Dead lifts are a more direct, gym based exercise that aims to work the multifidus during movement. The multifidus muscle needs to stabilise the lower back so that the major gluteal muscle (gluteus maximus) allows you to bend and lift. These 2 muscles work hand in hand in many major movements, such as sitting to standing, doing squats and walking up stairs.
Come up next to the bar and grip onto the bar just past waist width apart.
To lift the bar up, begin by doing the following
Bring your shoulder blade back and up just a little bit (although this is mainly a back exercise, it is important to set your shoulders up properly before lifting)
Bend your knees so that the bar begins just above your knees
Before lifting, squeeze your back muscles together to switch on multifidus (as previously described). Make sure you keep your back straight, and lift the bar using your gluteals
Keeping multifidus on, by continuing to squeeze the back muscle, and your knees a little bit bent, allow the bar to slide down the thighs until you feel a pull in the back of your thighs (hamstrings).
Keeping your back straight, using your gluteals, tuck your bottom in and allow the bar to slide back up your thighs to the starting position.
If you feel this exercise in your back at any stage, either the weight is too heavy for your gluteals and multifidus or the technique is not correct. You should be able to maintain contraction of multifidus throughout this exercise. If you can not, don’t slide the bar down the thighs as much when performing the exercise or reduce the weight or both.
Triathlon, both the events, but especially the training, puts an enormous load on all the major joints of the upper and lower body. In particular, the lower back, pelvis and hips struggle to cope with the repeated, constant loads placed on these joints and can break down leading to both short term, but more commonly, long term injury.
As a physiotherapist, seeing a common range of injuries with triathletes for the last 17 years, the most common being lower back disc bulges, pelvic instability and tears to the lining of the hip joints. The best protection you can give your joints to prevent or at least minimise the injuries to these joints is to improve your ability to control your core and improve its endurance.
Pilates is a great tool to work on your core stability, especially reformer based Pilates, which I have been using for 13 years, however, the choice of exercises needs to be specific and targeted for the best results, just like any form of training. Tailored Pilates exercises are always the best, however, here are 3 Pilates exercises you can do at home to improve your core stabilisers to get you started.
Basic exercise for Transversus Abdominis
This is a great exercise for working on core stability that does not put excessive load on the lower back and is safe for most athletes.
Lie on your back with your knees bent
Draw you stomach muscles in, just below the belly button (This activates the transversus abdominis). The client should be able to maintain a small arch in their back (This is important, because flattening the back activates the power muscles, and actually inhibits the transversus abdominis muscle from working)
Lift your leg into the air, take it out straight and then out to the side, maintaining control of the transversus abdominis muscle.
When you feel the abdominal muscles bulge, instead of that drawing in action, the client has lost clomid control and that’s where you should limit the exercise for the client (eg if they lose control when taking the leg out to the side, stop at that point, don’t make the exercise any more complex)
To add complexity, lift the arms up into the air. As you take the leg out straight and out to the side, lift the arms over the head.
To make the exercise harder, place a weight into the hands. This increases the load on the transversus abdominis without adding too much strain on the lower back
Superman – Hip Extension in 4 point kneel
This is a more direct exercise for the multifidus muscle, the direct stabiliser of the lumbar spine. You will still use transversus abdominis during this exercise; however the main focus is multifidus
Start the exercise on your hands and knees in 4 point kneel
Make a small arch in the lower back, and squeeze the back muscles together in the lower back (This will be a sensation more than a movement and you should be able to feel these muscles become bigger and tighter) This is activation of the multifidus muscle.
Draw your stomach muscles in below your belly button to activate transversus abdominus and lift your leg straight up into the air. Hold for 5 secs, then bring it back down again.
To make the exercise harder, take the leg out to the side as well and hold for 5 seconds.
To further progress this exercise, lift the opposite arm straight up into the air at the same time.
If you feel that the client can not maintain activation of the multifidus muscle during any of these exercises, the exercise is too hard, so go back to the previous level of the exercise (eg if the client can not maintain activation of multifidus when lifting the arm in the air, stick to just using the leg only.
