Sunday, April 24, 2005

Stabilizing The Core To Eliminate Low-Back Pain - Part 2By Rich Lauro MAT, MES

This is the second part of a series of articles that strengthens the core to help eliminate low-back pain. In this article I'll be addressing another one of the main core stabilizing muscles of the lumbar spine and its role in back pain, what is this muscle you ask?

The Multifidus. You should make these exercises part of your everyday routine, just like brushing your teeth.

What is the multifidus?

If you never heard of this muscle, don't feel alone. This is probably a mystery muscle to most people. The multifidus is one of many back muscles and it's situated more deeply then most back muscles.

It runs the entire length of the spine all the way up to the neck. Don't be mistaken it's not one long muscle its many individual multifidus muscles combined, all crossing two or more levels of vertebrae. This allows the multifidus to gain fine control over a single segment of the spine.

Like all muscles, the multifidus needs a nerve to carry a signal to it. It's this signal that makes the muscle contract and work. Think of it like an electrical cord that carries power to a lamp to make it light up.

Why is the multifidus so special?

The multifidus is special because it's the only muscle that's segment ally innervated. Meaning it gets its nerve message from only one level of the spinal cord, making it more prone to injury.

Other back muscles are innervated by multiple segments of the spine to help them contract, so that if one nerve doesn't work well, it still has others to help it out. Important stabilizer of the back

As I mentioned earlier the multifidus is capable of providing control over individual segments of the spine that compress each vertebra to resist torsional forces while increasing stability. It also controls flexion (forward bending) and anterior shear in forward bending.

The multifidus can become inhibited during a lumbar disc injury. This inhibition leads to atrophy (muscle wasting). The problem for back pain sufferers is that when the symptom of the disc problem is reveled the weakend multifidus muscle cannot perform its stabilizing role. The risk of the injury and re-injury is greater.

This is why specific exercise for the multifidus is key to low-back pain.

Low-Back Pain

Studies have shown people who had low-back pain also had wasting of the multifidus muscle on the side of the back that matched the painful side. The studies also showed that over time back pain did improve. But this does not mean the multifidus is back to normal.

In fact research found that their was a decrease in size of the multifidus. That's why increasing strength and endurance with specific exercises for the multifidus is so important.

Isometric Exercises for the Multifidus

There are lots of exercises that strengthen the multifidus as well as the other back extensor muscles. The only problem is all the extensor muscles will contract with traditional back exercises.

This will cause the strong muscles to compensate for the weak ones. The multifidus must first be isolated and re-activated through specific isometric exercises then followed up with functional exercises to further strengthen the muscles of the lower-back.

The following isometric exercise should be performed to strengthen multifidus muscle.

Multifidus- Exercise Instructions


Lie flat on your back with your right side several inches away from a wall
Abduct both legs 10 degrees (bring legs toward the wall)
Slightly side-bend to the same side with your upper body
Externally rotate your leg closest to wall as far as you can
Direction of Resistance:

Push legs into wall (as if you're trying to move the wall) keep your leg externally rotated
Feel the deep muscles of your back contract-closest to your spine on the same side as the wall.

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