Focus on the Multifidus

[Jim Pickles]

Here is the link an article that came into my inbox. Apart from the absurd title (Is Multifidus the New Psoas?), it contains some interesting information on these under-discussed muscles, which are so essential for spinal stability. I have always been aware of their importance because of my interest in spinal flexibility, contortion, and backbending. However this interest does not seem to have been picked up by members of this board. Of the 4 posts mentioning multifidus on this discussion board (as found by a search), 50% are by me.

 

At one point, I was going to post a picture of Nadya Vasina, a Ukrainian backbending contortionist standing with a naked back. This young woman is seems spends a lot of her life in a backbend with her spine and legs suspended somewhere over her head. It shows massively developed muscles in the area where the multifidus is - but I decided against it, as you cant be sure that they are not the erector spinae instead. However I can by popular demand if required (if I can find it).

 

 

https://yogainternational.com/article/view/is-multifidus-the-new-psoas-fresh-insight-into-relieving-back-pain?utm_source=Yoga+International&utm_campaign=607a465834-RSS_WEEKLY_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_943c6d823b-607a465834-88663749&goal=0_943c6d823b-607a465834-88663749&mc_cid=607a465834&mc_eid=916e7e7ffa

 

Jim.

[Ciaran]

It's an interesting topic that has been covered quite extensively during my physio degree. Most of the research shown to us focused on rugby league and cricket populations.

I haven't seen that many posts here about lower back pain. Perhaps thats why it hasn't come up Jim?

[Kit_L]

JimP said:

 

It shows massively developed muscles in the area where the multifidus is - but I decided against it, as you cant be sure that they are not the erector spinae instead.

 

100% accurate: multifidis can't be seen unless erector spinae have been flayed off – Hannibal Lector may have seen them from time to time. And the stronger the backbend, the fuller erector spinae appears as they shorten (think flexing your biceps).
 
And if the neural system is working, including active TA, then you can be sure that multifidis is working too. Multifidis became popular because of Paul Hodges' PhD, IIRC, and I read his PhD before it was submitted. Back pain was the key case study of my PhD research too, and I did not find the same correlation of delayed innervation to reduced activity in TA as others have, nor its alleged significance in back pain – not because this is not potentially real, but because there are many and far larger scale causes at work in back pain that have nothing to do with TA or multifidis, and which I have found to be more important.

 
If multifidis is important, why isn't the same importance given to rotatores? They are the same intrinsic spinal muscles, and distinguished (as in named differently) only because of slightly different function.

[Jim Pickles]

@Kit "If multifidis is important, why isn't the same importance given to rotatores? "

 

I agree entirely too. If I make the spinal "lift and extension" feel that I mentioned earlier, or described by Olivia as "lifting the chest", then I feel the muscles in the area of the rotatores working hardest. I suspect that they are at least as important or even more important than the multifidus for that action.

 

One thing that interests me, is how this feeling of a possible lengthening of the spine is produced, and whether it really is a lengthening. As far as I can tell, with the spine straight, I can lengthen the spine by about 1 -2 mm (from changes in the position of the top of the head). The simplest explanation is that I am just straightening the spine a bit more. But if it is accurate that the spine can be lengthened (or maybe braced better in the lengthened position), how can that occur? Surely muscles can only pull, and not push? It may be that it happens in the same way that you can extend an extension ladder by pulling on a rope (ropes can also only pull, and not push). This could happen if there is a certain arrangement of muscles and overlaps of the bone (a bony extension of a higher vertebra partly overlapping a lower vertebra). This bony configuration occurs in the facet joints and their supports, but in anatomical diagrams I cannot find suitable muscles – maybe they are there but are not shown because there is not sufficient detail in the diagrams. Anyway, it is a strong feeling, is very useful in supporting and extending the back in backbending, and it would be nice to know what underlies it.

[Kit_L]

@ JimP: Levatores costarum; Costal elevators (lift the sternum; "lift the chest"), and the paravertebrals (the erector spinae of the thoracic spine, and other muscles including my fave trivia one, serratus posterior superior). Lengthening of the spine consists of flattening the three curves (remember these cues? "Tuck the tail" (flattens lumbar lordosis if HF are long enough); "Lift the chest" (elevates sternum, flattens thoracic kyphosis); "bring the chin slightly and directly back" (flattens cervical lordosis).

 

I would like to see an image of Nadya Vasina if you can find one, just because it will be beautiful!

 

BTW, to everyone: TA (transversus abdominis) was not part of the Pilates lexicon before the findings of Paul's PhD became well known. Joseph did not mention it in his original book. At the time, the Pilates world was looking for a "powerhouse"; suddenly TA was it and lots of research ensued, as Ciaren mentioned above, and PTs started using pressure cuffs in the gym, spearheaded by my old friend Paul Chek. This era was probably the true birth of the "neutral spine", too. A neutral spine, braced by TA, seemed like a simple solution to a complex problem.

 

There are problems: low back pain has many causes, and at the time lifters found that activating and strengthening TA had little effect on their lifts. As a Oly lifting friend said to me at the time, "If you can squat 200Kg in good form, lots of muscles need to be working, and many of them are on the back side of the body". 

 

I am shooting the program "Overcome back pain" presently, as it happens, and I have been revisiting my earlier work in this area (Dr Beck has been very helpful in reading and commenting on the 4th edition of ONBP, too).

[Ciaran]

@Kit - I look forward to the ONBP series as I still feel unprepared to deal with these patients when I graduate this year. What we haved learned makes sense in theory, but I can't ignore that the problem feels far more complex than a lumbar stabilisation programme.

Not to mention I have had intermittent LBP for 6 years now after some poor form deadlifts. TA and multifidus qork hasn't helped.

[Pat (pogo69)]

I am shooting the program "Overcome back pain" presently, as it happens, and I have been revisiting my earlier work in this area (Dr Beck has been very helpful in reading and commenting on the 4th edition of ONBP, too).

 

YAY!

[Jim Pickles]

In relation to the muscles involved as well as TA, of course nothing works in isolation, and all work together. And of course there will be many different causes of back pain, in such a complex, critical, and vulnerable structure.

 

As far as lifting the chest is concerned, my comment relates more to the muscles along the back, around the spine. It is a very different feeling from lifting from the front ("puffing the chest out"? military brace?) but more a lifting from behind. In a backbend, it is as though someone has their hand behind your spine lifting and supporting you - a good and very strong feeling.

 

 

 

Nadya Vasina in a typical pose, and in a less typical one showing back muscles. You may need to click to get a reasonable sized image (not got that one worked out yet). She will be at the contortion convention in Las Vegas in early April (still time to get tickets, Kit!), which I hope to be performing in too. Off the rehearse my new act now.

 

Jim.

[Jim Pickles]

Added later - also note the possible reverse kyphosis in Nadya's back, common in backbending contortionists.

 

Jim.

[piotro]

That short clip of her warmup shows a very active approach (strength/muscles)

[[DW]]

That reverse kyphosis is quite intriguing.. it makes sense with the volume of back bending, but is still odd (in a good way) to observe.