Today I saw a young woman with a fairly long history of lower back pain. This pain was centered on the right side, at about the L4 level of the spine. After some careful palpation to clarify the exact location of her pain, I asked to to side-bend to the left. As she did laterally flexed left, the pain and tightness on the right was evident.
What was most remarkable to me was the intensity and abruptness of the quadratus lumborum to this gradual length change. It did not matter if the movement was passive or active, the contraction was overly reactive. The timing of the reaction matched perfectly with her perception of pain.
Placing her thumb on the tender spot, I had her feel the reaction of the muscle to length changes. "Wow," she said." I had no idea I have been doing that. No wonder I hurt." Keeping my finger over her thumb, I continued to have her laterally flex to the left while feeling the reaction of the right quadratus lumborum. The more times she laterally flexed, the more relaxed and appropriate her muscle response was.
The results were excellent; but the question remains as to whether the benefits were from the local effect of the pressure or the retraining which occured as her brain learned to inhibit the over-reaction of the muscle. In reality, the answer is probably both. If both are important, then we in PNMT need to do everything possible to facilitate re-educating the client's nervous system in addition to treating local restriction. This will be a continual focus for us in the future. Stay tuned. . .