Further Technical Information Contraindications and Precautions

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Muscle Structure

Research has shown that the two major stability muscles of our lower back, Transversus Abdominis and Multifidus, are inhibited by pain. This means they stop working as effectively as they should.

Transversus abdominis is the deepest of four layers of abdominal muscles, which runs from the lumbar spine around to the front of the torso in a transverse direction.

It acts very much like a corset, holding the abdominal contents in, and providing support for the spine. It has been shown to have a very close relationship to the Multifidus muscles in the lower back.

Multifidus muscles are very short muscles running from the transverse processes (on the sides) of one vertebra up to the spinous process (the middle of the back) of the next vertebra upwards, and whose main function is stability. They do not produce a large range of movement, but work to produce small, “fine-tuning” postural movements, all day long.

These two muscles are assisted by internal oblique abdominal muscles, quadratus lumborum, latissimus dorsi, and gluteal muscles.

Here’s a big clue …

Research has shown that in people with no back problems, any movement of the arms or legs is preceded by contraction of Transversus Abdominis and Multifidus.

Which means they are the first muscles to contract, even before those of the arms and legs!  The explanation for this is that the brain is preparing the back for the increased loads and stresses involved in movement.

Conversely, in people with a history of pain in the lower back, this does not occur – Transversus Abdominis and Multifidus do not “brace” the spine before movement, therefore increasing the stress on the spinal segments and surrounding structures.
Furthermore, research has shown that Multifidus muscles decrease in size and change shape on the same side as the injury at one level only.

This is not spontaneously reversible after recovery from back pain, and puts further stress in the form of an unbalanced force on the spinal segment.

Similar effects of pain at higher levels of the spine are likely.

In the thoracic (chest) area, stabilisers are short, deep extensor muscles. It is an inherently more stable area due to the attachment of the rib cage.

Stabilisation of the shoulder girdle to the thoracic area relies on middle and lower trapezius muscles, as well as the rotator cuff (consisting of supraspinatus, infraspinatus, teres minor and subscapularis muscles) of the shoulder joint itself.
In the cervical (neck) area, stability is provided by deep extensors and flexors of the neck and head, as well as suboccipital muscles.

Muscles Used in the Better Back Program Exercises.

The primary muscles activated in all the exercises are the stability muscles of the spine and shoulders.

In the lower back:

• Transversus Abdominis
• Multifidus
• Assisted by Internal Obliques, Quadratus Lumborum, Latissimus Dorsi and Gluteal muscles.

In the upper back and shoulders:

• Deep extensor muscles of the spine
• Middle and lower Trapezius
• Rotator Cuff muscles of the shoulder.

In the neck:

• Sub-occipital muscles
• Deep flexors and extensors of the neck.

Secondary muscles activated are the “movement” muscle groups of the shoulder (flexors, extensors and abductors).

As noted in the Better Back Program manual, the exercise band can also be used to target specific muscles for strengthening, but this is not the primary focus of the Better Back Program.