multifidus muscle size in youth boys is smaller in those with back pain

Multifidus Muscle Size in Youth Boys is Smaller in Those with Back Pain

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The purposes of this study were; a) to compare multifidus muscle cross sectional area (CSA) in male adolescents suffering from low back pain (LBP) with healthy male adolescents using ultrasonography (US), and b) to assess the correlation between multifidus muscle size and demographic variables.


A random sample of 40 healthy boys (as a control group) and 40 boys with LBP (as an experimental group) at the age range of 15-18 years was recruited in the present cohort study. Multifidus muscle dimensions including CSA, antero-posterior and medio-lateral dimensions were measured at level of L5 in both groups using US.


The results of an independent t-test to compare multifidus muscle size between the experimental and control groups showed a significant difference between the two groups in terms of CSA, antro-posterior and medio-lateral dimensions so that the experimental group had smaller muscle size than the control group. A significant correlation was found between height, weight and body mass index (BMI) and multifidus muscle size, but no significant correlation was observed between age and muscle size. Pain intensity and functional disability index was significantly correlated with muscle size in the experimental group.


According to the results, multifidus muscle size was decreased in 15-18 years old male adolescents suffering from LBP compared with their healthy counterparts. Further studies are needed to support the findings of the present study.


This study doesn’t differentiate causation from correlation. The smaller multifidus may occur from low back pain, not cause low back pain. However, it is unlikely these youth boys had back pain for a long period, so the multifus muscle either atrophies quick or can be a cause of low back pain.

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  1. Rahmani N, Kiani A, Mohseni-Bandpei MA, Abdollahi I. Multifidus muscle size in adolescents with and without back pain using ultrasonography. J Bodyw Mov Ther. 2018 Jan;22(1):147-151. doi: 10.1016/j.jbmt.2017.05.016. Epub 2017 May 31.

Dr. John Mullen


Dr. John Mullen, DPT, CSCS is a World renowned expert and speaker in sports training and rehabilitation. He received his Doctorate in Physical Therapy at USC, as well as the Josette Antonelli Division Service Scholarship, Order of the Golden Cane, and the Order of Areté. At USC, he also performed research on strength training and rehabilitation. Dr. John has worked with multiple professional and Olympic athletes, helping them earn Olympic medals.

His dedication to research and individualization spurred him to open COR in 2011. Since 2011, Dr. John has been featured in Gizmodo, Motherboard, Stack Magazine, and much more.

He has worked with the numerous colleges and teams regarding rehab and performance. Before his Doctoral program, Dr. John swam on an athletic scholarship at Purdue University.

At Purdue, Dr. John was an Academic Honorable Mention All-American and was awarded the Red Mackey Award and R. O. Papenguh Award. He also won the Purdue Undergraduate business plan and elevator pitch competition, as well as 1st prize with the Indiana Soy Bean Alliance.

Dr. John was born in Centerville, Ohio and was a 24-time high school All-American Swimmer. Dr. John is still a swimmer and holds a Masters Swimming World and Pacific Swimming Record.

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