Why I Do Not Believe in QL Dysfunction

“You’ve got QL dysfunction.”

That’s what the patient told me. She had seen two chiropractors, a massage therapist, and a PT.
Lower back pain, off to one side.
Every time she bent, walked, or slept wrong,  pain lit up along her back flank.
So they poked around and said, “Your QL is tight. That’s the problem.”

Quadratus Lumborum dysfunction.
Diagnosis made.
Treatment plan? Stretch the QL. Smash it. Dry needle it. Strengthen the glute med. Core work. Repeat.

Except nothing helped. Not really.

She came to me still in pain - frustrated, discouraged, and expecting another round of the same.

She walked out of my office pain-free.

And here’s the wild part:
I never touched her QL.

So... What’s the QL Anyway?

For those unfamiliar, the QL (Quadratus Lumborum) is a deep muscle that runs from the crest of your hip bone to your lowest rib, on both sides of your spine. It helps with side-bending, spinal stabilization, and breathing mechanics.

It also happens to be right in the area where many people feel pain.
So, when someone presses on it and it feels tight, it’s an easy target to blame.
And that’s the birth of a diagnosis: QL dysfunction.

The Real Reason I Don’t Buy It

I’ve had at least 50 patients come to me with a prior diagnosis of QL dysfunction.
Every one of them left without pain.
None of them were treated at the QL.

Let me be clear, I’m not saying the QL isn’t tight. It often is.
But that’s not the same as it being the problem.

Here’s what most providers miss:

Instead of asking “what feels tight?”
We should be asking, “why is it tight?”

The Common Explanation — And Why It Fails

To their credit, many providers do ask that question.
The answer is usually some version of:

• Repetitive movement patterns

• Poor posture

• Weak core

• Glute medius weakness (this one gets blamed a lot)

While those may play a role, they rarely explain why so many people are stuck in the same cycle of stretching the QL and strengthening things around it — with no lasting relief.

So, what's really going on?

FDM presents a different perspective  

The problem isn’t the QL.
And most providers have no idea the real issue even exists.

What I’ve found in every one of these patients is the same thing:
👉 Deep fascial herniations in the tissues surrounding the QL.

These are localized distortions in the fascial layers that don’t show up on imaging and aren’t taught in traditional training.

They create restrictions and abnormal tension patterns that likely result in the QL locking down in a facilitated state - not because it’s the problem, but because it’s caught in the middle of a much bigger fascial disturbance.

Once I treat those deep fascial herniations - not the muscle itself, the QL relaxes. The pain disappears, the function returns, and the diagnosis of “QL dysfunction” vanishes.

And to Be Clear…

I’m not here to criticize other providers.
Most are doing the best they can with the training they’ve received.

My goal here is to offer a better lens - one that explains why these “QL cases” so often turn into a never-ending cycle of retreating, or fail to provide any relief whatsoever, with traditional treatment. 

If that lens helps even one provider out there challenge their current model and elevate their outcomes, I'm happy.

The Takeaway

If you’ve been told you have “QL dysfunction” and nothing seems to help…
It’s not because your body is broken.
It’s likely because your fascial system is compromised, and no one has looked in the right place.

Once you treat the actual cause - not the tight muscle, things change fast.

👉 Book a Fascial Evaluation
Let’s stop chasing symptoms and start solving the real problem.