This installment of the Building Bigger Stronger Muscle
Series is going to focus on the bigger, major muscles.
There are many other muscles in the back and hip that we
need to be concerned about, particularly in regard to
the care and prevention of low back pain and disorders
that plague the American population. I will save those
muscles and issues for a future installment of FITBITs.
Muscle:
Erector Spinae. The erector spinae
is actually a large group of muscles: the
iliocostales cervicis, lumborum and thoracis;
the longissimus capitis, cervicis and thoracis;
and the spinalis capitis, cervicus and thoracis.
Origins:
The large grouping of erector
spinae muscles have origins beginning at the
lumbodorsal fascia (this is a tough, fiberous
membrane of the lower back and hip). The
lumbodorsal fascia has its origin at the lumbar
vertebrae, posterior surface of the sacrum and
the posterior iliac crest. The lumbar vertebrae
are the bottom 5 vertebrae, the sacrum is the
beginning of the “tail bone” (the sacrum and
coccyx form the “tail bone”, the coccyx at the
very bottom), and the posterior iliac crest is
the backside of your hipbone. The other muscles
have origins that continue upward along the
vertebrae and medial ribs and continue upward to
the top ribs and cervical vertebrae four.
Insertions:
The large grouping of
erector spinae muscles have insertions that run
up the entire rib cage, vertebrae and into the
skull.
Function:
The erector spinae extends the
trunk. Contracting one side of the erector
spinae assists in lateral lumbar flexion. The
most recent EMG studies indicate that the
erector spinae does not operate in the
agonist-antagonist relationship the way other
muscles perform. In the agonist-antagonist
relationship the antagonist always acts as
stabilizer during agonist flexion. EMG studies
however, show there is no activity of the
erector spinae in full lumbar flexion. Keep this
is mind when you have reason to have your
athlete completely relax the exector spinae,
full flexion of the trunk causes the erector
spinae to relax.
Muscle:
Quadratus lumborum
Origin:
At the posterior crest of the
iluim (back side of your hip bone, runs from the
lateral edge of the sacrum, across the top of
the iluim to the lateral edge of the iluim (hip
bone).
Insertion:
At the transverse processes
of the five lumbar vertebrae
(L-1 through L-5)
and into the inferior edge of the twelfth rib.
The transverse process refers to the lateral
protrusion of the vertebrae and the inferior
edge of the 12th
rib refers to the very bottom of the very most
bottom rib located in the back.
Function:
The quadratus lumborum extends
and can hyperextend the spine. When one side of
the quadratus lumborum contracts it can cause
lateral flexion. If the upper torso is fixed on
its side it can lift the legs. Conversely, if
the pelvis is fixed on one side it can lift the
torso. The quadratus lomborum helps supports the
pelvis and the lumbar spine.
Muscle:
Piriformis
Origin:
At the concave, lateral edge at
the base of the sacrum and the inside surfaces
of the pubis and ischium (lower portion of the
inominate or hip bone).
Insertion:
At the inside surface of the
greater trochanter (the thick process (knob) a
the top upper end of the femur (thigh bone).
Function:
This is a small muscle in the
hip that holds the femur into the acetabulum
(the depression on the lateral surface of the
innominate bone - {hip bone} that provides the
socket into which the head of the femur fits).
The piriformis helps to outwardly rotate the
leg. The piriformis is notable, not because of
its size or function, but because of how often
it is injured during strength training, sports
and/or exercise. The piriformis is a small, deep
muscle in the hip that can easily be over
trained, injured and inflamed. Unfortunately,
because of it’s close proximity to the sciatic
nerve, inflammation of the piriformis, will
cause pain to radiate down the length of nerve
into the legs, due to the muscle inflammation
causing friction along the nerve. This can be
extremely painful and debilitating. Trainers
should use extreme caution when an athlete
complains of deep hip pain, with radiating pain
going down the back of the thigh.
Muscle:
Gluteus Maximus
Origin:
At the posterior gluteal line of
the ilium (rear medial part of hip bone),
posterior iliac crest (rear part of the hip bone
as it curves downward), lateral posterior sacrum
and sacrotuberous ligament (along the lateral
edge of the tail bone).
