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The multifidus muscle is a deep muscle in the back that is responsible for providing support and stability to the lumbar spine. It is a series of long, narrow muscles that run down both sides of the spine and have several attachment points. The multifidus plays a crucial role in controlling the movement of individual vertebrae, preventing excessive motion, and maintaining proper alignment. Weakness or atrophy in the multifidus muscle can lead to low back pain and other related issues.
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What You'll Learn
The multifidus muscle's role in spinal stability
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine, from the cervical spine to the lumbar spine. It is one of the deepest muscles in the back and is considered a primary stabiliser. The multifidus muscle plays a crucial role in spinal stability, especially in the lumbar region.
The multifidus is part of the transversospinalis muscle group, which also includes the semispinalis and rotatores muscles. It is the thickest muscle in this group and has the highest cross-sectional area, giving it a high force-generating capacity. The multifidus muscle has several attachment points, including the vertebrae, the sacrum, and various ligaments. This allows the multifidus to work with other muscles to stabilise and move the spine in complex ways.
One of the key functions of the multifidus is to provide support and stability to the lumbar spine, or lower portion of the spine. It accomplishes this by controlling the movement of individual vertebrae, preventing excessive motion, and maintaining proper alignment. The multifidus helps to protect against spinal deterioration, arthritis, and other back-related problems. It also aids in extending the spine, particularly when reaching or stretching.
Weakness or atrophy in the multifidus muscle can lead to low back pain and other issues. This can be caused by various factors, including trauma, sports-related injuries, poor posture, and physical inactivity. Retraining the multifidus muscle is important for maintaining spinal stability and preventing further injury. This can be done through a series of steps, including isolating the muscle and co-contracting it with other core muscles during functional activities.
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The anatomy of the multifidus muscle
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine. It is a deep muscle in the back that is part of the transversospinal muscle group. The multifidus is divided into five bands, each band arising from the spine of a lumbar vertebra and associated tissues. The multifidus is the thickest muscle in the transversospinal group.
The multifidus muscle is innervated by the medial branches of posterior rami of spinal nerves in the corresponding cervical, thoracic, and lumbar regions. The cervical multifidus muscles arise from the superior articular processes of C4–C7, extending superomedially to insert on the lateral aspect and the tips of the spinous processes of C2–C5 vertebrae. The thoracic multifidus originates from the transverse processes of the thoracic vertebrae, with fibers taking a superomedial course to insert variably on the spinous processes of the vertebrae 2–5 levels above their origin. The fibers of the lumbar multifidus arise from the mamillary processes of lumbar vertebrae and the posterior surface of the sacrum.
The multifidus muscle has a high cross-sectional area, giving it a high force-generating capacity. It also has a low fiber length, resulting in low muscle excursion. Investigators have categorized multifidus fiber types by layers, with the deepest layer contributing more strength and stability to the spine than the superficial layers. This is because the deep layer only spans two vertebral segments, while the other layers can span up to four. The shorter "excursion" of the deep layer means that when the muscle contracts, it contributes to more compression-type motion at the spinal joint.
The main function of the multifidus muscle is to stabilize the lumbar spine, preventing excessive motion, and maintaining proper alignment. It also helps extend the lower spine during reaching or stretching. The multifidus muscle has several attachment points, allowing each spinal bone (vertebra) to work individually and more efficiently. This helps protect against spinal deterioration and the onset of arthritis.
Weak or atrophied multifidus muscles can cause back pain and other back-related problems, such as herniated discs. This is due to the destabilization of the spine, which puts pressure on the muscles and connective tissues surrounding the spinal column.
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The impact of a weak multifidus muscle
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine, with several attachment points. It is part of the transversospinal muscle group and is located in the third or deep layer of the deep muscles of the back.
Spinal Destabilization and Back Pain
The multifidus muscle is a critical stabilizer of the lumbar spine, or lower spine. When the multifidus muscle is weak, it can no longer effectively stabilize the spine, leading to spinal destabilization. This destabilization increases pressure on the muscles and connective tissues surrounding the spinal column, resulting in chronic low back pain. The pain may be felt during simple activities such as reaching for an item, bending over, or after maintaining a posture for a prolonged period.
Increased Risk of Injury
The weakness in the multifidus muscle can lead to a higher risk of injury. The loss of muscle strength and stability can cause the muscle to atrophy or waste away over time. This deterioration can result in compression of the vertebra and other back-related issues, such as herniated discs.
Compromised Core Stability
The multifidus muscle is part of the core muscle group, which includes the abdominal and pelvic floor muscles. Weakness in the multifidus can compromise the entire core, further increasing the risk of back pain and injury.
Posture and Vertebrae Control
The multifidus muscle is responsible for controlling the position of the vertebrae, which helps maintain proper posture. When the multifidus is weak, it can lead to poor posture, such as slouching or hunching the shoulders, further exacerbating the pain and instability.
