Spasms are involuntary, uncontrolled muscle contractions accompanied by severe pain. Their duration is several minutes (from 1 to 20). The pathology can manifest itself at any age, and can be either one-time or long-term. It can cramp the calf muscles, thigh (front side) and ankle muscles.
The disease is characterized by symptoms:
- instant hardening, inability to move;
- sharp pain.
General description of the quadratus lumborum muscle.
The quadratus lumborum muscle (Latin - musculus quadratus lumborum) is a complex paired muscle that plays a significant role in the human body. Some experts claim that it is the cause of a significant number of cases of lower back pain, while other scientists do not find definitive evidence for this. Topographically, the muscle is most often referred to as the muscles of the abdominal region. But sometimes in the literature you can find it among the back muscles. Based on its belonging to the abdominal region, the quadratus lumborum muscle is the deepest muscle in this region. It is important to note that the quadratus lumborum muscle is part of the abdominal complex, which maintains intra-abdominal pressure. The quadratus lumborum muscle consists of three layers of muscle fibers, each of which has its own direction.
- Layer 1 (superficial) - connects the iliac crest and the last rib;
- Layer 2 (intermediate) - connects the transverse processes of the lumbar vertebrae (according to some sources, all five, according to others from L1 to L4) and the last rib;
- Layer 3 (deep) - connects the iliac crest with the transverse processes of the lumbar vertebrae (also according to some sources L1-L5, according to others L1-L4).
How to help?
The answer to the question of what to do if your leg is cramped in the thigh is useful for everyone. You can’t put off going to the doctor, but what can you do if a muscle spasm occurs at night? You need to know about actions that will help eliminate hip abduction.
First aid
First aid for eliminating a cramp consists of several simple actions, which in some cases can save lives, for example, if your leg cramps in water.
If a person has been bothered by cramps for a long time, then when swimming in the lake you must adhere to the following rules:
- Pin to a swimsuit or swimming trunks with a pin.
- You cannot swim in cold water (below 20).
- If a cramp occurs, you need to lie on your back and pull the toe of your foot towards your body.
- As a last resort, prick the thigh with a pin.
The main condition for implementation is calm, since additional worries can lead to even greater spasm.
If your hip cramps at home, you need to do the following:
- Stand with your feet together and straighten up.
- The foot of the affected limb should be pulled towards the body.
- Rub the thigh area, you can pinch or beat.
- If the muscles of the anterior thigh are cramped, you should lie down and point the thigh towards the body, and grab the back of the thigh with your hands.
Insertion points for the quadratus lumborum muscle.
- Twelfth rib (lower border)
- Lumbar vertebrae L1-L4
- Fifth lumbar vertebra (L5) - It is important to note at this point that it is often not included in the attachment site. Based on anatomy, the quadratus lumborum muscle is connected to it indirectly through the iliopsoas ligament. Since this does not have a global impact on the movement, we present this point of view with reservations.
Direction of fibers of the quadratus lumborum muscle.
The quadratus lumborum muscle is heterogeneous in the direction of the fibers. They come in three vectors:
- The most superficial layer of muscle runs from the iliac crest to the twelfth rib;
- The middle layer runs from the lumbar vertebrae to the last rib;
- The deepest layer runs from the iliac crest to the transverse processes of the lumbar vertebrae.
This muscle structure allows you to reliably connect three separate segments together, interacting between them: the lumbar spine, pelvis and chest. At the same time, the complex organization of the muscle does not allow a precise determination of the relationship between fibers of different directions and the movement they create.
Diagnostics
Diagnosis boils down to the fact that a neurologist or orthopedist will examine the patient and conduct a thorough interview. Identifying the causes and treating them will help get rid of muscle problems faster, so the doctor must know the following data:
- Past illnesses, chronic pathologies.
- Recent injuries.
- Lifestyle.
- Taking medications.
After the interview, standard tests will be prescribed. You may need to consult doctors of another specialization, for example, a rheumatologist or vertebrologist.
Blood supply and lymphatic drainage of the quadratus lumborum muscle.
The muscle is supplied with blood through the subcostal artery (a. subcostalis), lumbar arteries (1st to 4th) and through the lumbar branch of the iliopsoas artery.
Venous outflow occurs thanks to the subcostal vein (v. subcostalis), lumbar veins (1st to 4th) and through the iliopsoas vein.
There are few lymphatic vessels near the quadratus lumborum muscle. But it is worth noting that it quite strongly affects the abdominal region, in which the number of elements of the lymphatic system is large.
Basic movements and functions of the quadratus lumborum muscle.
- Lateral tilt of the spinal column (lateroflexion) - the point of origin of the muscle in this case is the punctum fixum, while the attachment points on the processes of the lumbar vertebrae are the punctum mobile. Contraction of the muscle toward the iliac crest results in lateral flexion in the lumbar region on the same side as the muscle. Based on the data given by Kapandzhi, the amplitude in this segment is 20°. It is important to note that the quadratus lumborum muscle is not a primary lateral flexor, as its overall contribution to this movement is quite minor.
- Extends the body in the lumbar region with contraction of both quadratus lumbar muscles. As with lateral bending, muscle involvement is not significant. As in the previous case, the origin of the muscle will be a fixed point, while the attachment will become mobile.
