Dr. Stu McGill's 10 Best Habits For a Healthy Back
Author - Stephen Griffith C.S.C.S. Pn1
No person has broken more backs than Dr. McGill. With hundreds of scientific publications, several textbooks, and tens of thousands of broken spines you can say no one knows better how to break a spine.
And after helping thousands of the most difficult back pain cases in the world its also safe to say that there is no one better at repairing and fixing a broken, painful back either.
For years I worked on wall street where most of my clients spent days sitting hunched over a desk. By the time they made it to me they were already dealing with back pain. I didn’t know how to help.
So it was in search of answers I discovered the work of Dr. Stu McGill. I can say firsthand that not only does he know but his techniques work at helping to relieve back pain.
Back pain is the leading cause of disability in the world as the spine is central to all movement. Back pain is terrible and today I’d like to share some of Dr. McGill's top suggestions for maintaining a healthy spine long through your life.
Add Variety To Your Movements
In the words of Dr. Stu McGill, “Perhaps the most important guideline should be this: Don’t do too much of any one thing. Both too much and too little loading are detrimental”
Cumulative repetitive stress wears down the tissues.
Just like you rotate your tires you should vary your movement. By varying your movements and postures you will use different muscles and not put too much wear on any one part of your spine.
If you spend long periods of time sitting, then this means changing your position frequently even if you were sitting with “Good posture”
If you’re doing a dynamic exercise such as cycling it means standing up and pedaling every so often.
When you pick items off the floor, it means not always using the same technique every time.
Avoid Prolonged Sitting
Continuing from the theme of the last habit that too much of any one thing is bad is the thing we do most often of all often- sit.
Prolonged sitting is associated with disc herniation and several movement dysfunctions.
Dr McGill recommends adjusting your position frequently and standing up at least every 50 minutes, extending the spine, and walking for a few minutes.
In his textbook, McGill shares a case study of a worker in a radio center. Whose job required mostly sitting for 12-hour shifts. Despite this, there were no reported back pain and a likely reason was that the employees had to get up every 10 minutes to check certain the readings.
Eventually, the company renovated the room and made it so the employee could monitor everything without getting up. After the changes, back pain became an issue for the workers.
McGill recommends standing up every 10 minutes and stretching your arms overhead for 10-20 second to extend and decompress the spine.
Do Not Perform Strenuous Exercise Immediately After Prolonged Flexion (Such as sitting)
When you hold your spine in position for a long time, the ligaments and nucleus change shape and adapt to that position.
With flexion, such as when you're sitting, the ligaments stretch and ‘loosen’ and the forward bending of the spine pushes the nucleus backward in your vertebral disk.
The result is a lack of support and increased risk of herniation or risk damage.
Dr. McGill’s recommendation is to avoid strenuous activity after a long period of flexion - such as sitting. Your spine needs time to go back to its original state.
For example, if you’ve spent all day sitting at your desk it would be wisest to leave some time before your after work deadlift session. If you can’t wait, then be sure to get a proper core warm up in before your session and be sure to lift with perfect form.
Waiting for a little, walking, doing some extensions can help.
Avoid Lifting or Spine Bending After Rising From Bed
Fun fact: You are shorter in the evening that when you first wake up. By as much as half an inch.
The reason is that throughout the day the weight from gravity compresses the discs of your spine.
At night, as you lay down these discs rehydrate and decompress becoming full again. If your back feels stiff in the morning this can be one contributing factor.
You can think of this like a bike tire that naturally loses air as you ride it. Every night your body “refills” the tire for the next day's ride. However, like a bike tire, if it’s overfull then the tire is at a higher risk of popping.
When you wake up your spinal disc are essentially an overfull tire vulnerable to damage or injury.
Stresses from forward bending on the disc and ligaments are higher after rising from bed causing the disc to become injured at lower levels of load and bending.
Dr. McGill recommends avoiding lifting and spinal bending immediately after rising from bed. Instead, he says to wait an hour for the disc to decompress. If you do some walking the spine can decompress in as soon as 30 minutes. This will keep you from putting undue stress on your spine and reduce your risk for an injury.
Use Good Rest Break Strategies
Your core muscles are important, they provide stability and protection for your spine.
Throughout the day or during activity these muscles fatigue. As they fatigue, it becomes difficult for them to provide the proper support your spine needs. The result is that as your muscles fatigue, your posture weakens, and the threshold it takes to damage or injure your spine also decreases.
When sufficiently fatigued even lifting small objects can cause an injury.
Dr. McGill’s recommendation is to take breaks. if you’re sitting all day he recommends taking frequent and dynamic breaks. If you're engaged in dynamic work, he suggests taking longer and more restful breaks. These breaks may include some light stretching.
Remember this the next time your out gardening or moving furniture.
