Dominic Stone
The back muscles are what allow us to stand, move, twist, and bend. They support our torso, help us maintain our posture, and assist with breathing. There are three types of back muscles that help spinal function: extensor muscles, flexor muscles, and oblique muscles. The extensor muscles are attached to the back of the spine and include the large muscles in the lower back (erector spinae) and gluteal muscles. The erector spinae muscles are part of the intermediate layer of muscles and are responsible for the extension and lateral flexion of the spine, head, and neck. The deep layer of muscles consists of the transversospinalis muscles, which are responsible for extension, lateral flexion, and rotation of the head and spine. The intrinsic/deep muscles extend from the skull base to the sacrum and include the semispinalis, multifidus, and rotatores muscles, which help stabilize the vertebral column. The superficial layer contains the splenius cervicis and splenius capitis muscles, which extend and rotate the head and neck. Latissimus dorsi (or lats), levator scapulae, rhomboids, and trapezius muscles are also part of the back muscle groups.
| Characteristics | Values |
|---|---|
| Superficial layer muscles | Splenius cervicis and splenius capitis |
| Intermediate layer muscles | Erector spinae |
| Deep layer muscles | Transversospinalis, Semispinalis, Multifidus, and Rotatores |
| Superficial back muscles | Latissimus dorsi, Levator scapulae, Rhomboid Major, and Trapezius |
| Intermediate back muscles | Serratus posterior superior |
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What You'll Learn
- Erector spinae muscles help with extension and lateral flexion of the spine
- Latissimus dorsi muscles extend from the shoulder blades to the spine
- Levator scapulae muscles extend from the neck to the shoulder blades
- Rhomboid muscles connect the shoulder blades to the spine
- Transversospinalis muscles are involved in the extension, lateral flexion, and rotation of the spine
Erector spinae muscles help with extension and lateral flexion of the spine
The erector spinae muscles are a large, complex group of muscles that work together to support the trunk and hold the body upright. They are attached to the back of the spine and help us stand, walk, and lift objects. The erector spinae muscles are the most superficial of the posterior trunk muscles, ascending vertically on either side of the vertebral column.
The erector spinae group includes the spinalis, longissimus, and iliocostalis muscles. The spinalis muscles are the most medial erector spinae muscles, while the longissimus muscles are the central and thickest erector spinae muscles. The iliocostalis muscles are the most lateral erector spinae muscles.
The function of the erector spinae muscles is to extend and laterally flex the spine. Bilateral contraction of these muscles causes back and head extension, while unilateral contraction results in lateral flexion and rotation of the head and neck. The erector spinae muscles help to maintain posture by steadying the spine on the pelvis during walking. They also provide the extensor force needed for lifting objects.
In individuals with low back pain, the erector spinae muscles may not function properly. The flexion-relaxation phenomenon, which is typically present in healthy individuals, is absent in those with low back pain. The flexion-relaxation phenomenon refers to the silencing of the erector spinae muscle activity during full trunk flexion. Lumbar stabilization exercises can help restore this phenomenon and decrease low back pain.
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Latissimus dorsi muscles extend from the shoulder blades to the spine
The latissimus dorsi muscles are the largest muscles in the upper half of the body. They start below the shoulder blades and extend to the spine in the lower back. They are responsible for extension, adduction, transverse extension (also known as horizontal abduction or horizontal extension), flexion from an extended position, and medial internal rotation of the shoulder joint.
The latissimus dorsi muscles play a crucial role in spinal function. They are attached to the back of the spine and enable us to stand and lift objects. They work in synergy with other muscles to facilitate movements such as pulling the trunk upward and forward when the arms are in a fixed overhead position. This is particularly evident in activities like rowing, swimming, and chopping.
The latissimus dorsi muscles also contribute to respiratory functions. They are active during deep inspiration and forceful respiratory actions such as coughing and sneezing. When coughing or sneezing, the muscle can be felt pressing inward as it compresses the thorax and abdomen.
Additionally, the latissimus dorsi muscles can influence spinal movement and posture. If these muscles are short or tight, the back will extend and rotate when the upper extremity is flexed overhead, such as when reaching for an object on a high shelf. Assessing the length and flexibility of these muscles is essential for managing low back pain.
The latissimus dorsi muscles are also relevant in the context of breast reconstruction surgery after mastectomy or correcting pectoral hypoplastic defects like Poland's syndrome. They can be a source of muscle for surgical procedures.