Insertion:
At the gluteal tuberosity of
the femur (top part of the thigh bone) and the
iliotibial band of the tensor fascia latae (T.F.L.
is a short muscle that originates below the
lateral crest of the hip bone and inserts into
the iliotibial band (IT band is a tendon that
runs from the top of the thigh bone, along the
entire length of the thigh bone and inserts into
the outside of the tibia).
Function:
The gluteus maximus is the
strongest and largest muscle in the body (at
least on J-LO). The gluteus maximus is a very
powerful extensor and outward rotator of the
leg. It aids in abduction of the thigh, but the
lower fibers also adduct the leg. The muscle
maximally contracts during walking with long
strides; this makes the walking lunges and the
wide stance single leg squat popular exercises.
Muscle:
Gluteus Medius
Origin:
At the lateral, upper surface of
the iluim, (upper, side of the hip bone), above
the gluteus minimus.
Insertion:
At the lateral and superior
surface of the greater trochanter of the femur.
Function:
The gluteus medius works in
conjunction with the gluteus minimus to abductor
the leg. Since it is considerably bigger and
stronger than the minimus, it is the primary
abductor of the femur and assists in medial
rotation of the thigh.
Muscle:
Psoas Major
Origin:
At the transverse processes of
L-1 through L-5 (Lumbar Vertebrae 1 through 5)
and the bodies and discs between them.
Insertion:
At the lesser trochanter of
the femur and the shaft just below the lesser
trochanter (medial (inside) the thighbone, just
below the top.
Function:
The psoas major is the larger
of the two psoas muscles (the other is the psoas
minor) and it flexes the leg (as in the leg
raise). It can also flex the torso on the pelvis
when the legs are held down as in the
traditional (BUT CONTRAINDICATED) SIT-UP.
Muscle:
Tensor Fascia Latae
Origin:
At the anterior, lateral surface
of the ilium below the anterior iliac crest and
posterior to the anterior iliac spine (below the
most lateral part of the hip bone).
Inserts:
At the iliotibial band that
travels the lateral thigh and itself inserts
into the lateral patellar retinaculum and
lateral tibia (below the knee, to the outside of
the shin bone).
Function:
The tensor fascia latae
assists the gluteus medius and minimus in thigh
abduction, thigh flexion and medial rotation.
Indication of Weakness
Test for weakness in the erector spinae group by using
the “Biering-Sorense Position”. You have your athlete
extend their upper body, face-down, countilevered out
from the end of a bench/massage table/etc. The athlete’s
waist is at the edge of the bench and you secure their
pelvis, knees and hips (this can easily be by you
strapping their feet down or holding their legs down.
You can substitute a Roman chair, but observe carefully
for failure of the erector spinae, not the hips or
hamstrings). The athlete holds their arms folded, across
their chest, with the hands resting on the opposite
shoulders. The test is complete when failure occurs
(when the athlete’s upper body drops from the horizontal
position).
Normative data for this test was collected from young,
healthy individuals with an average age of 21. Men held
position for 161 seconds and woman for 185 seconds (men
have heavier upper bodies - just in case your
wondering).
Obviously, weakness in the erector spinae decreases
lumbar extension strength. Lack of strength leads to
instability of the lumbar vertebrae. Instability leads
to injury and pain. Overuse - chronic contraction of the
erector spinae, from continuous standing, walking or
lifting can cause spinal curvature of the lumbar spine,
potentially creating pain in the facet joints. Therefore,
it is critical to determine if the erector spinae is
weak and needs strengthening or it is over used and
needs flexibility to increase ROM.
Weak hamstrings can cause many back problems.
Particularly in women, who often have weak hamstrings.
Weak hamstrings can increase hypertonicity in the
erector spinae, because the weak hamstring allows the
ilia to rotate anteriorly, increasing the lumbardic
curve. This can cause lordosis (excessive arch in the
lower back, picture a female gymnast walking with an
excessive lower back arch and her gluteals poked-out).
This lordosis can cause jamming of the lumbar facet
joints and excruciating pain.
Weakness in the quadratus lumborum can cause muscle
spasms during lumbar flexion (any crunch type movement).
Shortening of the quadratus lumborum can also create a
jamming of the facet joints. Extensor test is also an
indicator of the quadratus lumborum.
Caution:
The ‘weight lifters arch” is
the proper biomechanical position for both
squats and dealifts, but if your athlete
presents “lordosis” be extremely careful.
Lordosis and/or inflammation in the facet joints
can make any squat or deadlift type movement
extremely painful.
