Physical Therapy Continuing Education: Spinal Stabilization – Is It All About Transverse Abdominus?
In more recent times, physical therapy continuing education courses focusing on training the muscles of the spine have placed a huge emphasis on Transverse Abdominius. There are differing views on the importance of this muscle.
We recently interview a spine rehab expert to get his thoughts. This is what he said.
Interviewer: Well, if we talk a little more specifically about your work, can you describe your research findings on the roles of the different muscles in spine stabilization?
Spine Rehab Expert: I knew we had to get to that one. Well, you know, we’ve heard so much about muscles like how important it is to correct transverse abdominis pathology, and the multifidus is so important and whatnot. I think there’s really a disconnect between the science and clinical practice. These muscles are no more important than any other muscles. I’ve already mentioned a couple of minutes ago that if you don’t have quadratus lumborum you can’t walk, and yet in the clinical discussion you never hear, well, very rarely would you hear a clinician talk about QL.
If you’re going to carry an object, if you’re going to plant a foot on the soccer pitch or the football field and change direction and run, if your pelvis collapses on the swing way side you’ll be a very ineffective sportsman and you’ll load up your back. So, there’s an example where quadratus lumborum is absolutely crucial.
For lifting, when you go to Russia and you study their lifting culture, they put huge emphasis on latissimus dorsi. Very rarely do I hear lifters in North America, when they’re pulling a bar, trying to bend the bar, external rotate through the shoulders and pull with latissimus dorsi, strapping and stiffening their back down to the sacrum, for example.
The role of the gluteal complex is enormous for hip extension, and particularly those who have back problems. We know those muscles tend, not in all but in a lot of people, tend to get inhibited.
So, the answer to the question is all of the muscles are important when it comes to spinal stability. They form a guide wire system that allows the spine to bear tremendous loads. It allows the spine to store and recover elastic energy when they’re throwing an object or kicking or punching, for example. Or it might be just to simply pick your groceries out of the back of the car. So, all muscles are important. How they play together is crucial. You have to recognize these patterns, measure it, and train it appropriately. But, this emphasis on single muscles, well, I think that’s dying out now as you probably have detected as you go to different meetings.
Interviewer: Right. So, just to clarify on that, we know that the transverse abdominis, for example, is not the whole answer to spinal stability. Some research –
Spine Rehab Expert: It is probably one of the most minor muscles, mind you.