Treating Trigger Points in Multifidi - Dr. Jonathan Kuttner
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.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).
Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
NAT courses are accredited for continuing education by over 30 professional associations in North America, United Kingdom, Australia, and European Union countries. These include The National Academy of Sports Medicine, Physical Therapy Board of California, AAFA, National Certification Board for Manual Therapists and Bodyworkers, Sports Therapy Institute, and Myotherapy Australia.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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Our courses are modular, and designed to build on what you already know. For more information, please visit our "Where to Start?" page.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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