Back Pain Exercises – The Posterior Muscle Group

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Welcome to the Back Pain Solutions Podcast – Back Pain Exercises. The Posterior Muscle group

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Introducing Back Pain Exercises. The Posterior Muscle Group

Whilst we need to think of the core muscles as an orchestra, the posterior group of muscles plays an important role in resisting shear movement of the spine, that is the movement of one vertebrae over the top of another anteriorly. It is an important muscle group in relation to back pain, and back health.

In this episode we introduce the muscles that contribute to spine stability posteriorly as well as discuss some of the smaller muscles that provide a proprioceptive function in the spine. That is to stay they help provide feedback on joint position, which provides feedback to the brain when joints are at their end range, and tissues are at risk of injury.

Not all muscles are created equal!

Not all of the muscles in the back contribute to movement, or resisting movement. The rotatores, and intertransversarii, play a proprioceptive (joint position) role in spine health. As some names suggest, and is often the case when we look at muscles in purely anatomical terms, these muscles were thought to help rotate the spine, or contribute to lateral bending of the spine. However, evidence demonstrates that very little activity is experienced in these muscles during movement. Research has shown that there are a greater percentage of muscle spindles throughout these muscles, than in many other muscles, which demonstrates the proprioceptive role they play.

The extensors, largely the longissimus and illiocostalis, are very long muscles that run along the back of the spine. These muscles can run across multiple segments of the spine, that is to say they cross a number of different vertebrae. The further they extend, the longer the lever arm, and the greater influence they have on movement. Some of the tendons of these muscles are very long, extending some distance, so in order to make them effective they are covered in a fibrous sheath of tissue to help anchor them down.

There is some debate about how we should train the posterior group of muscles. As the muscles are largely extensors, many therapists, or trainers, would incorporate exercises that introduce spine extension. A classic example of one such exercise is when lying face down we’re asked to extend the arms above the head and lift the legs off the floor. However, that introduces a lot of compression on the discs of the spine, which we want to avoid. Instead we want to train these muscles with a neutral spine. As always when we’re looking at spine stability these muscles should not be trained in isolation, we want to involve them in exercises that recruit additional muscles that contribute to the core.

Show Highlights Back Pain Exercises. The Posterior Muscle Group

As is often the case people are not training their core effectively but out of all of the muscles that contribute to the core it is the posterior group of muscles that are often neglected when people attend a gym. It is important to start to understand the exercises that can engage these muscles, which allows us to build the foundation for a much stronger back.

Interview Transcription for Back Pain Exercises. The Posterior Muscle Group

Ben James 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. Somewhere along the line, we’ve developed poor habits and become more vulnerable to back pain. Smart, strong features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better health. So join us as we demystify some of the commonly held beliefs about back pain. build your confidence, we’re stronger back the smart Welcome back to the smart stone podcast with me Ben James and a good friend and co host Jacob stay morning, Jacob. Good morning, man. So last time we taught abdominals and anterior abdominal wall today we’re talking about the posterior muscle group. There’s a lot of muscles involved here. Some of those we’re going to talk about and then on another episode, they’re a little bit more unique or shall we say separate to the muscles we want to focus on today which are the extensor so latissimus dorsi. So us and qL quadratus lumborum. We’re going to talk about in a different episode today with Focusing on the extensors and some of those smaller muscles, the rotor Tory’s into transverse area that offer appropriate perceptive and function within the spine and contribute perceptively to spine health. Again, we’re going to talk about some of the mistakes that we’re making or with it that we’re seeing with people trying to train these muscles or just not being aware of these muscles. And then we’re going to focus on some of those exercises that are important to train these muscles and how we should train these muscles effectively, what our goal should be with some of these muscles again, so we can be improving spine health, improving stability, and making sure we’ve got a resilient and strong back. So Jacob, where do we start so we introduce some of those smaller muscles first and talk about those and some of their mechanisms and the role that they play and then we move on to the the extensor specifically and talk exercises.