- Fixes the 12th rib when inhaling, which helps the diaphragm to carry out its functions.
- According to some reports, it is involved in the rotation of the lumbar region. As in other cases, the possible influence of the muscle is quite small. The action is possible due to the fact that the general direction of the muscle from the origin to the insertion is at a slight angle.
- Considering that the muscles work in both directions, with the chest and lumbar region fixed, when the attachment points become punctum fixum, it can be argued that the quadratus lumborum muscle is involved in the posterior rotation of the pelvis. But, as with other functions, given the location and scale of the muscle, the effect is small.
- Quite often, the quadratus lumborum muscle is viewed as a crossroads of various forces at which the influence of nearby muscles converges. And this, in turn, leads to the fact that the quadratus lumborum muscle itself affects the adjacent muscles. There is a possibility that this feature connects this muscle with painful manifestations.
Natural movements that involve the quadratus lumborum muscle are almost all that involve the lumbar region.
Muscles and landmarks lying adjacent (muscle topography) to the quadratus lumborum muscle.
The quadratus lumborum muscle is a deep muscle. Among the abdominal muscles, it is considered the deepest.
Superficial anatomy of the quadratus lumborum muscle:
These guidelines are relatively arbitrary, because The size and volume of the muscle can vary greatly from person to person; accordingly, the distances between the bony landmarks will also vary.
- Top - 12th rib;
- Below is the iliac crest;
- Medially - paravertebral muscles, spine.
Internal topography of the quadratus lumborum muscle:
Since the muscle lies deep, it overlaps (sequentially):
- Latissimus dorsi muscle;
- External oblique muscles (obliquus externus abdominis);
- Internal oblique muscles (obliquus internus abdominis);
- Transverse abdominal muscle (transversus abdominis);
- Iliocostal muscle (iliopsoas);
- Slightly overlapped by the lower posterior serratus muscle (serratus posterior inferior).
When viewed from the back, the quadratus lumborum muscle overlaps the iliopsoas muscle (section of the psoas major).
Diagnostic tests for quadratus lumborum muscle.
Video with manual muscle test:
Manifestation of imbalances in the quadratus lumborum muscle.
“Oblique pelvis” (translation, tilt to the side) - manifests itself in the form of a lowered hemipelvis. In this condition, on the “high” side, the gluteus medius will be lengthened, while the quadratus lumborum and internal oblique will be shortened. On the side that is lower, the picture will be the opposite. Antalgic scoliosis (pseudoscoliosis, pain avoidance mechanism) - shift, lateral displacement of the upper part of the lumbar region and all overlying segments on the side of pain.
Pain symptoms:
Quadratus lumborum syndrome (quadratus syndrome) - can imitate various pain syndromes, differential diagnosis is difficult. Given the strategic location of the muscle, problems with it can lead to pain in the higher or lower regions.
Impaired daily movements:
Movements will be difficult and may be unnatural in the lumbar region due to the body's attempt to reduce the load on this area: Instead of hip extension, extension and lateroflexion of the lumbar region, accompanied by flexion of the pelvis, may be observed. The hemipelvis on the hip extension side will rise up. A slight “C”-shaped scoliosis will appear in the spinal column towards extension. There will be little or no movement in the hip joint. A - rear view. B - side view Instead of flexion of the lumbar region, extension in the lumbar region may be observed, accompanied by lateroflexion. The hemipelvis on the side of the “problem” muscle will rise up, while the ribs on the same side will move down. This will lead to the formation of scoliosis with a convexity towards the “problem” muscle. The middle and upper parts of the chest will rise upward, compensating for the situation. This will be accompanied by an increase in thoracic kyphosis.
A - side view. B - rear view.
Why does the hip suffer from cramps?
The pathogenesis of seizures is quite extensive. There are several groups of factors that lead indirectly and actually to spasm. Since all the muscles of the body are connected in one way or another, the cause of hip cramps can be a spasm of the pelvic muscles - for example, the iliosacral muscle, if damaged or pinched, can radiate to the leg. Conversely, a cramp of the femoral muscle can radiate to the sacral area.
The most common cause of spasm is the load on the limb during sports. 78% of those who constantly experience such sensations are athletes. For example, due to fatigue of the quadriceps muscle, which is responsible for flexion of the limb, contraction of the biceps femoris muscle, which is responsible for extension, may occur.
Interesting! If the hip area is broken or bruised, a cramp will develop as a defensive reaction. Often, when the femoral neck is fractured, the muscles become toned, which prevents the possibility of moving the broken bone elements.
The most common causes of seizures:
- Degenerative bone diseases. As a result of destruction of the joint, lumbar vertebrae, inflammation of the periarticular or periosteal tissues, spasm may occur in the femoral region.
- Dehydration. Taking diuretics, especially on hot days, can lead to spasms, since salts are released from the body along with urine. Muscle contractions are likely to occur throughout the body.
- Disturbances in the balance of potassium, magnesium, calcium. A decrease in the normal amount of these elements leads to disturbances in the autonomic nervous system.
- Contracture of the hip joint. The thigh muscles shorten and contract involuntarily. In some cases it is not considered to be the cause of seizures.
- Diseases of the pelvic organs can lead to muscle spasms, first in the pelvic area, and then in the hip joint.