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In this article Doug Alexander In this article you will learn to recognise multifidi muscles. When there is a more local
explains how to recognise multifidi shortness and high tone associated inability to flex, it is more likely caused by a
with facet joint hypomobility, as well as purely multifidus shortness and/or high
multifidi shortness and high multifidi inhibition that tends to be associated tone.
tone associated with facet joint with disc pathology.
hypomobility, as well as multifidi
inhibition that tends to be
associated with disc pathology.
The lumbar multifidi are small but important
muscles. They lie on each side of the spinous
processes of the lumbar vertebrae and fill
the deep space in the laminar groove.
While the erector spinae and other long
muscles move the spine as a whole, the
multifidi provide segmental stability by
orienting adjacent vertebrae to each other.
spinous processes and give each one an Inhibited, low toned multifidi and unstable Short and/or hypertonic multifidi can be
anteriorly directed pressure. Each spinous lumbar spinal segments require treatment treated with the spine on a bit of flexion (i.e.
process should feel similarly firm and give that is directed toward facilitating contraction prone with one or even two pillows under the
slightly in an anterior direction as you press and strengthening/stiffening of the abdomen).
on it. multifidi. The erector spinae, serratus posterior
If a spinal segment is restricted in mobility, In either situation, the erector spinae and inferior, quadratus lumborum and oblique
the spinous process of that vertebra will feel quadratus lumborum usually have too much abdominal muscles usually require some
harder because the vertebra doesnt move tone, and need to be treated with classic attention. This can be done with a variety of
anteriorly when it is pressed upon. Clients massage movements. In clients who have conventional massage movements that cant
will often feel an ache or sharp pain when inhibited multifidi, this drop in tone of the be covered in this short article.
the segment that is restricted is pressed longer muscles makes training the multifidi The multifidi need to be scanned for
upon. easier to perform and more effective. In hypertonicity by exploring all along the two
You can further explore findings of clients with short multifidi, treating the sides of the spinous processes. Treatment
sensitivity and lack of motion by applying erectors and quadratus lumborum helps to can be through static contact, kneading or
anteriorly directed pressures over the facet alleviate the general high tone and myofascial sustained bowing of the muscle. When the
joints on either side of the spine. Over time, tone drops in a particular multifidus the
shortness in the area.
a clinician can develop sensitivity to the muscle can be stripped to lengthen it. These
quality of motion of the underlying facet Short and/or Hypertonic Multifidi stripping movements often lead your fingers
joints. Clients will often confirm which facet to the attachments of the multifidi across a
joint is most vulnerable as you palpate up hypomobile facet joint.
and down the spine. Facet joint hypomobilities can be treated
with a variety of joint mobilisations that we
Interventions
also will not be exploring in this article.
Inhibited Multifidi
An inhibited multifidus or a region of inhibited
multifidi need to be facilitated into contracting
and gradually strengthened. Ask the client
to swell the muscle up against the resistance
of your thumb and/or finger. Most people
cannot do this right away: thats why the
Figure 9: The multifidus attachments to the muscle is inhibited!
spinous processes can be stripped in a
sequential flowing fashion as you allow your Contraction of the multifidi is facilitated
thumbs and/or fingers to travel down the spine. by contraction of the transverses abdominus
Figure 8: The erector spinae are globally acting muscle. This can be taught by asking your
muscles that often have high tone and need to clients to draw their bellybuttons towards
be treated fully. This unloads the spine as a their spines when they exhale. If they recruit
whole and lessens the amount of noise in the
system, making if easier for clients to release their pelvic floor as if they are trying to stop
tension in other muscles as well as to sense a stream of urine, the multifidi are facilitated
contraction of the multifidi if they need to even more.
become aware of it!
I often have clients practice just the
Your treatment of the multifidi will depend transverses abdominus and pelvic floor
on what you have found during the recruitment on their own for a week or two,
assessment. before asking them during a treatment to
High toned and/or short multifidi require swell the multifidus at the same time as the
interventions to drop their tone, lengthening other two muscles.
Figure 10: The multifidis lock on the facet joint
movements and often some joint mobilisation can be reduced by lengthening the muscle fibers When the client does this properly, there
to help restore more normal movement of from spinous process attachment to the attach- is a feeling of increased fullness or turgor in
the related spinal segments. ment just past the margin of the facet joint.
the multifidus region close to the spine
Winter 2008 15
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