Where the muscle sits and what it does
The quadratus lumborum, or QL, is a deep slab of muscle in your low back. Each side runs from the top of your pelvis up to the lower edge of the rib cage and the side of your lumbar spine. Its main jobs are to hike the hip, side-bend the spine, and stabilise the lower back when you load one side of the body.
In rugby that one-sided demand is everywhere: carrying a heavy bag on one shoulder, a unilateral lift, a tackle where you absorb force on one hip, or a scrum where one side of the back is fighting harder than the other. When the QL is overloaded faster than it can adapt, fibres tear at the muscle belly or near where it attaches to the pelvis or rib.
How it usually feels
- A deep, one-sided ache between the bottom rib and the top of the pelvis
- Sharp catch when you side-bend, twist, or stand up from sitting
- Pain on coughing, sneezing, or laughing
- Difficulty rolling over in bed without using both arms
- Tenderness when pressing into the muscle just above the top of the hip bone
What helps in the first 48 hours
- Keep moving gently rather than lying still for long stretches
- Walk regularly through the day in short, comfortable bouts
- Avoid heavy lifting, twisting under load, and prolonged sitting
- Use a warm shower or heat pack to ease the muscle guarding
- Sleep with a pillow between or under the knees, whichever is more comfortable
Self-check: how a physio grades it
| Grade | Typical presentation a physio assesses |
|---|---|
| Mild (I) | Localised tenderness, mild pain on side-bend, full or near-full range, walking fine |
| Moderate (II) | Sharper pain, visible guarding, range limited at end of side-bend and rotation, antalgic gait possible |
| Severe (III) | Difficulty standing upright, marked spasm, very limited range, pain interrupts sleep |
Recovery timeline at a glance
Calm the spasm
0-5 days
Keep gently moving, restore relaxed standing posture, build tolerance to short walks.
Restore range
5-14 days
Reintroduce pain-free side-bend, rotation, and hip hike patterns; light core work.
Reload strength
2-4 weeks
Progressive carries, side planks, anti-rotation work; return to gym lifts at reduced load.
Return to rugby
3-6 weeks
Full strength training, then contact, then competition once pain-free under sport demands.
When to seek further help
- Pain shooting down a leg, with pins and needles or numbness
- Any change in bladder or bowel control (urgent)
- Fever, chills, or feeling generally unwell with the back pain
- Severe pain after a high-energy impact or fall from height
- No clear improvement after two weeks of sensible self-management