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Levator scapulae muscles extend from the neck to the shoulder blades
The levator scapulae is a slender skeletal muscle that extends from the neck to the shoulder blades. It is situated at the back and side of the neck, originating from the transverse processes of the four uppermost cervical vertebrae. The muscle fibres descend diagonally, inserting onto the upper portion of the medial border of the scapula. The levator scapulae is innervated by the anterior rami of spinal nerves C3 and C4, and frequently also by the dorsal scapular nerve (C5).
The main function of the levator scapulae is to elevate and retract the shoulder girdle at the scapulothoracic joint. It works in combination with other muscles such as the rhomboids, serratus anterior, serratus posterior superior and inferior muscles, and the trapezius to produce downward rotation of the scapula. When the spine is fixed, contraction of the levator scapulae elevates the scapula and rotates its inferior angle medially. This can contribute to the extension of the neck when both sides contract simultaneously.
The levator scapulae is one of the muscles that form the floor of the posterior triangle of the neck. It is bounded in front by the scalenus medius and behind by the splenius cervicis. The superior part of the levator scapulae is covered by the sternocleidomastoid, while its inferior part is covered by the trapezius. The levator scapulae may lie deep to the sternocleidomastoid at its origin and deep or adjacent to the splenius capitis at its origin and mid-portion.
The levator scapulae is considered a superficial muscle of the back and is prone to stiffening and chronic pain due to poor posture. It is important to note that the levator scapulae muscles are separate from the deep or intrinsic back muscles, which are located deeper and are also known as the true back muscles. These deep back muscles include the erector spinae, which help to hold up the spine, and the flexor muscles, which allow us to bend forward and arch the lower back.
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Rhomboid muscles connect the shoulder blades to the spine
The rhomboid muscles are a group of muscles in the upper back, consisting of the rhomboid major and minor on each side. They are deep intrinsic shoulder muscles that form the shoulder girdle, which helps to keep the shoulder blade and shoulder stable. The rhomboids attach to the shoulder blades, spine, and rib cage. They receive innervation from the dorsal scapular nerve and are supplied by the dorsal scapular artery.
The rhomboids are important for upper limb movement and stability of the shoulder girdle and scapula. They work together with the serratus anterior, trapezius, and levator scapulae to elevate and retract the scapula, as well as anchor it and prevent winging. The rhomboids are also vital for actions such as pulling, lifting, rotating the shoulder blade, and enabling arm movement, especially overhead and throwing movements.
Rhomboid muscle pain is common and may be caused by injury, overuse, repetitive motions, overstretching, or sitting for long periods. It often occurs between the shoulder blades and spine and may feel like tenderness around the shoulder blade. Treatment options include gentle exercises, pain relief medications, anti-inflammatory drugs, and hot and cold therapy. Specific exercises recommended by healthcare professionals can help ease rhomboid muscle pain.
The rhomboids are a relatively rare site of surgery, but rhomboid muscle flaps can be used in the treatment of head and neck cancers, oesophagus reconstruction, mandibular defects, and Sprengel disease (congenital elevation of the scapula). Rhomboid palsy is another clinical pathology associated with the rhomboids, often underdiagnosed due to its deep anatomic position.
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Transversospinalis muscles are involved in the extension, lateral flexion, and rotation of the spine
The transversospinalis muscle group is a deep group of back muscles that play a crucial role in spinal stability, proprioception, and posture. These muscles lie deep to the erector spinae, which include the large muscles in the lower back that help hold up the spine. The transversospinalis muscles are composed of three major subgroups: the semispinalis, multifidus, and rotatores muscles.
The semispinalis muscle is the most superficial of the transversospinalis group. It spans the thoracic and cervical regions of the vertebral column, attaching to the occipital bone at the base of the skull. Bilateral contraction of the semispinalis muscle extends the neck and thoracic spine, while unilateral contraction causes ipsilateral flexion of the neck and thoracic spine, along with contralateral rotation of the head.
The multifidus muscle lies deep to the semispinalis and spans the entire length of the vertebral column, with the greatest development in the lumbar region. The main function of the multifidus is spinal stabilization during movements. Bilateral contraction of the multifidus results in the extension of the vertebral column, while unilateral contraction produces ipsilateral lateral flexion and contralateral rotation.
The rotatores muscles are the deepest layer of the transversospinalis group. They are present along the entire length of the vertebral column but are most prominent in the thoracic region. The rotatores include short rotatores breves and long rotatores longi, which connect the transverse processes of adjacent vertebrae. Bilateral contraction of the rotatores causes rotation of the spine to the opposite side, while unilateral contraction leads to extension and hyperextension.
Overall, the transversospinalis muscles are involved in the extension, lateral flexion, and rotation of the spine. They work together to stabilize the vertebrae during localized movements of the intervertebral joints, contributing to spinal stability and posture control.
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