Month: November 2018

and in Yoga

by Doug Keller

The multifidus muscles come into play when you are: standing still, bending forward, twisting to either side, picking things up or lifting heavier objects, walking.

They are not active when you are: bending directly to one side or the other (no twisting of the spine involved), bending backwards when there is no resistance (such as when bending backwards while standing), lying down.

These muscles are at work through a specific range of movement, and also need to know when to let go. In a forward bend the multifidus muscles contract as you bend over until you are about 40° to 70°—and then the back muscles normally relax as the ligaments take over.

Fist Steps
From our description of the kind of actions in which the multifidus muscles are active, it’s fairly easy to see that the majority of the basic hatha yoga āsanas will help strengthen them. The multifidus muscles are given a workout most when you are practicing forward bends and twists, as well as basic standing postures. They’re also strengthened when you do simple back-bending actions which involve resistance from gravity, such as in prone positions like Locust Pose (Śalabhāsana) in which you lift and extend your legs behind you.

If you do suffer from low back pain, you of course have reason to be careful before attempting such poses. Thus we should start with a couple of simple suggestions that are safest for relatively inexperienced students, and then look more deeply at the basic actions of the bandhas that can be incorporated into a more seasoned yogi’s practice.

The first step is a fairly familiar warmup that can be part of any practice:
1. Start on your hands and knees, placing a folded blanket under your knees if necessary. Keep your head in line with your spine and begin with a natural, neutral inward curve in your lower back.
2. As you exhale, extend your leg back, bringing it in line with your spine, the leg parallel to the floor and big toe pointing straight down. Keep your hips level and steady, and your abdomen firm to keep your lower back from moving.
3. Hold for a second, and then lower your knee to the floor as you inhale.
4. Alternate between the two legs, doing a few repetitions on each side, until you can work up to doing either a total of two minutes work, or twenty repetitions with each leg. Once a day for two or three days a week is plenty when you’re just starting out.

If you can manage this amount, then you add more weight and resistance to the exercise by including arm extensions:
–As you extend your right leg back, raise and extend your left arm forward at the same time, palm facing downward. Don’t lift the arm so much that it causes pinching in your shoulder or increased arching in your lower back.
–Lower your arm and leg down at the same time, and follow the same program of repetitions. As this becomes easier, light ankle weights can be added (starting with 1 lb. each); the weight is appropriate if you can manage 30 seconds of doing the exercise or 10 repetitions.
–Balance is of course more tricky in this version, and it has the added advantage of toning your lower abdominals and obliques as you work to steady your balance!

The next logical step is to take the same action into Downward Facing Dog Pose: step one foot a bit closer to the midline and lift the other leg until it is in line with your upper body. Keep your big toe pointing straight downward to keep your hips level. In this case there is no need to twist: your focus is on working the muscles at the back of the spine symmetrically. Firm your lower belly, gently pressing the muscles below your navel toward the spine, drawing them upward slightly as your tailbone lengthens back.

This last action in Downward Facing Dog Pose introduces us to the actions of the bandhas in conjunction with the multifidus muscles. This is where the deeper yoga begins.
*Yoga As Therapy, Volume Two: Applications

by Doug Keller

The name comes from a combination of the Latin words multus, meaning ‘many’, and findo, meaning ‘to cleave’. The name really refers to a group of many tiny individual muscles that ‘cleave’ the facet joints of the spine, interwoven from the top of the sacrum all the way up the base of the head. There are lots of multifidus muscles, each one crossing just two to five vertebrae each. As a whole, the multifidus muscles work together to provide stability to the spine, keeping the vertebrae in a safe position regardless of what the spine is being asked to do. And each multifidus has an individual job to do, controlling its own single segment of the spine.

And that can be the problem. In many cases of back pain, it’s just a single multifidus muscle – rather than the group – that is not working properly, and there is plenty of evidence linking failure of a single muscle to the specific area of back pain. And each multifidus is particularly vulnerable to a breakdown. Most muscles in the body are controlled by several nerves, which means that they have a backup to keep them running if one nerve fails. But the multifidus is rather unique, in that each of them is run by a single nerve from the spinal cord. If something happens to the nerve, the muscle stops functioning properly, like a single light going out on the Christmas tree. Since it lacks a backup, the multifidus is more prone to failure.

Why would this cause back pain? Because of the specific job entrusted to it. Each multifidus attaches directly to the joint capsule or tissue that surrounds the small facet joints at the back of the spine. When the multifidus contracts, it pulls backwards on this capsule, pulling the capsule or tissue that surrounds the small facet joints at the back of the spine. When the multifidus contracts, it pulls backward s on this capsule, pulling the capsule away from the bones of the joint so that it doesn’t get nipped or pinched by the vertebrae as you bend forward or twist. Since the capsule contains nerve endings, any pinching of the capsule will result in an attack of back pain, even if you’re doing simple everyday movements that never caused pain before.

But back pain from the multifidus does not arise only from pinching of the joint capsule. Often it is the muscle itself that is crying out in pain. Paradoxically, back pain often arises when the multifidus muscles don’t relax and release they’re supposed to! In the case of pregnant women – where the increasing weight of the child steadily increases the load on the spine – studies have found that the increased activity in the multifidus goes hand in hand with the increasing intensity of back pain that comes with pregnancy. In fact, measurements of increased activity in the multifidus provide a good predictor of which pregnant women will suffer from back pain.

In cases of disk herniation, we’re finding that the effect upon the mutifidus is also involved. Though the casual relationship is not fully understood, it’s been found that a herniated disk causes the multifidus to be overactive and contract more than it should. Moreover, the multifidus muscles in the area of the herniation have been shown to be much smaller (hence weaker) than normal. By the same token, studies have shown the exercises for the lower back muscles in cases of disk herniation have had high success rates in overcoming back pain.

An overworked multifidus muscle is weak and stressed, and even smaller or shrunken. A strong muscle, it seems, is also one that is able to relax and release when it ought to.
*Yoga As Therapy, Volume Two: Applications

Multifidus Muscle Atrophy and Association with Low Back Pain
Dysfunction in the lumbar multifidus muscles is strongly associated with low back pain. The dysfunction can be caused by inhibition of pain by the spine. This dysfunction frequently persists even after the pain has disappeared. Such persistence may help explain the high recurrence rates of low back pain. Persistent lumbar multifidus dysfunction is diagnosed by atrophic replacement of the multifidus with fat, as visualized by magnetic resonance imaging or ultrasound. One way to help recruit and strengthen the lumbar multifidus muscles is by tensing the pelvic floor muscles for a few seconds “as if stopping urination midstream”.

More at Wikipedia