Jacob Steyn 1:55
Sure, the small ones you just mentioned already That are not really functioning as a primal spinal mover, but more as a what we call a transducer, something that tells the brain more of the position between vertebrae. Those are the rotatores. And the transversari. And originally when these muscles were dissected, the anatomist thought that they’re actually contributing to rotation and lateral bending of the spine. What we know now from looking at, like you said, looking at the actual function of these muscles, when they measured when we do rotate through the spine, or when we bend laterally, they’re actually not doing so much.

Ben James 2:45
Yeah, and there was a good study on the the rotatores is if you if you take the the right side because there’s rotatory is on left and right on the spine, very close to the spine, obviously, because they’re attached to the vertebra. But if you rotate Left, actually you see more activity in the road stories on the right, which suggests they’re reacting to that stretch. And therefore, like you say that there’s that that probe receptive that that joint position sense that feedback to the brain, about the spine movement rather than it contributing directly to the movement. And again, it’s back to that anatomical thinking of a lay attached to their to their and if they do that, then that means that they rotate the spine, hence the name.

Jacob Steyn 3:27
Exactly, no. And that’s a very clever system. Now, while there was another study quite a while ago already 80s or 90s, I think where they looked at the spindles in the muscle, and I think it’s something like on average between 4.5 to seven times more spindles in their auditories than in other back extensor muscles, which means they, they pick up a lot more what happens to them when they become stretched like you’re just like you just explained.

Ben James 3:58
Yeah, and just for the listeners, Those those spindles just briefly in terms of a definition there. Do you want to just touch on that? So people are aware?

Jacob Steyn 4:07
Yeah, those are just little organs, which picks up whether the muscles getting stretched and how much, okay, which then sends the information to the brain. And the brain then uses that information to either use other muscles or muscle groups to protect the area.

Ben James 4:26
So kind of a stretch reflex is effectively so muscles are stretching a bit too tight feedback to the brain, and then other muscles react to say, hang on a minute, we’re going to far as a layman’s terms to to make it easy for the listener.

Jacob Steyn 4:40
Yeah, yeah. So yeah, so I think those are the little muscles are, like really close to the spine, like we said, not really doing very much in terms of actually moving the spine. Well, then we have the second group that we mentioned, we’re going to talk about today and those are the extensors. Mainly Loneliness umas and alienvault starless Shall I just talk a little bit more? Go for it. So they are running quite close to each other. They are multi segmental, which means for the layman, they’re not crossing only one joint complex in terms of two vertebrae, but they actually run across multiple vertebrae, and some of them are multiple, multiple vertebrae. So they’re very long muscles along the spine. And so they have you know, that the more vertebrae they cross, the bigger lever arm they have, so the more influence they have on the extension.

Ben James 5:36
Yes, yeah. And when you look at some of the anatomical texts, and diagrams and pictures, again, some of these tendons, particularly from the middle of the back with a kind of thoracic region, they extend right the way down to the sacrum that the base of the spine if you like, so some of these tendons are very long. And therefore when we’re, when we’re extending, it’s important to mention the thoracolumbar fascia this again, this fibrous sheet of tissue, which is an important it’s not a muscle, obviously, but it’s an important structure here because it acts as a bit of a sleeve of what we call a retina killam around those tendons to, to help keep them close to the spine as it will close to the body. And in check, I guess.

Jacob Steyn 6:21
Are you talking about the thoracolumbar fascia now?

Ben James 6:24
Yes, yeah, just to add into that around you know, especially when you mentioned those tendons, because some of them are so long, they’re the kind of moment arm as if you were that that lever is very effective. But but they they have that potential I suppose to bow out without that retiniculum keeping them in check.

Jacob Steyn 6:43
Yes. So, just talk a little bit more about the retinaculum the thoracolumbar fascia versus a fibrous tissue quite spread out over the back of the back. And it’s offers a lot of protection, which means that actually gives a lot of stability, passive stability to the low back. Do you want to add to that then?

Ben James 7:09
Yeah, and again, I think back to, you know, we talked about not isolating these muscles, were isolating them on the podcasts to talk about them, but the the abdominal wall again, extend round and has joined with this thoracolumbar fascia as does latissimus dorsi. So I so again, it’s creating that, that barrel, but with particular reference to the extensor muscles, it acts as that retinaculum that sleeve as well. But like you say, it’s an important structure, when we’re looking at stability and function of these muscles, while not been a muscle itself.

