Back pain is the second most common reason for people to go to the doctor's office and the third most common reason for surgery. This is due to the fact that 60% will have a reoccurrence of low back pain within a year and 45% will experience a painful reoccurrence within 4 years (Liebenson et al 1996).
A major reason why back pain reoccurs is because the multifidus muscle does not spontaneously get better after a painful episode. Scans have shown fatty deposits in the multifidus muscle associated with the painful side and spinal level (Parkkola 1996).
Many people have never heard of the multifidus muscles but the multifidus muscles are a series of paired muscular bands that run the length of the spine. Each multifidus starts at the spinous processes of a vertebra and descend 1-3 spinal segments.
The multifidus muscles are deep stabilizers of the spine resisting shear forces and are active during lifting of an arm or a leg or while extending the spine. The multifidus muscles are postural meaning they are activated with low load and exhibit endurance over powerful movements.
Because of the postural nature of the multifidus muscles adding a five second hold at the end range of certain exercises has been shown to increase the size of the multifidus muscles in people that have been suffering from chronic pain (Danneels 2003).
One of the exercises done in the research study by Danneels (2003) was to hinge over a table (holding onto the sides of the table with the hands) and then lift both legs as high as possible, hold the position for 5 seconds. The goal is to work up to doing 3 sets of 15 repetitions and then to add weight.
You can mimic this exercise by doing double leg extension over an arc barrel, a BOSU or as pictured over the Hooked on Pilates MINIMAX. The MINIMAX comes with adjustable resistance straps so adding resistance is as simple as placing your feet into the loops!