I'm a 42 yr. old female who's had back pain for over a year after seemingly pulling a muscle during sit-ups. I've been under going trigger point therapy for about 9 months and it has helped tremendously with the pain. However, a recent evaluation by a physical therapist has revealed that the trigger points are a result of overload on the quandratas lumborim (? - QL). It seems that whatever muscle should bend your torso forward & back is "asleep" and therefore the QL is doing this work. I cannot remember the name of the muscle and the PT didn't seem to know why the muscle would be asleep. It was strange though because I could not engage it -- like my brain was not connected to that muscle. Any thoughts how something like this happens? Is this just a mechanical issue or could it be neurological?
Hi there and thanks os much for posting this question.
In my opinion there is not a neurological condition unless you think you need to rule that out. That process that you are describing it is more common than it looks like.
When you refer that a muscle is asleep and can't get engaged in muscular activity we refer it in physiology that a specific muscle doesn't fire properly meaning that when you fire a muscle (concentric, eccentric and stabilize) you need to contract that muscle lengthen (eccentric) the opposite muscle and stabilize the muscle so it is a quite complicated process that you can train and improve
Let me review with you some general concepts first
Skeletal muscle is made up of bundles of individual muscle fibers called myocytes. Each myocyte contains many myofibrils, which are strands of proteins (actin and myosin) that can grab on to each other and pull. This shortens the muscle and causes muscle contraction.
It is generally accepted that muscle fiber types can be broken down into two main types: slow twitch (Type I) muscle fibers and fast twitch (Type II) muscle fibers. Fast twitch fibers can be further categorized into Type IIa and Type IIb fibers.
Wanted to share a great sight that may give you some insight
"In other words The quadratus lumborum (Illustration A) is frequently overloaded when we work stooped forward for long periods of time. A Myofascial Trigger Point (TrP) is a hypersensitive spot in a muscle that when stimulated, often produces pain referred in a predictable pattern away from the Trigger Point. Trigger Points develop in muscle as the result of direct trauma, overload or overuse"
In my opinion I will give you few recommendations:
1.- Stretch that specific muscle group
2.- Work in an isolate manner that muscle with very mild movements (Face down bring your torso up and hold ithttp://www.youtube.com/watch?v=haI9Hh5OSmc&feature=plcp
3.Worl the opposite muscles (psoas, hip flexor) http://www.youtube.com/watch?v=DsSGnpzoTzs&feature=plcp
4. Strengthen the lower back http://www.youtube.com/watch?v=ahCG9YLyDWw&feature=plcp
I hope this helps and consult to your doctor before doing these exercises
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