The Keys to the Core

The key muscles in the back can be broken down into two categories or functions: the deep or stabilizing muscles and the superficial or mobilizing muscles.  The importance of the deep stabilizing muscles, which help to maintain the solidity of the spine, cannot be overlooked.  The term spinal stability describes the ability of muscles to stabilize or hold the spine as well as coordinate movements of the spine.  They are important for safety of the spine during everyday activities, especially during more advanced and complex activities such as sport.

So what are these muscles?

Two of the most important deep muscles of the spine are the Transverse Abdominus (TrA) and the Multifidus (MT).  Research has shown that after the first episode of low back pain, these muscles can become impaired and stop functioning properly.  This has to do with altered and delayed firing patterns, or in other words the ability of the body to recruit the correct muscles at the right time.  Studies have also shown that shortly after the initial onset of back pain these muscles can begin to atrophy, especially the lumbar multifidus.  What’s more important is that these muscles do not just return to normal after the pain goes away.  This can cause abnormally large motions of individual vertebrae which in turn can cause compression or stretch on pain-sensitive structures such as discs, ligaments and joints.  Current research is looking into atrophy of the lumbar multifidus as being one of the main causes for the high recurrence rate seen with low back pain patients.

How do we retrain these muscles?

Conventional strength training and stretching protocols for the low back, although important for the later stages of rehab, are not sufficient for targeting these muscles and creating a solid foundation from which to progress.  A lumbar stabilization program will specifically target the TrA and MT muscles.  The aim is to improve the neuromuscular control, strength, and endurance of these muscles which are central to maintaining dynamic spinal and trunk stability.  Through a lumbar stabilization program you will learn how to individually recruit these muscles as well as help to reestablish correct firing patterns.  Once normal function of these muscles is demonstrated, you will be advanced to more dynamic and functional strength and endurance training exercises.

Joey Strazzullo, SPT