INNER UNIT ACTIVATION - LOWER BACK PAIN SECRET
Have you been plagued with back pain on and off for years? Do you experience random flare ups that seem to be occurring more and more frequently? Have you googled back stretches, completed them for a couple days until the pain resolves, but then experience pain a couple months later? Has this become an endless cycle? You may be struggling with activating your “inner unit.”
What is the inner unit? It is comprised of the deep local stabilizer muscles. These include the transverse abdominis, lumbar multifidus, pelvis floor and diaphragm. These muscles are important for intervertebral movement control and people with low back pain tend to show changes in the recruitment of these muscles.
The transvers abdominis is a broad muscle found on the lateral sides of the abdominal wall. It activates during spinal movement and is needed to maintain spinal stability. The transverse abdominis is the deepest of the abdominal muscles and wraps around the trunk from front to back between the ribs and pelvis. They run horizontally, similar to a back support belt. If activity is delayed or reduced during movements that challenge the stability of the spine, lumbar spine motor control can be compromised.
The multifidus fill up the groove on either side of your vertebra spinous processes. They allow stabilization of motion segment during lifting and rotational movements of the spine. Multifidus has a role in both static and dynamic spinal stability. They are continuously active during anti-gravity activities, such as being in an upright posture. They also stabilize the vertebra as the spine moves. They are deep, with direct attachments to the spine, running from the transverse process to the spinous process. They span the whole length of the vertebral column but are most developed in the lumbar area. How can such a tiny muscle play such an important role in stabilizing the entire spine? This is mostly achieved through a length tension relationship. Multifidus has a high cross section area and low fiber length. This allows for a high force generating capacity with low muscle excursion. When the muscles contract, they contribute to more compression at the spinal joint they affect. Weakness and atrophy of the multifidus are associated with low back pain.
The transverse abdominis and multifidus work together. The neural subsystem anticipates the loading of the spine and activates contraction of the transverse abdominis and multifidus ahead of loading. A delay in contraction of these muscles results in the larger and more superficial muscles contracting to compensate for delay in increasing stiffness of the lumbar spine. Lumbar multifidus rapidly atrophy following low back injury and this atrophy does not spontaneously improve even after the back pain resolves which results in altered motion control and may predispose to recurrence. Delayed activation leads to excessive stress on structures of the low back.
A physiotherapist will be able to assess your ability to activate these muscles and give specific exercises to enhance their recruitment to regain motor control to allow for proper lumbar stabilization, breaking the cycle of low back pain. Call one of our convenient clinics to book a consultation.