Exercises

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Physioworks: Multifidus exercise protocol

1. Stand, about arms distance from the wall, reach out with one hand to ALMOST touch the wall, raise yourself onto the balls of your feet while maintaining your trunk erect, place your other hand, fingers down, onto the area of the muscle and you should feel it contract - perhaps briefly at first, but with practice this contraction can last for minutes.
   
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   Alternatively, if you have an exercise ball, try sitting erect, knees about 10 cm apart, feet gently on the ground, rotate your trunk slightly and perhaps lean back ever so gently - you should feel the contraction. Another method is to stand, place your hand on your spine in your lower back, rock forward and back, feel the contraction in the muscle at your spine, this is multifidus (or it should be !).
2. Lying on your back, bend one leg (say the right) about 60 degrees, feel the top of (in this case your left) hip - "pull" your left hip towards the bottom of your right shoulder blade - the muscle you are using is very likely to be multifidus. Learn how to initiate this contraction and this exercise you can do whilst driving, sitting, standing in fact most of the time - especially if you are going to lift or work your back.

To exercise the "sling" muscles spoken of earlier first establish if you have the required hip extensor strength - gluteal power. Lying on your tummy, with your right foot resting on the back of your left knee (called "figure of 4 position" because your legs sort of match the 4) lift your right leg into the air - or use the left foot on the right knee and lift the left leg into the air - do not squirm about in your trunk, do not use your arms to assist, just use your hip extensor muscles to extend your hip. If you can't you have probably had some lower back pain in your life and the connection from brain to bum - motor cortex to gluteal muscle is more correct - is not 100% - OK, then activate it. Try in sitting to "squeeze" your bottom and push up (the feeling is to "lift off" the seat), hold the contraction a few seconds. Try lying face down, squeeze your bum (gluteal) muscles then raising your knee just off the ground - hold onto your hamstring muscles and only let them contract a small amount, the majority of the "lift" should be coming from your gluteal muscles.

Ball exercises are designed to improve your "Core stability". The important thing to work towards is that the balance is good. The initial exercise is just to sit on the ball, and not wobble about. Investigations however show you can sit on the ball and not activate or exercise your core muscles at all - so feel them actually working and don't waste time.

A useful beginning is above - just raise one leg, hold that position for about 15 seconds. Try raising the other leg - not both at the same time, just the right, then the left - look for a different feeling of balance between the two sides - an ideal would be no difference, reality would suggest your dominant side is stronger. Then raise one arm, or if you like raise the arm and leg as illustrated.

This one raises both right arm and right leg, as opposed to above, the opposite arm and leg - which one feels more secure for you. Now you are introducing trunk rotation with your balance, when you get this right, try raising one leg and rotating.