Weakness of the gluteus maximus make any squat or
deadlift type movement very difficult. In case of a very
deconditioned gluteus maximus the patient may have
difficulty rising out of a chair and will need their
hands to push off the armrests to get up. It may also
cause lateral knee instability when the knee is loaded
during squats or dead lifts. Failure to keep the knees
tracking over the toes requires you to decrease the
load. If necessary use less than body weight by using a
Vortex Machine or similar (CLICK
TO VIEW). If the gluteus maximus become
shortened or hypertonic, this can also cause lordosis.
If it is hypertonic on one side, it may present as
scoliosis on the affected side. Test for both strength
and flexibility (with ROM tests) to determine if
strength training and/or flexibility training will be
the best remedy for your athlete.
Weakness in the gluteus medius will present as decreased
leg abduction strength and pain in the gluteus medius
when doing any squatting type activities on the affected
side. Performing a standing a posture exam will reveal
that the ilium is higher on the affected side. You can
use an Alignabod to help you perform an accurate posture
assessment.
Weakness in the psoas will cause instability in the
lumbar spine and may cause pain in and around the
inguinal ligament (groin area). If the psoas is weak on
one side only, walking stride will be shortened on the
affected side.
Hypertonicity in the psoas can also result in lordosis.
The psoas major and minor are grouped with the iliacus
and called the iliopsoas group. Hypertonicity can be
caused by athletes doing the old, traditional
(contra-indicated) “sit-up with feet anchored”; the old
fashioned sit-up with the feet anchored causes a pattern
called the “flexor synergy”. The flexor synergy
contracts the tibialis in the shin, the rectus femoris
in the thigh and the iliopsoas in the pelvis. This can
overdevelop and tighten the iliopsoas causing lordosis
and the resulting hyperextension on the spine, leading
to lower back pain and resulting injury. Flexibility
training can remedy this problem. This is what causes
lordosis in gymnasts.
Weakness in the tensor fasciac latae can cause pain in
the lateral hip (the origin point and/or the lateral
knee area (the insertion point). Weakness can decrease
lateral knee support during flexion (as in any squatting
type movement or running). This combination of hip and
knee dysfunctions is commonly referred to as “snapping
hip syndrome”, “IT back syndrome” or “Iliotibial back
syndrome”. Flexibility training and strength training
can remedy this problem.
Optimum Training Principles
The power clean is argueably one of the best exercises
for the lower back and hips. Unfortunately, it is a
fast, explosive, high-intensity exercise that requires
the athlete to be both an experienced strength trainer
and well conditioned.
Another, less explosive exercise that should be a main
stay for conditioning the low back and hips is the
deadlift. The biomechanically correct technique for the
deadlift should be used by everyone, every time they
lift an object off the floor. Improper lifting mechanics
can lead to serious injury for anyone with even
relatively minor back and hip dysfunction.
The deadlift uses most of the muscles in the back, hips
and thighs, with the erector spinae being very highly
active. Use extreme caution and great attention to
detail for anyone with any level of back dysfunction.
For details on correct technique, refer to the IFPA
Personal Fitness Trainer Certification Manual; The
Book on Personal Training, 2006 by Doctors Jim Bell,
PhD and Karl Dauphinais, M.D. and Robert Simons, PhD and
Mark Kovacs, M.Ed., Chapter 10.
How to Perform the Deadlift Correctly:
Preparation:
1. Stand with the balls of the feet directly under the
bar.
2. The feet should be flat on the floor with the toes
pointing directly forward or slightly toe-out (5-10
degrees).
3. Stance is relatively narrow with feet positioned
between shoulder width and hip-width apart. {See the
IFPA PT Manual, chapter 10 for Sumo Deadlift or Narrow
Stance Deadlift variations}.
4. Keeping the hips below the shoulders, squat down
until the trainee can grip the bar with an alternated
(mixed) grip.
5. The hands should be slightly wider than shoulder
width apart; arms completely straight and outside the
knees.
6. While in the squat position, the bar will be
approximately one inch in front of the tibia (shin).
7. The body position will be similar to the squat and
all good lifting positions:
7.1. Head neutral
7.2. Shoulders back
7.3. Upper back straight
7.4. Trapezius relaxed and slightly stretched
7.5. Chest up and out
7.6. Scapula retracted
7.7. Maintain “Weight Lifters Arch”
7.8. Shoulders over or slightly in front of the bar
7.9. Eyes focused on a point slightly upward or
straight
ahead.