During pregnancy, most women develop a split in their abdominal muscles. Sit-ups increase the abdominal pressure and encourage the split between the abdominal muscles, making the recovery of these muscles after childbirth slower and problematic.
Sit ups do NOT strengthen the core stabilisers. It does NOT work the core stabilisers, the transversus abdominus and multifidus. These muscles need to be trained to help with the recovery of the split in the abdominal muscles.
Sit ups is a dynamic exercise, specifically training the prime movers which often inhibits the activity of the core stabilisers from working. Without the strong base of core stability, sit ups can cause back pain, as it puts extra pressure on the discs of the lower back. It also increases the risk of injuring the discs and causing long term lower back pain.
Lower back pain explained – Pathologies of the lumbar spine
Back pain, in particular lower back pain is a condition which affects many people every day. However, the term lower back pain is very general and does not specify the underlying cause of pain or pathology. Lower back pain generally refers to pathologies of the lumbar spine but is also often used to describe pathologies of the pelvis and sacro-illiac-joint. For the purpose of this article we will be focussing on the main pathologies of the lumbar spine. The lumbar spine is made up of the five largest vertebrae in the spine, each separated by intervertebral discs, which are subjected to the greatest compressive loads in the spine. The orientation of the facet joints in the lumbar spine allow for mainly flexion and extension based movements with a limited amount of rotation, particularly the lower lumbar vertebrae.
Back Pain – Lumbar Disc bulge
The most common pathology of the lumbar spine is lumbar disc bulge. This refers to a tear in the annulus fibrosis (outer fibrous layer of intervertebral disc) allowing the nucleus pulposus (inner liquid portion of the disc) to bulge, most commonly posteriorly and anteriorly in very rare cases. This disc bulging can cause compression of the nerve roots, resulting in radiating pain and distal weakness of the corresponding areas of the body which those nerves innervate. People with posterior lumbar spine disc bulges will typically present with pain on flexion based (forward bending) movements of the lumbar spine and will generally find extension based (backward bending) movements relieving. In the rare case of anterior disc bulge, people will present with the opposite pattern, however imaging such as MRI is often required to confirm this. Risk of lumbar disc bulge is often associated with increasing age, participation in activities which involve repeated flexion and rotation movements and heavy lifting.
Back Pain – Lumbar Facet Joint irritation
Lumbar facet joint irritation is the other main pathology of the lumbar spine. The facet joints are the posterior synovial joints between vertebrae and can be irritated or damaged by activities which put too much load on them. This includes activities that involve repeated lumbar extension and rotation such as fast bowling in cricket. People with lumbar facet joint irritation will generally present with stiffness and discomfort with extension based movements of the lumbar spine and flexion based movements and stretches will often relieve pain to some degree. Activities such as prolonged standing or lying down on the back will often reproduce pain with lumbar facet joint irritation.
Back Pain – Other Causes of Back Pain
Two of the other main pathologies of the lumbar spine include spondylolisthesis and spinal canal stenosis. Spondylolisthesis refers to the forward slipping of one lumbar vertebra on the segment below, often as a result of repetitive extension based activities. This condition will often present similarly to facet joint irritation when symptomatic, however a step deformity (due to the forward slippage of the effected segment) will often be felt, with significant instability at that segment. Spinal canal stenosis refers to the narrowing of the spinal canal which may cause compression of the spinal cord and exiting nerve roots. This often occurs with increasing age as a result of degeneration; however it can also be caused from disc bulge, osteophyte formation, spondylolysthesis or calcification of the intervertebral ligaments. People with lumbar spinal canal stenosis will often present with pain when walking (claudication), weakness and a loss of deep tendon reflexes.
In any case, thorough assessment of the lumbar spine is required to determine the underlying pathology which is causing lower back pain. Thorough and accurate assessment and diagnosis of lower back pain will allow for more specific treatment, resulting in greater clinical outcomes.