If you haven’t yet experienced lower-back pain, the bad news is, you probably will. Roughly 80 to 90 percent of Americans suffer lower-back injuries at some point in their lives. Not only are these injuries painful and debilitating, but they also cause secondary problems. Specifically, when the muscles primarily responsible for stabilizing the lower spine — known as local lumbar stabilizers — become deactivated, the result is a cascade of muscle imbalances spreading throughout the body, reduced mobility and physical performance, and increased risk of future injuries.
And unlike other, more superficial, back muscles, your local lumbar stabilizers stay deactivated unless you reestablish their connection to your brain. Luckily, it’s relatively easy to get back on track.
It’s a Core Concern
Our local lumbar stabilizers tend to remain inactive because we sit so much, and other muscles do the work of keeping the torso upright. “Because it’s being underused, the musculature that’s supposed to stabilize the spine becomes weakened,” says Staffan Elgelid, PT, PhD, assistant professor of physical therapy at Arkansas State University in Jonesboro.
This lack of stability usually affects one side more than the other. “If one side of the low back is unstable, it moves too much,” says Michael Clark, DPT, PT, PES, CES, president and CEO of the National Academy of Sports Medicine. “Then the other side locks down, creating a compressive pathology that breaks down the cartilage around the facet joint, causing swelling, which pushes on the nerve in that area and causes pain.”
That swelling and pain tell the brain to deactivate the affected muscles, explains Clark, team physical therapist of the Phoenix Suns. As a result, they quickly atrophy, and other muscles, such as the psoas (which connects the lumbar spine to the upper thigh), are forced to assume the job of protecting the lower back. But these muscles really weren’t designed for that role. “Your psoas is normally a pretty powerful hip flexor,” says Clark. “But if it has to create stability at the lumbar spine and flex your hip, it’s like driving with your parking brake on.” For athletes and active individuals, that means compromised performance and increased risk of other injuries, such as hip flexor tendinitis.
Back to Basics
Research has shown that the local lumbar stabilizers remain shut down unless their connection to the brain is reestablished. In 1996, a team of Australian physiotherapists led by Julie Hides, PhD, popularized a simple technique to reactivate these muscles, variations of which physical therapists around the world now practice. The technique involves “locking” your lower spine into a stable, neutral position with isometric contractions of the targeted muscles, while performing basic actions with other parts of the body (for examples, see “Reconnecting With the Brain,” below).
Isometric contractions are the quickest and surest way to reawaken the connection between the local lumbar stabilizers and the brain, and most mimic the work of postural muscles, Clark says. “When your stabilizers fire, the muscle spindles send a message to your brain, which sends a message back, creating a feedback loop that creates positive dynamic stability.”
Because the first step is just reestablishing communication, not strengthening, results can occur very quickly. “It’s almost like flipping a switch,” says Elgelid. “You can regain control of these muscles in a matter of days and bring them back to full strength in just a few weeks.”