Dr. Stuart McGill's Back Exercises

Lumbar Support

Stresses develop during sitting that become problematic if they are not reduced. For example, when sitting slouched, muscle activity is minimal but the passive tissues (ligaments and annulus of the disc) become stressed. The implications of prolonged loading on these structures is just beginning to be understood with the work of Dr. Solomonow showing the impact on proprioception. Specifically, prolonged loading results in back muscle spasms and diminishing reflex responses. Full flexion during slouched sitting increases disc annulus stresses; this posture has produced disc herniations in the lab (e.g., Wilder et al., 1988). In fact, Kelsey (1975) discovered a specific link between prolonged sitting and the incidence of herniation. on the other hand, sitting with an upright torso posture requires higher activation of the psoas and the back extensors (Juker et al., 1998) which impose higher compressive forces on the spine. A few strategies have been shown to be very helpful in reducing these stresses. The objective is make sitting a dynamic activity with frequent posture change. Changing lumbar postures causes a migration of the loads from one tissue to another.

Reduce the Risk. Make Sitting a Dynamic Task.

The ideal sitting posture is one that continually changes. The EmbraceAir and LumbAir dynamic sitting supports (shown below) use the latest science to ensure minimal stress on the low back tissues, and to provide for posture change. Using an inflatable bladder the user increases or decreases the lumbar support. This avoids the damaging flexed posture. The easy inflation/deflation pump facilitates easy pressure change to create regular posture change. More inflation is needed later in the day to accommodate the diurnal change in disc hydration (See detailed explanations in Dr. McGill's textbooks). Static back rests simply cannot provide these advantages.

Even with the dynamic sitting supports, those who have back pain exacerbated from sitting generally are able to reduce disc annulus stresses with the following exercise (shown below). Stand up out of the chair, reach for the ceiling, then push for the ceiling with the hands, then fully and deeply inhale. This process should take about half a minute. Gentle and progressive extension of the lumbar spine is achieved dispelling the accumulated stresses.

Stuart McGills core exercises for the back. Prevents herniated discs.

Core exercises that supports and protects the spinal disc (disci intervertebralis). 

Good exercises for those who suffer from degenerative disc disease and for those of us that have been struggling with sciatica and a painful back.

STUART MCGILL'S BIG THREE BACK EXERCISES

Stuart McGill, professor of spinal biomechanics at the University of Waterloo, ontario, is one of the world's leading experts on lumbar research. McGill has identified three exercises referred to as the Big 3 that focus on stabilization. The exercises are often used in clinical populations by those in chronic pain. They put minimal load on the back and focus on endurance. The benefit from any exercise is only as good as the technique applied to the exercise. McGill suggests some very specific techniques to accomplish core stability.

The Curl-Up

The curl up varies from a standard crunch. There should be no movement through the lumbar spine. Hands are placed in the small of the back to monitor movement. Elbows are down to begin and elevated as a progression. Maintain the entire spine in neutral, including the neck; lift only the head and shoulders. Compared to a crunch, the curl-up involves very little curl and the upper body and neck stay elongated. There is minimal range of motion. Other progressions involve prebracing the abdominals and deep breathing during the exercise.

The Side Bridge

The side bridge, or plank can be performed from the knees if you have limited strength or ability to engage the abdominal wall. Begin by lying on the right side supported by the right elbow, hip and knee. Using support of the left hand, press up through the hips until you are supporting your body between your elbow and your knees. The top hand can rest on the hip. Progressions include moving to the feet, and changing your arm position to reach across to the opposite shoulder.

The Birddog

From a quadruped position, one leg is lifted and then returned, followed by lifting the opposite extended arm. To progress, both the leg and opposite arm are lifted. Making a fist can increases the tension in the extended arm. Further progressions involve drawing a square with both the foot and hand simultaneously. The exercise is performed on alternating sides.

Features

Training times begin at 10 second intervals. Build up endurance for stabilization with repeated short bouts, rather than increasing duration. According to McGill, once these are tolerated, progression to a more difficult version of the exercise or other exercises is justified. Bracing, rather than hollowing, during exercise enhances stabilization. To brace, avoid drawing in the navel and instead tighten the entire core, as if you were about to be thrown a punch.

References

• "Core Training: Evidence Translating to Better Performance and Injury Prevention"; Strength and Conditioning Journal: Stuart McGill; June; 2010
• Sports Rehab Expert website: teleseminar
• "Exercises for Spine Stabilization: Motion/Motor Patterns, Stability Progressions, and Clinical Technique; Archives of Physical Medicine and Rehabilitation; Stuart McGill and Amy Karpowicz; January; 2009

Dr. Stuart M. McGill PhD

Dr. McGill is a professor of spine biomechanics at the University of Waterloo (Ontario, Canada). He lectures internationally and has authored over 200 scientific publications that address the issues of lumbar function and low back injury mechanisms. His advice is often sought by governments, corporations, legal experts and elite athletes and teams from around the world. Difficult back cases are regularly referred to him for consultation.

Dr. McGill has authored Low Back Disorders: Evidence Based Prevention and Rehabilitation and Ultimate Back Fitness and Performance. 

http://www.backfitpro.com

http://well.blogs.nytimes.com/2009/06/17/core-myths/

http://www.ostenzen.com/newsflash/stuart-mcgills-back-exercises.html

http://www.livestrong.com/article/392341-stuart-mcgills-big-three-back-exercises/

http://www.backexercisedoctor.com/journal/2011/11/22/stuart-mcgill-the-right-way-to-do-do-core-training-for-low-b.html