that tells us
Lumbar side-bending, standing trunk shift and the functional movement that originally reproduced symptoms.
Patient focus
Improve painful side-bending restriction or lumbopelvic guarding when QL involvement is supported by examination.
Therapist verifies
Lumbar side-bending, standing trunk shift and the functional movement that originally reproduced symptoms.
Success signal
Keep the technique only if the re-test shows a meaningful improvement in lumbar side-bending, standing trunk shift and the functional movement that originally reproduced symptoms. without symptom worsening.
Full clinical application
Position the patient
Side-lying with the treated side uppermost. The trunk and pelvis are positioned to gently lengthen the waist on the treated side without provoking pain.
Set the contact
Stabilize the lower rib cage/trunk with one hand and control the iliac crest/pelvis with the other.
Apply the technique
Ask the patient to gently 'hike' the pelvis toward the ribs against resistance. After relaxation, increase the distance between the iliac crest and rib cage only to the new comfortable barrier.
Dose & re-test
3–5 contractions of 5–10 seconds at low-to-moderate effort. Re-test: Lumbar side-bending, standing trunk shift and the functional movement that originally reproduced symptoms.
Clinical pearl
Pelvic hiking is the key contraction; do not turn it into a forceful lumbar side-bend.
Safety / avoid
Avoid if the position worsens leg symptoms, produces neurological change or there is concern for fracture/systemic pathology.