Jacob Steyn 7:45
Yeah. So if we look at how we actually train these muscles, especially lower swimmers and local stars, there’s quite a bit of a controversy about how to train these muscles same as When we look at the anterior abdominal wall, which we talked about the previous episode. First of all, it’s safe to say that we we work with these muscles together with the rest of the muscles around the core in an orchestra, like we always do to try to make sure that every every muscle possible working together is actually offering more stability.

Ben James 8:25
Yeah, yeah.

Jacob Steyn 8:27
And so we, these muscles are called extensors, which means we’re, we’re bending the back backwards. And this is just to clarify, this is not bending through the hip. So we’re not using the glutes. This is we’re purely talking spinal extension. Yep. Right. So, so the general take on this is okay, let’s lie flat on the floor. Keep the arms and legs straight above our head and the leg straight out down and then raise the legs and raise the arms. And so now we’re bending through the low Back and now were working our extensors,

Ben James 9:02
So when we’re lying on our front there.

Jacob Steyn 9:04
Yeah, that’s what a lot of people would think that’s what we got to do to train these muscles. Yes. Yeah. And and then we’re actually, we’re doing a sort of reverse setup within our belly. And now we’re working these extensors, and I see, I see a lot of people doing this when I go to the gym. Luckily, not my gym, but other gyms. And so that’s actually something that we we don’t really encourage you to do.

Ben James 9:31
No, and what’s the reason for that? Again, presumably back to the compressive load on the spine, and that can create as one, one problem.

Jacob Steyn 9:40
Yeah, so so we know compressing the spine, top down in a neutral spine posture would be the most ideal and most safe way to do that. So that’s encouraging all the muscles around the barrel to do to do the job together, and so we create the stiffness which is obviously creating a lot of compression, but in a safe way. Yeah. compared to if we do this often called Superman exercise lying on your tummy on the floor raising your your legs and arms are actually compressing the disc at the back. Yeah, the back, the back part of the spine is getting compressed more. And we’re we’re not working stability. We’re not working with stiffness.

Ben James 10:25
Yes. Yeah. And again, you know, we’ve we kind of advise the exercise particularly for patients or specifically for patients suffering from disc herniation aggravation that that line on the front. And a relaxation exercise to extend backwards is is a good exercise for relief. But what we’re saying is, again, back to not training that that specific spine movement, as in trying to train those muscles into extension of the spine. We’re saying, keep that neutral spot posture because again, We can train those muscles effectively, particularly insurance, which is what we’re aiming for. In that neutral posture. Again, it’s back to that isometric non contractile stressor of the muscles as opposed to, we must shorten that muscle and create movement to exercise that muscle.

Jacob Steyn 11:20
Exactly. And a good example is doing a deadlift. It’s just explaining exactly what you were mentioning. Now, there’s ideally no extension through the low back. The extension comes from the hips. So we’re locking down the shoulders on the hips. We’re tightening the barrel around the core, the abdomen, and so we keep the back stiff. And obviously the depending on the way that you’re picking up the extensor muscles that we’re mentioning now, they’re going to work very hard, but we want to use the rest of the muscles around the barrel to maintain this neutral spine. So we don’t lose we don’t lose this neutral spine. So we go into extension of the back like we quite often see with a deadlift, which now means that we get unwanted directional forces going through the the discs. And, and this will this will cause further problems, maybe another part as well.

Ben James 12:15
Yeah so so kind of back to where we focused a lot about keeping the neutral spine and avoid inflection when we’re doing things like deadlifts or exercises in general. And the same rule applies in terms of the risk to anatomy of the spine. If we were to do the reverse, as in do a deadlift, but then kind of almost throw that back into extension as it were. So still breaking from neutral, but in the opposite direction.

Jacob Steyn 12:42
Exactly. And, exactly, you know, I’m not gonna elaborate on it too much, but that goes if we look a little bit broader, it goes into the maybe not strong enough glutes, so we were taking more work. We were getting more work from the back extensors. Maybe tights house pulling their pelvis forward, weak abdominal wall on the front, which means we’re giving again more work to the extensors. So they all it all goes together. And what we see quite often is if you know young guys going too quick, they’re building up the deadlift too quick, going too fast and giving too much work and, you know, in a couple of months to the extensors, yeah, they they’re not creating strength in a balanced way.

