We load squats and deadlifts for core strength, but multifidus training plays by different rules.
After a back injury, many people return to lifting once pain fades. It makes sense—rebuild strength, regain stability. But research shows that one key spinal muscle, the lumbar multifidus, doesn’t always recover on its own.
The multifidus is a deep stabilizing muscle that helps control small spinal movements. When back pain strikes, it can weaken and “switch off,” even after pain improves. Without retraining, that loss of control can persist, increasing the risk of future injury.
The Hidden Problem After Back Pain
The lumbar multifidus is built for fine control, not heavy lifting. It keeps your spine steady while larger muscles move your body. After an episode of back pain, this muscle can shrink or lose coordination within just a few days (Zhang et al., 2018).
Standard strength work—like squats and deadlifts—builds global power but doesn’t necessarily restore the multifidus’ timing and segmental coordination. Those lifts rely mainly on large superficial muscles, not the deep stabilizers that guide intervertebral motion.
Why Strength Alone Isn’t the Whole Answer
Several studies indicate that common “core” or compound lifts don’t always produce selective multifidus recruitment. Gentle exercises such as bridges and bird-dogs often produce greater relative multifidus activity than sitting or unsupported positions (Okubo et al., 2010; Kelly et al., 2016). Heavy lifts like squats and deadlifts tend to load the erector spinae and hip extensors more than the deep stabilizers (Liang et al., 2019).
Research Nuance: What About Heavy Lifting?
A 2017 study in Spine compared two programs for people with back pain:
- Low-load motor control training
- High-load deadlift-based training
Both groups showed increased multifidus muscle thickness on the smaller side, reducing asymmetry and improving spinal muscle balance. The changes occurred regardless of load, as long as the exercises emphasized proper spinal alignment and control (Berglund et al., 2017).
This means heavy lifting can stimulate multifidus adaptation—but only when the movement is controlled, aligned, and technically sound. Early-phase rehab focuses on control; later, high-load lifting reinforces that control under real-world demands.
However, restoring timing and anticipatory control of the multifidus usually requires specific retraining. You can restore muscle size without necessarily restoring precise neuromuscular control. Clinically, both structure and coordination must work together for durable spinal stability.
When Specific Multifidus Training Is Needed
Targeted retraining becomes valuable when the multifidus has lost independent activation — common in:
- Recurrent or chronic low back pain
- Imaging or palpation evidence of multifidus atrophy
- Poor motor control or inability to voluntarily contract the muscle
- Early-phase rehab after back injury before heavy loading resumes
Multifidus atrophy can occur within 24–48 hours of injury (Zhang et al., 2018). If not retrained, it often remains inhibited despite resolution of pain.
Multifidus Training in Practice
Multifidus training focuses on restoring control and coordination, not just muscle size.
Early work often uses gentle, low-load contractions to re-establish the brain–muscle connection. Progression then adds movement and eventually load once control is consistent.
Walking, especially uphill or backward, helps maintain low-level activation (Lee et al., 2014), but walking alone is insufficient for full rehabilitation if timing and segmental control are impaired.
From Back Injury to Barbell
A safe, evidence-based progression connects motor control to performance:
- Restore control: Re-establish anticipatory multifidus activation and segmental stability.
- Build endurance: Sustain low-level activation during functional tasks.
- Add load with alignment: Integrate strength work while maintaining spinal alignment so load reinforces stability.
This sequence ensures that load-based hypertrophy (which the Spine study showed is possible) translates into functional spinal stability, not just muscle size.
The Takeaway
Deadlifts build global strength. Multifidus training builds local control. Both matter — but they are not interchangeable.
Under the right conditions, heavy lifting can increase multifidus thickness; however, restoring the muscle’s timing and coordination usually requires targeted motor-control work first. Precision first. Power later.
Ready to rebuild your back strength the right way?
References
- Berglund, L., Aasa, B., Michaelson, P., & Aasa, U. (2017). Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness: A randomized controlled trial. Spine, 42(15), E876–E882.
- Fritz, J. M., et al. (2021). Optimization of spinal manipulative therapy protocols. The Journal of Pain, 22(6), 655–668.
- Okubo, Y., et al. (2010). Electromyographic analysis of transversus abdominis and lumbar multifidus muscles. JOSPT, 40(4), 198–204.
- Kelly, J., et al. (2016). Comparison of electromyographic activities of lumbar iliocostalis and multifidus muscles. Journal of Physical Therapy Science, 28(10), 2856–2860.
- Liang, M. Y., et al. (2019). Trunk muscle behaviours during stoop and squat lifting. PeerJ, 7, e18797.
- Lee, H. S., et al. (2014). Facilitating effects of fast and slope walking on paraspinal muscles. Annals of Rehabilitation Medicine, 38(4), 514–521.
- Zhang, S., et al. (2018). Functional and morphological changes in the deep fibers of lumbar multifidus. Scientific Reports, 8, 14484.