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The multifidus muscle is a deep muscle in the back that spans the entire length of the vertebral column and is most developed in the lumbar area. It is responsible for providing segmental stability to the spine and plays a crucial role in maintaining spinal stability. Weakness or atrophy of the multifidus muscle is associated with low back pain. Activating and strengthening the multifidus muscle can help alleviate back pain and improve spinal stability. This can be achieved through specific exercises and cues such as co-contraction with the pelvic floor and transverse abdominis muscles, isolated contractions, and spinal stabilization exercises.
| Characteristics | Values |
|---|---|
| Location | The multifidus muscle runs along the entire back on each side of the spine, from the sacrum to the cervical spine |
| Function | The multifidus provides segmental stability of individual joints of the spine, and it does so in anticipation of movement. It also has the capacity to move the spine. |
| Activation | To palpate the multifidus, place your thumb right next to the spine on the low back. Shift your weight forward and allow your heel to come off the ground. |
| Exercises | The multifidus walkout is a great way to strengthen the multifidus in a more functional standing position. The cat and camel exercise is another example of an exercise that activates the multifidus. |
| Cues | Verbal instructions such as "draw your belly button towards your spine" can help activate the multifidus. |
| Co-contraction | The multifidus co-contracts with the TA, pelvic floor, and diaphragm. |
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What You'll Learn
The multifidus muscle's role in spinal stabilisation
The multifidus muscle is a long, narrow muscle located on either side of the spinal column. It is a deep muscle of the spine and plays a crucial role in spinal stabilisation. It spans the entire length of the vertebral column, originating at the transverse process of the vertebrae and attaching to the spinous process of the vertebrae 2-4 segments above.
The multifidus muscle has numerous attachment points to the spine, which allows each spinal bone (vertebra) to work individually and efficiently. This helps protect against spinal deterioration and arthritis. The multifidus muscle works alongside two other deep muscle groups, the rotatores and semispinalis muscles, to stabilise and move the spine in complex ways.
The rotatores muscle, located on each side of the spine, enables unilateral rotation (turning from side to side) and bilateral extension (bending backward and forward) of the spine. The semispinalis muscle, situated above the multifidus, allows for the extension and rotation of the head, neck, and upper back. Together, these three muscle groups provide stability and facilitate movement of the spine.
The multifidus muscle helps to maintain spinal stability by contracting isometrically (without changing length) to resist the pull of other muscles. This keeps the spine erect and helps prevent excessive movement. Additionally, the multifidus muscle provides proprioceptive feedback to the central nervous system, helping the brain identify the location and movement of the spine. This feedback is essential for maintaining correct posture and alignment during back extension, reducing the risk of injury.
To strengthen the multifidus muscle, it is important to first learn how to properly activate it. This can be done through exercises such as the multifidus walkout, which involves attaching a band to a secure object at chest height and stepping to the side while keeping the arms directly in front of the chest. This challenges the multifidus muscle and helps train it in a functional standing position, as many daily activities that require spinal stabilisation are done in an upright stance.
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How to palpate the multifidus
The multifidus is a deep back muscle that runs along the entire length of the spine, from the pelvis to the highest vertebra in the neck. It is covered by larger muscles, which makes it difficult to palpate. However, the best place to palpate the multifidus is at the base of the lumbar spine, where it is covered only by a thin layer of fascia.
To palpate the multifidus, place your thumb right next to the spine at the lower back. Shift your weight forward, allowing your heel to lift off the ground. You should feel the multifidus contract into your thumb. Try to maintain this contraction as you shift your weight back to the starting position.
The multifidus lift test (MLT) is a reliable and valid clinical test used to identify lumbar multifidus dysfunction in patients with low back pain. During the test, the patient is asked to lie in a prone position and relax. The examiner then palpates the multifidus muscle immediately lateral and adjacent to the interspinous space of L4/L5 and L5/S1. The patient is then instructed to flex their arms to approximately 120 degrees and their elbows to 90 degrees before raising their contralateral arm towards the ceiling by about 5 cm.
During the arm lift, the examiner determines whether the patient demonstrates a normal or abnormal lumbar multifidus contraction by palpating the degree of contraction. A normal contraction is one in which a robust and obvious muscle contraction can be felt during the arm lift. An abnormal contraction occurs when there is little to no palpable contraction during the arm lift.
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The importance of co-contraction
The multifidus muscle is a deep muscle that spans the entire length of the vertebral column and is most prominent in the lumbar area. It is a local core stabiliser, playing a crucial role in maintaining static and dynamic spinal stability. Weakness or atrophy of the multifidus can lead to low back pain and decreased spine stability.