Ben James 13:29
No. And what you often see is that with those guys is they kind of get a bit too enthusiastic and they’re trying to use momentum, so that the weights too heavy, so they kind of almost throw the backup and extend to get the to get the weight off the floor rather than focus on let’s lighten the load. Let’s look at technique and let’s move from the hips. And that’s why you see, you know, there’s there’s the risk of muscle strain ligament damage if you throw in that back into extension to try and lift the way

Jacob Steyn 14:00
Exactly and I want to add to this, what I typically see in our gym is the person that comes twice a week to do CrossFit and may do lifting twice a week, they are less likely to get injured because they have five days of the week to recover. But you’re not that I’m justifying it. But you’ve got your other more enthusiastic athlete who comes for 4 5 times a week, they have less time to recover going into the same movement quicker onto each other, you know, not taking a lot of rest between training sessions. Yeah. And that’s when we start seeing you know, backache and, and other problems leading from that onwards.

Ben James 14:44
Yeah. And just back to kind of exercise in general. Do you find that? A lot of people you see, when you’re talking about exercises, they often say, Yeah, I do sit ups and I train that anterior abdominal wall in the back, the lower back is over. Did you know I’ve got a friend at the moment that I’m working with on, on his recurring back issues? He’s a, he’s well trained. So again, he’s one of these guys. You’d think he’s athletic, he’s training, he’s strong. But he openly admits he does nothing in terms of training for his lower back in terms of endurance or anything. Absolutely nothing. It just seems to be an area of muscle. And a group of muscles that is is overlooked and not considered at all somehow.

Jacob Steyn 15:26
Yeah. Yeah, of course. Yeah. No, you’re right. What I you know, if I shall I mentioned a good exercise I think we can offense for the backers, the Sorenson hold. The Sorenson hold is usually done with a CrossFit GHD machine, and that’s where you sometimes called the Roman chair. It’s where you have your feet underneath, you have your feet hooked in underneath a couple of cushions. You have a couple of questions on your thighs. With your belly facing the floor, then you straighten your body straight out from heel to head. And you just simply hold it horizontal for 20 30 seconds. So we’re not moving up and down bending through the hips, we’re just holding it still for 20 30 seconds. But the danger here is that you know, we’re going to we’re going to lose the low back going into hollow low back position, which means the low back muscles the extensors are going to take over instead of actually squeezing the glutes, almost twisting the hips a little bit forward. So you know flattening out your low back not too much. Obviously, you don’t want to lose the lumbar curve and the neutral but if you can maintain that position for a while, it’s a great exercise for low back.

Ben James 16:48
Yeah, I know it’s an it’s an exercise. He you were showing me when I was out in in Holland training not too long ago and the focus was very much on the on the glutes. Do you think it’s an exercise here? That Is this a good beginner exercise? Or should we should we be really introducing this further down the line because again, a lot of people that I’ve seen doing a similar exercise in the local gym where I’m at, are, are moving through the back, they’re not focused, they’ve got the, the equipment positioned in the wrong way. So then they’re kind of almost introducing flexion down and then extension back from the spine rather than from the hips, and also is one of those that can put a lot of, again, a lot of compressive load through the spine. So if there’s someone that does have particularly painful back, again, we’re saying, you know, maybe maybe there’s something easier to do before this exercise you think?

Jacob Steyn 17:43
Yeah, absolutely. It’s, it’s, you know, it’s not an exercise that you can only do when you’re an advanced athlete simply because the Sorenson hold is not it’s not you’re not bending to the hips, you’re just holding it still, which means that makes it relatively safe if your technique is good and suggest you look at the videos and the programs we offer. Where we actually explained this very well make sure you do it the safe way. Yeah, but the it’s definitely not a starting point I, you know, something like the bird dog on hands and knees where you have the opposite arm and leg stretched and stretched out in front of you, and then hold it for 10 seconds. That’s already working the extensors a hell of a lot. Yeah, actually, if you if you if you’re you have an injured back then I prefer you starting with something like that, for example.

