The multifidus is a deep spinal stabilizing muscle, and strengthening it is a powerful step toward managing chronic low back pain. This muscle group is a fundamental component of the body’s internal support system, contributing directly to core stability and spinal health. Strengthening the multifidus helps ensure proper movement mechanics and provides a resilient foundation for physical activity. Restoring the function of this often-overlooked muscle improves the spine’s ability to handle daily stresses.
Anatomy and Role of the Multifidus
The multifidus muscle is a collection of short, triangular muscle bundles forming the deepest layer of the back muscles. These bundles run along the entire length of the spine, from the sacrum to the cervical spine. Its fibers span between two and four vertebral segments, connecting one vertebra to the spinous process of a vertebra a few levels above it. This arrangement allows the multifidus to fine-tune spinal movement.
The primary function of the multifidus is providing segment-by-segment stabilization, acting as a “local” stabilizer. It controls the small, intricate movements between individual vertebrae, unlike the global stabilization provided by larger, superficial muscles. By contracting, the multifidus maintains the stiffness and stability of each spinal joint, reducing friction and preventing excessive motion. This deep muscle also provides proprioceptive feedback, informing the brain about the spine’s position to regulate muscle activation.
Foundational Exercises for Activation
The initial focus must be on muscle activation and awareness, as the multifidus can become inhibited, particularly in individuals with chronic low back pain. These foundational exercises are isolated movements designed to re-establish the mind-muscle connection. The goal is to feel a small, deep contraction rather than a large, powerful movement.
Begin with Abdominal Bracing while lying on your back with knees bent and feet flat. Gently draw your navel inward toward your spine, aiming for a minimal contraction that does not cause your pelvis to tilt. Hold this subtle engagement for about six seconds while breathing normally, then fully relax, performing about ten repetitions.
Prone Hip Extension is performed while lying on your stomach with a pillow under your hips to maintain a neutral spine. Focus on the muscle near the spine as you slowly lift one leg only an inch or two off the floor. Ensure the movement comes from the deep back extensors, not the larger gluteal or hamstring muscles.
The Quadruped Knee Lift starts on your hands and knees with your back flat. Without allowing your torso to shift, slowly lift one knee slightly off the floor, controlling the movement with your deep core muscles. This challenges the multifidus to stabilize the spine against gravity. Hold the knee off the floor for two to three seconds before returning to the start position, repeating ten to twenty times per side.
Progressive Techniques for Building Strength
Once you can consistently activate the multifidus in isolation, the next step is to integrate that engagement into functional movements to build strength and endurance. These progressive techniques challenge the muscle’s stabilizing role during integrated, multi-limb activity. The focus remains on maintaining a neutral spine and controlled movement throughout the exercise.
The Bird-Dog exercise is a classic progression performed on your hands and knees. Extend one arm forward and the opposite leg backward simultaneously. The challenge is preventing rotation or arching in the lower back, forcing the multifidus to stabilize the spine. Hold the extended position for five to ten seconds before slowly returning to the start, aiming for ten to twelve repetitions on each side.
The Modified Side Plank trains the multifidus to stabilize the spine against lateral forces. Lie on your side propped up on your forearm with your knees bent, and lift your hips until your body forms a straight line from head to knees. This requires the deep spinal muscles to work with the obliques to maintain neutral alignment. You can progress this by extending the top leg or increasing the hold time up to thirty seconds per side.
The Bridge with March builds strength by combining hip extension with an unstable base. Perform a standard two-legged bridge, lifting your hips until your body is straight from knees to shoulders. While holding the bridge, lift one foot two or three inches off the floor, hold briefly, and repeat with the opposite foot. This alternating march forces the multifidus to stabilize the spine and pelvis against the changing load, preventing dropping or rotation.
Ensuring Proper Form and Professional Guidance
Maintaining proper form is essential in multifidus strengthening, as the deep muscles are easily overshadowed by larger, superficial muscles. A common compensation is using the hamstrings or the large erector spinae muscles, which defeats the purpose of isolating the deep stabilizers. If you feel the exercise primarily in your glutes, hamstrings, or the large muscles of your lower back, you are likely not engaging the multifidus correctly.
Signs that the multifidus is not engaging include excessive movement in the spine, such as arching or rotating, or a feeling of strain or pain outside the deep muscle area. Consistent, controlled breathing is necessary, as holding your breath can inhibit the deep core muscles. Always move slowly and deliberately, prioritizing perfect form and minimal movement awareness over speed or range of motion.
If you experience sharp or increasing pain during any exercise, immediately stop the movement and rest. Consult with a physical therapist if you have chronic low back pain or are unable to feel the deep muscle engagement after attempting the foundational exercises. A professional can provide tactile cueing and personalized instruction to ensure you are targeting the correct muscles.