To effectively cue the multifidus muscle, it is essential to understand the concept of co-contraction. Co-contraction involves the simultaneous activation of agonist and antagonist muscles surrounding a joint, breaking away from their typical pattern of action and counteraction. This mechanism enhances joint stability, movement control, and injury prevention.
The multifidus muscle is continuously active in upright postures and during anti-gravity activities, working alongside other muscles to maintain spinal stability. During co-contraction, the multifidus helps stabilise the vertebrae as the spine moves, ensuring a pure axial rotation without unwanted trunk flexion. This is particularly important during dynamic activities and sports that involve sudden changes in direction, speed, and impact, such as football and basketball.
To cue the multifidus muscle, individuals can perform specific exercises. One example is the "multifidus walkout." This exercise involves attaching a band to a secure object at chest height. By stepping to the side while keeping the arms directly in front of the chest, the band creates resistance, challenging the multifidus and other core muscles. Additionally, individuals can start by standing with one foot in front of the other and placing their thumb next to the spine in the lower back. As they shift their weight forward, they should feel the multifidus contract under their thumb.
In conclusion, the importance of co-contraction for the multifidus muscle lies in its ability to enhance spinal stability, improve movement control, and prevent injuries. By understanding the role of co-contraction, individuals can effectively cue the multifidus muscle during exercises, leading to improved spinal stability and overall physical health.
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Axial loading and posture cues
The multifidus muscle is a deep muscle that spans the entire length of the vertebral column, running along the spine from the sacrum to the cervical spine. It is part of the transversospinales muscle group and is most developed in the lumbar area. Weakness or atrophy of the multifidus is associated with low back pain due to decreased spinal stability.
To effectively target the multifidus muscle, it is essential to learn how to properly activate it during core exercises. This can be achieved through various exercises that involve axial loading and posture cues. For example, the "stretch tall plus arm extension" exercise involves axial loading through the length of the body with a stretch tall cue to maintain proper posture and avoid slouching. This exercise has been found to produce a significant contraction of the transversus abdominis muscle.
Additionally, the "arm extension and thoracic cue" exercise involves axial loading of the body and has been shown to result in the greatest contraction of the multifidus muscle. This exercise condition combines arm extension with a thoracic cue, leading to increased contraction of both the transversus abdominis and multifidus muscles.
Furthermore, exercises that challenge spinal stabilization in a functional standing position are beneficial. The multifidus walkout is an example of such an exercise, where an individual steps to the side while attached to a band at chest height. This setup challenges the multifidus muscle to stabilize the spine during axial loading and helps train the muscle in an upright position, mimicking daily activities.
In summary, axial loading and posture cues are integral components of exercises designed to target the multifidus muscle. These exercises help improve spinal stability, reduce back pain, and safeguard against spine injuries, particularly in environments with altered gravitational conditions, such as spaceflight.
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Multifidus activation exercises
The multifidus muscle is a group of small but powerful muscles located in the lower back that help support posture, stability, and movement. It is a deep spinal stabilizer of the lumbar spine and is responsible for supporting and stabilizing the spine, helping us maintain good posture and optimal mobility. When the multifidus is weak or injured, it can cause a range of health issues, including chronic low back pain.
To activate the multifidus muscle, start by standing with one foot in front of the other. Place your thumb right next to the spine on your lower back and shift your weight forward, allowing your heel to lift off the ground. You should feel the multifidus contract into your thumb. Try to maintain this contraction as you shift your weight back to the starting position.
Another great multifidus activation exercise is the bird dog. To perform this exercise, start on your hands and knees with your hands directly under your shoulders and your knees directly under your hips. Engage your abdominals and glutes as you extend your left arm and right leg out simultaneously.
You can also try multifidus walk-outs to strengthen the multifidus in a functional standing position. Attach a band to a secure object at chest height. Keep your arms directly in front of your chest as you step to the side. As you step out, the band will try to rotate your spine in the opposite direction.
Finally, you can try leg extensions. Breathe in to rest or hold, and breathe out as you extend your leg. Maintain the leg lift for 10 seconds and build up to 3 sets of 10 repetitions.
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Frequently asked questions
The multifidus muscle runs along the entire back, on each side of the spine, from the sacrum to the cervical spine. It is a deep muscle of the spine and is extremely important in spinal stabilisation.
Weakness in the multifidus muscle is associated with low back pain. Atrophy and weakness of the multifidus will lead to decreased stability of the spine, which can result in a vicious cycle of low back pain.
To cue your multifidus muscle, you must first learn how to properly activate it. Stand with one foot in front of the other and place your thumb next to your spine on your lower back. Shift your weight forward and lift your heel off the ground. You should feel the multifidus contract into your thumb.