Treatment and Prevention
The issues caused by a weak multifidus muscle can be addressed through a series of steps. The first step is to isolate the multifidus muscle and then learn to co-contract it with other core muscles. This is often done through core stabilization programs and specific exercises that target the multifidus, such as those done with a dumbbell and bench or on all fours. Additionally, regular low-impact exercises like walking, swimming, or cycling can help strengthen the multifidus and improve overall spinal health.
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Exercises to strengthen the multifidus muscle
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine. It is part of the transversospinalis muscle group, which also includes the semispinalis and rotatores muscles. The multifidus muscle is responsible for stabilising the lumbar spine and extending the lower spine during reaching or stretching. It also aids several movements of the vertebral column.
Weak multifidus muscles can lead to various health issues, including lower back pain, herniated discs, and posture issues such as slouching and rounded shoulders. Therefore, it is important to incorporate exercises that target the multifidus muscle into your fitness routine to promote strength, stability, and overall spinal health. Here are some specific exercises that can help strengthen the multifidus muscle:
Bird Dog Exercise
This exercise is performed on all fours, with your hands placed directly under your shoulders and your knees placed directly under your hips. It targets the multifidus muscle as well as other core muscles. While maintaining a neutral spine, lift one leg off the ground, keeping it straight. Hold this position for 10 seconds, and then slowly lower it back down. Repeat on the other side. For balance, you can modify this exercise by placing your hands on a chair or wall.
Quadruped Leg Lift
Similar to the bird dog exercise, begin on your hands and knees with your hands and knees in alignment with your shoulders and hips, respectively. Lift one leg off the ground while keeping it straight. Hold this position for 10 seconds, and then slowly lower it. Repeat on the other side. You can also modify this exercise by lifting only one knee at a time instead of extending the entire leg.
Bridge with Leg Extension
This exercise targets the multifidus muscle while also engaging the glutes and hamstrings. To perform this exercise, lie on your back with your knees bent and feet flat on the ground. Lift your hips off the ground, creating a straight line from your head to your knees. Engage your multifidus muscle and hold this position for 20-30 seconds. Switch sides and repeat.
Dumbbell Row
For this exercise, you will need a dumbbell and a bench. Place your right knee and right hand on the bench so that your torso is parallel to the floor. Place a dumbbell on the floor beneath your left hand and grab it. Lift the dumbbell smoothly until the back of your arm is parallel to the floor. Hold for a second or two, and then lower the weight steadily. Repeat for 8 to 12 reps, and then switch sides. Remember to breathe in as you lift and exhale as you lower the weight.
In addition to these specific exercises, any exercise that activates the core will also engage the multifidus muscle to some extent. It is important to incorporate these exercises into your regular activities to improve your overall spinal health and reduce the risk of low back pain.
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The multifidus muscle and its relation to back pain
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine. It is part of the transversospinal group of deep back muscles, which also includes the semispinalis and rotatores muscles. The multifidus muscle has several attachment points and is serviced by a specific branch of nerves called the posterior rami. This allows each spinal bone (vertebra) to work individually and more efficiently, helping to protect against spinal deterioration and arthritis.
The main function of the multifidus muscle is to stabilise the lumbar spine, particularly during movement. It also helps to extend the lower spine when reaching or stretching. The multifidus muscle is also responsible for controlling the position of the vertebrae, which helps to maintain proper posture. When the multifidus muscle is weak or atrophied, it can cause back pain. This is because a weak multifidus muscle destabilises the spine and provides less support to the individual vertebrae, putting pressure on the muscles and connective tissues surrounding the spinal column.
Weakness in the multifidus muscle is often associated with low back pain and can lead to chronic low back pain. This weakness can be caused by inhibition, where the muscle shuts down and becomes weak over time. Inhibition of the multifidus muscle can be triggered by low back pain or strain, leading to a cycle of pain and weakness. Over time, a weak multifidus muscle can atrophy and degenerate, with normal lean muscle tissue being replaced by intramuscular fatty deposits.
Treating multifidus muscle pain and dysfunction often involves physical therapy, which may include stretching, motor control and core stability exercises, and general full-body movement retraining. In some cases, medication may be prescribed to reduce inflammation, alleviate pain, and relax the muscles. For example, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and corticosteroids can be used. If conservative treatments are ineffective, neurosurgery may be an option. A new minimally invasive procedure that uses neurostimulation to reactivate the muscle may help reduce or eliminate pain.
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Frequently asked questions
The multifidus muscle is a long, narrow muscle that runs down both sides of the spine. It is one of the deepest muscles in the back.
The main function of the multifidus muscle is to stabilise the lumbar spine. It also helps extend the lower spine whenever reaching or stretching.
The multifidus muscle is made up of several fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae.
A weak multifidus muscle destabilises the spine and provides less support to the individual vertebra. This can cause lower back pain and, over time, the muscle may atrophy or waste away.
The multifidus muscle can be strengthened by tensing the pelvic floor muscles for a few seconds, as if stopping urination midstream.