Ben James 18:32
Yeah. And again, it’s trying to it’s trying to move is trying to keep that pelvis and those shoulders working as a unit or or more stationary, really extending and you want to see these glutes move first or fire first, but then it’s still going to have an impact on that low back and those extensors like you say.

Jacob Steyn 18:51
Yeah, absolutely. So yeah, I think there’s a lot of exercise that we can look at. Yeah, but I think that what I mean the main message is that we understand that like you mentioned before the people neglect training the extensors and quite often if they do try next so they over over train the extensors.

Ben James 19:14
Yes with, and what you find is, yeah those exercises like the deadlift, and that we know a very very good if if if our technique is very good, they’re fantastic for lower back training and conditioning. But a lot of these muscles, like you say multi segmental but they’re quite, they’re quite small compared to some of the other pectorals and Latin people will often go to something like a deadlift first, rather than taking it back and doing exercises like the bird dog to condition and start to learn to control these muscles and fire these muscles properly and build that endurance because again, we’re looking for more endurance These muscles than we are powerful strength as it were.

Jacob Steyn 20:05
Yes, and I think we can safely say that the starting point is always finding the neutral spine. And you know, having, for example, the hip hinge with a Dell stick in the back, making sure that you can maintain the neutral spine when you bend over. So you don’t only give them the work to the extensor muscles, or in worst case scenario, flex fully through the low back where you lose the function of the extensor muscles. Yes, and then from there, you build it up. So you know, we want to make sure you have this this engram this motor pattern, this understanding in your brain in a subconscious way, where you maintain this position, when you give the work to the low back, which is so necessary and crucial for not only getting injured but also building strength. Yeah, because if you if you don’t do that you you will reach the ceiling much sooner than you want to in terms of either building strength. or the amount of weight you’re lifting off the ground? So I think that’s a very good point. And I think that if you, as a listener understand that, it’s not about how quickly and how many weeks I can get to lift how much weight off the floor, it’s actually, this is a much, much bigger challenge for you guys. It’s actually how much can I stick with my, my, my, my, my posture and my technique. And if I do that, actually over a longer time, I’m limiting the risk of injury and I will eventually be a lot stronger. And I will have a lot more enjoyment in what is what could be looked at as a very complex movement like the deadlift.

Ben James 21:45
Yeah, yeah, absolutely. And kind of back to your point, which you alluded to, and I know we’ve discussed in a previous podcast, but back to the kind of line of drive and the function of these muscles. In particularly with the deadlift. If you look at the research The one of the functions of these muscles, the extensor muscles, is to resist that anterior shear so vertebra to slide forward on one another. And if you’re in a neutral spine and doing a deadlift, the the angle of the fibers posterior is around 45 degrees in there, they’re helping to pull those vertebrae back. If you lose that neutral spine and go into flexion. And again, we always talk about drifting into flexing and avoiding it, the liner driver, those muscles changes, and they’re much more parallel in line with the spine contributing to compression, and not resisting that shear force or that sheer movement. So if you then go and lift a heavy load, your serious risk of damage to those structures in the spine because, again, you’re not helping the body help you by getting that posture right. And I think again, we reiterate, it’s all about Keeping that neutral spine and in keeping that neutral spine, and exercising, by putting stress through the muscles without them contracting and changing length isometrically still has a huge impact on building endurance and strength. More so than a lot of people would think that I’ve got to move those joints, I’ve got to move those muscles to, to create strength. And I’ve got to use a lot of weight through those muscles to get any size or bulk. We’ve got to look at our end goal as always, and say, Well, why am I training these muscles? What am I trying to achieve? And really, the focus should be improving that endurance, keeping that spine neutral. And over time, like you say, you’re going to have a much more effective technique and you’re going to be able to lift a lot heavier loads and challenge yourself a lot more. If you train those patterns and movement patterns well initially.

Jacob Steyn 23:59
Exactly. Exactly.

