Exercises to Decrease Low Back Pain

Studies indicate 60—70% of adults will experience low back pain sometime during their life. While there are numerous individual factors that contribute to a person’s pain, one variable that highly correlates with reported back pain is decreased activation or use of the small stabilizing muscles of our spine.

We can classify the muscles in our body into two groups: Movers and Stabilizers.

The Movers are all of the big muscles most of us are familiar with - our quads, our hamstrings, our biceps, etc. They are the ones that move our limbs and trunk and generate force.

The Stabilizers are the smaller muscles that are closer to our joints and whose main job are to support the movers. Because they support the movers, the stabilizers need to fire, or contract, before the movers, otherwise the movers have nothing to help them “push” or “pull”. Think of it like trying to shoot a cannonball from a canoe. That cannonball is going to have a hard time getting anywhere without capsizing the boat.

One muscle that is an especially important stabilizer is called the multifidus (highlighted in orange). It runs all the way up and down our spine on each side and is one of the main contributors to spinal stability. Without it firing well, other muscles have to take over for it and do its job.

If the Stabilizers can’t work appropriately, that leaves the movers to both stabilize AND move. Eventually, the movers get tired of doing two jobs and this is often the point at which injury or pain occurs.

Patients often ask, “Why did my stabilizers stop working well?” and that’s a difficult question to answer without diving into the individual’s personal history, past injuries, and movement patterns. But a question we can answer is “how do I help these muscles start functioning better?” Below are three of my favorite exercises to improve your multifidi function and spinal stability.

Hip Hikes

Thoracic spine foam rolling

Supine March