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for her several times, then have her do the movement four or five times. Hip hikes and lateral flexion of the spine are two other possible movement patterns. Pelvic Tilt: Sidelying with both knees bent, the client should tuck the tailbone under in a posterior tilt of the pelvis (Image 3a), then back again in an anterior tilt (Image 3b). Repeat four to five times while working the tissue. Running Man: This maneuver involves thigh flexion and extension. Even though the QL is not directly involved, the iliac crest shifts during these movements when done in a side- lying position, engaging the QL. 1. Ask the client to slowly slide the top leg toward the chest, keeping the entire leg in contact with the table (Image 4a). The thigh does not need to come into full flexion. Whatever the client can do without straining is fine. The bottom leg should be comfortable, with a small degree of flexion at the thigh and knee. 2. Have her slowly slide the top leg into extension (Image 4b). 3. Lift that leg about one inch above the bottom leg and place it behind the bottom leg (Image 4c). 4. Repeat the above steps three to five times while working the tissue. SIDE-LYING PALPATION The side-lying position offers the most advantages for precise deep-tissue work on the quadratus lumborum. Place a small, rolled towel under the client's waist, and, if possible, place the client's top arm behind her head on the table. This will elevate the rib cage, allowing even more space for you to work. If your client's shoulder won't tolerate that position, place that arm on the table and support it with a pillow. Another pillow should go between the client's knees/thighs. Find the iliac crest and the 12th rib, and then place your fingers halfway between those bony landmarks. Move your fingers about ¼- to ½-inch posterior and gently press toward the table (Image 1). You will be on the most lateral layer of the QL. Have your client hike her hip to verify your position. You should feel the QL shorten under your fingers. Keep in mind you should be pressing deep to the erector spinae. Step 1: Warm the Tissue We'll use the Pin and Rock technique to prepare the QL for deeper work. Place two or three fingers of your uphill hand on the belly of the QL, using gentle pressure. Place your downhill hand on your client's hip. Maintain moderate pressure on the QL as you slowly rock your client's hips forward and back (Image 2). The hand on the QL is still; the working hand is the rocking hand. Instruct your client to breathe deeply. Do this until you feel the QL begin to soften. After the central part of the QL softens, angle your fingers to the iliac crest and continue to pin and rock. Once you feel that section soften, repeat with your fingers angled to the 12th rib. Since we're working in a small area, angling the fingers usually suffices to connect with these attachments. Step 2: Warm the Deeper Layers After the attachments have softened, return your fingers to the central section of the muscle, continue to pin and rock, and feel if you can soften and warm the deeper layers of the muscle where it attaches to lumbar vertebrae 1–4. It's essential that you take the time to warm these deeper layers. Many therapists just release the superficial fibers, which is good, but not good enough. Step 3: Pin and Move Once the tissue is warm and receptive, it's time to release knots, adhesions, and trigger points with our Pin and Move technique. When you feel a knot, adhesion, or trigger point, gently pin the area while the client does active movement. Two suitable movement patterns are pelvic tilts and a maneuver I call Running Man. When using one of these, teach your client the movement pattern using passive movement. Do it 86 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 4 1 2 3a 3b