Our body is comprised of over 600 hundred muscles that all have to work in a coordinated fashion to ensure we are able to move well without pain. Very commonly these muscles don’t work as well after injury and our bodies never learn how to use those muscles properly until they are re-trained. This situation occurs after a low back injury and can lead to continual problems in the future.
There are 2 primary types of skeletal muscles; Type 1 and Type 2. They play a different role in movement based on their attachments as well as how the cells work. Type 1 fibers are endurance muscles that are designed to hold contractions for longer periods of time, making them resistant to fatigue. Type 2 muscles are big powerful muscles that work for short periods of time to generate force. In the spine we have those types of muscles present and how they work may determine whether or not we can perform activities we like.
The 2 main deep muscles are the transversus abdominis and multifidus muscles are endurance muscles designed to provide stability . When people hear the term “core stabilization” commonly they are referring to exercises that target the 6-pack muscles.
In patients without back pain these deep endurance muscles will contract before your arms and legs move to ensure a stability during movements. In patients that have an injury, these muscles do not fire in that pattern. You in essence could have a back injury years ago and these muscles and movement patterns have never recovered.
While this concept seems very straight forward, it is by far more complex than described above. How our body reacts to chronic pain after an injury has healed has a different mechanism of pain. There is some conflicting evidence as to whether or not exercises targeting these muscles provides more improvement than a general exercise program. This is why advice regarding these exercises is general and a more specific individualized evaluation by a physical therapist may be warranted. If you would like to learn more about this topic, keep your eyes open for an upcoming seminar at Specialized PT in Candler this summer.