Keep Spine Power Low
Just like every part of your body, your spine has a limit to the amount of stress it can take before breaking.
If you exceed that threshold you will get injured.
Dr. McGill makes special note of power.
Power is the product of force and velocity(speed). High spine power causes disc injury.
You should be wary of moving too much weight or moving too rapidly but especially wary of the combination of the two.
Dr. McGill recommends the following
If the force on the spine is high, such as when you're moving a lot of weight, then you should move your spine slow.
If you're moving quickly, then you should keep the force low.
The spine was built for stabilizing, providing support, and transferring force. If you want to create sustained power you should focus on using your hips.
Brace and Stabilize The Spine
As mentioned, the muscles of your core are meant to stabilize and provide support for your spine.
Dr. McGill recommends pre-stressing and stabilizing your spine even during light task.
When lifting heavy objects it is necessary to brace and create maximum tension to support the spine.
When lifting smaller objects or performing other tasks, your core should engage. Although McGill mentions that this bracing should be automatic and reflexive.
If your core is not working as it should then you may need to brace continuously while working on reflexive core work in the gym until it becomes automatic.
Use The Hips and Maintain A Neutral Spine
This is the most crucial movement skill and position for sparing your spine.
It’s why I wrote an entire article with progressions on how to teach yourself this skill.
The spine is best able to handle loads and forces when it is straight.
When the spine is bent under load, it can’t manage the forces. The result is damage and the opportunity for injury.
McGill’s recommendation when under load is to maintain a stiff neutral spine. Instead, use the hips and legs to generate motion and force.
Below is a picture of one of his test subjects. In the bent position with an unweighted barbell, the rounded back is under 1’900N of Shear force. When the subject corrects his posture those shear forces drop to only 200N.
If you’re lifting with a rounded back, you are asking for injury.
Lifting with a straight back in the real world is not always possible, for example, when you’re moving awkwardly shaped objects. If your spine must be flexed, McGill's recommendation is to brace the core, lock it in position and not to bed it.
The worst action you can do is bending your spine while under load.
Managing Rotation and Minimizing Stress
We can break rotation into two categories - Creating rotation and resisting rotation.
While the spine can rotate Dr. McGill's recommendation is to create most of the power and movement from the hips and limbs. You should use your spine to transfer forces, not as the prime generator. Using your spine as a prime mover is a sure way to get yourself hurt.
An additional recommendation comes from The Work of Physical Therapist Greg Cook creator of the Functional Movement Screen. In his joint by joint approach, he states that each joint is built either for mobility or stability. In the case of the spine, the lower back is built for stability while the thoracic spine is built for mobility
With this in mind, when you are rotating, most of the rotation should come from the upper back instead of the lower back.
The primary job of the spinal musculature is to resist motion. When the spine moves when it shouldn’t injuries occur. This is why the primary job of the core is to resist motion, not to create it.
To minimize the amount of force your back is put under Dr. McGill recommends the following adjustments to your day-to-day activities
Keeping the load close to the body. To visualize this, take a weighted item and held to your chest. Now push it out and hold it in front of you. Notice the difference in stress and the amount your core needs to work to stabilize.
Balance weights in both arms. If you’re carrying something use both arms to do so. To visualize this notice the difference in stress and how hard your core must work when you hold a weight at your side with one arm vs a weight in each arm balanced out.
Transfer force through the lower back.
For example, when you push or pull something try to do so closer to your center of gravity and lower back. If you're pushing something push at waist level instead of at shoulder level as this will reduce the amount of stress put on your spine.
Exercising consistently is a great way to maintain your health and keep your body functioning as it should. However, your workout programs can do more damage than it does good.
There is a difference between fitness and health. Some of the fittest people in the world suffer each day from pain and injuries.
Far too often though, people air on the side of more is better. More weight, more reps, more exercise, putting unnecessary stress on their joints while not allowing their bodies to recover.
Compounding this is the exercises chosen. Exercises such as sit ups, or the various weighted ab machines are likely to put more wear on your spine. While they may help you define your 6 pack it will also come at a cost to your long term spinal health.
It‘s for this reason Dr. McGill makes the note it’s better to be undertrained than over-trained.
With this said, maintaining a sensible exercise regime, which emphasizes proper technique and spine saving exercises can do a lot for keeping your back strong, safe and pain-free long into old age.
The recommendations and advice above can be summarized with the following
Move well, move often.
Brace your spine and use your hips.
Whether you suffer from back pain or not you should adopt the recommendations on this list.
Health starts with how you move. If you suffer from back pain the advice in this article can go a long way in reducing the severity and frequency of your pain.
If you’re fortunate to not have back pain I can assure you that you want to keep it that way. Back pain is a debilitating affliction, and unfortunately most of our lives are set up in a way that promotes future back pain. Take these recommendations and spare yourself the trauma.