Trigger Point Therapy - Multifidus / Rotatores
Multifidi and Rotatores - Trigger Point Anatomy
Trigger Points in Multifidi may be the cause of a high percentage of back pain, and may increase the chance of back injuries occurring
The multifidus muscles help to take pressure off the vertebral discs so that our body weight can be well distributed along the spine.
These muscles are a major contributor to neuromuscular efficiency of the “core.”
The superficial muscle group keeps our spine straight while the deep muscle group contributes significantly to the stability of our spine.
These two groups of multifidus muscles are recruited during many actions in our daily living, includes movements such as bending backward, sideways and even turning our body to the sides.
Whilst spinal integrity relies on the combined ability of all muscles, special consideration should be given to the transversus abdominis muscle in maintaining pelvic stability, and to the action of multifidus and rotatores in stabilizing the spinal structure.
Multifidus / Rotatores - Common Trigger Point Sites
BuiIt-in Injury Prevention
A number of studies have shown that the multifidus muscles get activated before any action is carried out in order to protect our spine from injury.
Take for example when you are about to carry an item or before moving your arm, the mutifidus muscles will start contracting prior to the actual movement of the body and the arm, so as to prepare the spine for the movement and prevent it from getting hurt.
Multifidus and Back Pain
Many studies have been carried out to identify the relationship between back pain and mutifidus. One such study was published in 2002 in the European Spine Journal.
The objective of the study was to compare the level of back muscle activity - in healthy adults and those with low back pain - during coordination, stabilization and strength exercises.
Electromyographic activities of the multifidus muscles and the iliocostalis lumborum were measured when the subjects performed the exercises.
The results showed that low back pain subjects, especially those with chronic pain, displayed significantly smaller multifidus muscle activity as compared to healthy subjects during the coordination exercises.
This would indicate that over the long term, back pain patients have a reduced ability to voluntarily recruit the multifidus muscles in order to maintain a neutral spine position.
With strength exercises, subjects with chronic low back pain also had significantly lower multifidus muscle activity as compared to healthy subjects.
Possible explanations for this finding could be due to pain, pain avoidance and de-conditioning leading to reduced multifidus activity.
Hence, when multifidus function is poor, one may be more susceptible to back injuries.
Trigger Points and Mutifidus
Trigger points in these muscles may refer pain to the lower back, abdomen, and neck in accordance with well documented pain maps.
It is likely that trigger points in these muscles create the inefficiency that leads to a large percentage of common lower back pain, especially postural related cases.
Whilst stretching alone is unlikely to dissipate trigger points, it may help avoid them becoming active, and accelerate healing as part of a broader trigger point therapy treatment program.
Here is a simple stretch that anyone can do at home or at work, and which we often recommend, especially to office workers and long distance drivers.
Most importantly, as always, invest in a good manual therapist!
While sitting on a chair with your feet flat on the ground, look straight ahead and keep your body upright. Slowly bend to the left or right while reaching towards the ground with one hand.
Do not lean forward or backward: concentrate on keeping your upper body straight.
Muscles Being StretchedPrimary muscles: Quadratus lumborum. External and internal obliques.
Secondary muscles: Iliocostalis lumborum. Intertransversarii. Rotatores. Multifidus.
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