Caution:
The body position described
above is to be maintained for both the
concentric and eccentric phases. Never allow
the hips to rise in relationship to the
shoulders. This would create a poor mechanical
position for the lift and hazardous levels of
shearing torque on the lumbar vertebrae.
Failure to maintain a retracted scapula,
shoulders back, chest up and out position can
create hazardous levels of shearing force on
the cervical and upper thoracic vertebrae.
Concentric Phase
1. Begin the lift by exhaling and having your athlete
drive the energy of the low back, hips, and thighs
through the knees and shins into the heels. You can
have your athlete visualize this by having them sit
back on their heels and visualize driving their heels
through the floor. This visualization makes your
athlete start with the hips and thighs and prevents
them from shifting from the heels onto the balls of
the feet and big toe. This prevents an abnormal proprioception of the foot, which could inhibit the
hip, erector spinae and other back extensor muscles
from fully contracting. This is another of the body’s
protective flexor mechanisms. If your athlete allows
their weight to shift to the ball of the foot and big
toe, the feet will invariably pronate causing high
stress to the interpholangeal joints and small,
relatively thin muscles of the feet to stretch. This
proprioception of the foot protects the muscles and
joints from excessive force and damage.
Caution:
Wearing quality athletic
shoes with good arch support is very important
for both the safety and effectiveness to help
your athletes both functionally and
neurologically in all their lifts.
2. Keep the bar as close to the tibia as possible
without touching. This makes your athletes lifting
mechanics much more effective and far safer. When the
bar “drifts” away from the shins the strength needed
to complete the lift increases dramatically due to the
increase length of the lever arm. It also makes the
lift more unsafe due to the shearing force on the
lower lumbar vertebrae.
3. Once the bar clears the knee, drive the hips
forward and the knees will pass under the bar. The bar
will contact the thighs near the completion of the
lift.
4. Continue lifting the bar and driving the hips
forward until your athlete achieves a slightly arched
position (hyperextension can stress the low back and
hip joints). The end position should be achieved
smoothly and simultaneously at the point when both
knee and hip are fully extended. Focus should be on
the smooth coordination between the extensions of both
joints.
5. Exhale with a two-second timing on the concentric
phase.
Eccentric Phase
1. Reverse, precisely, the technique described above
2. Lower the bar by slowly and simultaneously flexing
the knees and hips.
3. Inhale with a four second timing on the eccentric
phase.
How to Perform the Back Extension (On machine or
Roman
chair):
1. Have your athlete visualize all the numerous
origins and insertions of the erector spinae and other
back extensors that range from the low back and hips,
all the way up along the spinal column and medial
(inner) section of the posterior ribs, up into the
skull.
2. You can help your athlete’s visualization with
proper, judicious and professional use of “touch
training”.
3. The focus is on the individual muscles and not on
the back as a single-whole.
4. By rounding (flexing) the torso in a sequential
segment from top to bottom (eccentric phase) and then
extending, sequentially from top (skull) to the bottom
(hip); your athlete can maximally contract all the
erector spinae and back extensors (concentric phase).
5. Weight can be added (weight plate or dumbbell) as
your athletes strength increases
6. Exhale 2-seconds: concentric phase
7. Inhale: 4-seconds: eccentric phase
The reverse back extension machine is also an excellent
low back and hip exercise. The machine allows the upper
torso to be fixed on the table while the legs hang down
and off the table. The concentric contraction is to flex
the low back, hips and gluteals to lift the legs and
extend them backward. This exercise places no axial load
on the spine.
Another important advantage of the deadlift is, that
like the squat, the greater load capacity of these two
lifts causes the endocrine system to produce increased
levels of anabolic hormones, such as Human Growth
Hormone (HGH), Insulin Like Growth Factors-1 (IGF-1) and
Testosterone (at least in males). Our friends at the
American Academy of Anti-Aging Medicine tell us that
this increase in anabolic hormones has a multitude of
benefits, including increasing lean body tissue,
decreasing fat mass and numerous longevity and
anti-aging health benefits.
James
T. Bell, PhD is the
founder and president of the International Fitness
Professionals Association, IFPA.
More
Books from Jim Bell, PhD
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