Ben James 24:01
And just in just, again, for the listeners, we talked about extensors, I know we’re coming up towards the end of the podcast again, but we talked about training these muscles. We’ve talked about how people are often ignoring these muscles, it is a group that they ignore. But just for those people that have suffered back pain, what you often see is when they’re in a standing position, they’re often leaning a little bit forward, and they’re almost activating those extensor muscles, constantly. And that’s something else we want to try and avoid. Because if you, you can, you can put your your hand on your back on your lower back as you’re standing and kind of lean forward and back. And as you lean back, you kind of can feel them switch off. And that’s something again, that we try and get people to be aware of, isn’t it in terms of, you know, those muscles being constantly under contraction?

Jacob Steyn 24:55
Exactly, yeah, no, that’s a very good point. I’m glad you brought that up, Ben. I termed that the the Russian soldier technique. I tell my patients, let’s, let’s learn the Russian soldier. Basically, they look at me, they look at me crazy, you know, they look at me like I’m crazy. And so, what I do with my patients is I just get them to widen the feet a little bit, which means that the pelvis relaxes, you know, at the hip joints. And then I get them to put their hands, their hands on top of each other like a soldier behind their back behind the behind the hips, holding the hands basically. And then I get them to lean into the hips, so not doing any lumbar or low back extension, not bending through the back, but actually leaning into the hips so they push the hips forward, and so the shoulders are a little bit backwards compared to the hips. And then the, like you said the low back muscles, just turn off contract. lately and I make them feel this on my low back, how when I have my hands in front of me and I just stand up straight, my low back muscles are on. And if I put my hands behind my back and I just lean into my hips a little bit, how they turn off completely, you know, from hard to completely soft and light. So when they feel this and see this, they go, Oh, wow. Okay, yeah, now my back now My back is completely relaxed. And if they have a little bit of a tight muscle, quite often when I do this, they go, yeah, now, I feel it that’s completely off. And if you explain that concept to them that having the muscles turned on all day means a lot more compression throughout the day of maybe an injured disc. And, you know, if you just go into that posture in that position, you take the pressure off the back, then maybe half of the day, you’re able to to have a lot less pressure through the injured desk.

Ben James 26:55
Yeah, and obviously the muscle tension as well as it is another thing because having those muscles detention all day in itself can become uncomfortable if you know if you find in that you’re standing for long periods, and this is something definitely to be to try and be aware of. As always, the advice is, well what’s the best posture, a variable posture. So if you’re standing for however many hours a day, then you need to be giving yourself that opportunity to sit every half hour and, and rest. And and the converse is if you’re sat on a standard every half hour and giving yourself a break, it’s got to be an awareness and a habit that you get into. But when you’re in those different postures, just be aware of those extensor muscles on the low back. And as we say, you can put your hand very easily on the low back and feel those muscles switch on and switch off. And being aware of that helps you to just switch them off a little bit and take that tension out the muscle and take that compression out the spine. Particularly if you’re you’re suffering from back pain, but as always refer to the show notes will have a video on that because I think that’s That’s something that’s quite important. It’s something that’s very easy for people to do and start to adopt as part of their daily routine, as well as some of the guidance on some of these exercises and what we want to be focusing on for those extensor muscles. So, as always, refer to the show notes, jump over to the to the website, because we’ve got a lot of information on there to to help you visualize and see some of these exercises in conjunction with the information that we talked about on the podcast because we appreciate with some of the discussion points is always nice to have the the video support or illustrative support to better visualize and understand some of these concepts. So thanks again, Jacob. I think it’s it’s been another good episode talking about these these posterior group of muscles and yes, we are talking about them in separation to other muscles. just for ease of listening and to introduce The importance of these two groups. But as we keep referring to, it’s an orchestra, we need to work these muscles together and as a as a unit. And that’s how, and why some of the exercises that we talked about are so effective because they are making these muscles work together. And next time we’re going to talk about the latissimus door side. That’s a muscle that that people know very well and like to train to give themselves that V shape. But we’re going to talk about why that’s so important for back health, along with some of those other muscles we introduced at the beginning the associate QL. So listen in next time for some important discussion points on those. And as always, head over to iTunes, give us some feedback. Give us a rating and that will help share the information with others that that need that advice. So thanks again for listening, guys. Thanks, Jacob. And we’ll speak again soon.

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