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
