Low Back Pain: Multifidi

In the past I have spoken about the importance of deep core musculature for the prevention and rehabilitation of low back pain. The deeper (less superficial) the muscle is, the better vertebral stabilizer it becomes. The multifidi are the king of this kingdom. Often overlooked, these small muscles produce effects inversely proportional to their size. These muscles work to stabilize during all postural actions, such as bending forward, backward, to the side, and even rotational (twisting actions). Recent studies have shown that the multifidi activate and tighten before movement even occurs. Strong multifidi take pressure off the intervertebral disks and bring balance to the spine during movement. Most muscles become weaker when being stretched. The multifidi do the opposite; which is what makes this muscle so fascinating. For example, if you bring your leg up and maximally stretch your hamstring, it becomes very weak and won’t be able to generate much power. But when you bend your spine significantly in any direction, the multifidi tighten up and become even stronger, making them an incredibly important stabilizer in the reduction of back pain and injury occurrence.

Current literature has shown that patients with low back pain have smaller and less active multifidi than patients who experience no low back pain. Literature has also shown that patients with low back pain have more trouble controlling and activating their multifidi versus individuals with no back pain. In general, when acute injury ensues and becomes chronic, deep core muscles tend to shut down and “go to sleep.” This can become a viscous cycle, because once the multifidi shut down, you will be more susceptible to future spinal injuries. Outside intervention is needed to reawaken these muscles.

I can try to explain how to activate and exercise these muscles, but I wouldn’t be doing them any justice. It is very important to get a visual of how to perform multifidi strengthening. As I always say, I am a huge fan of YouTube for educational exercises. Just type in “multifidi strengthening” and find the ones that work for you.

Dr. Rofe
Esprit Wellness (Find us on Facebook)