Exercise helps low back pain….but which ones should you do?!
Exercise has repeatedly been shown to improve low back pain. Not all exercises are created equal however. With the popularity of Pilates and a myriad of other exercise programs sprouting up across America it is all the more confusing to figure out which exercises to focus on specifically to target low back pain.
So which muscles deserve more attention than the rest? The research continually points to one muscle in particular: Lumbar Multifidus. This small muscle (about the size of your tricep) attaches directly to the back of your spine and serves a vital role in controlling movement in the vertebrae of your low back. Researchers are finding that in people with back pain the multifidus muscle specifically undergoes atrophy (shrinking) and becomes dysfunctional 1. Furthermore, the multifidus muscle does not spontaneously recover, meaning that if you do not directly retrain this muscle it will not return to normal function!
In 2001 patients with first episode low back pain were randomly separated into two groups: exercises targeted specifically at rehabilitating the multifidus muscle or general exercises. One year after starting treatment the recurrence rate of low back pain (meaning the back pain had returned at least once) was 30% in the multifidus specific group versus 84% in the general exercise group2!!! So it looks like the multifidus is the big winner in the treatment of low back pain. Now for the exercises that best target the multifidus……Back Extension and Bridging.
Here are the pictures: (Remember: Contact your health care professional if any pain or discomfort occurs during performance of these exercises)
Back Extension: Start in position A with feet firmly against wall, raise chest up to assume position B, hold for 5 seconds and return to starting point. Perform 2 sets to the point of fatigue
A. 
Back Extension 1
B. Back Extension 2
Bridge: Start lying flat on your back with knees comfortably bent and feet flat on floor. Utilizing your gluteal, hamstring, and back muscles to bring your pelivis off the floor as show below. Hold 10 seconds, repeat 10x.
1. Hides,J.,Jull,G.,Richardson,C.(2001) Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine, 26(11_, E243-E248
2. Hides, J., Richardson, C., Jull, G. (1996) Multifidus recovery is not automatic following resolution of acute first episode of low back pain. Spine, 21(23), 2763-2769.
by Jeff Moore, DPT, MTC
