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Protocols to Strengthen & Pain Proof Your Back

Episode 174 Apr 29, 2024 2h 3m 15 insights
In this episode, I explain how to strengthen and build a stable, pain-free back and how to reduce or eliminate existing back pain. I explain the anatomy and physiology of the spinal cord and vertebrae, intervertebral disks and nerve pathways, and the abdominal and back muscles that together can be leveraged to stabilize the back.  Then, I describe protocols: “McGill’s Big 3” exercises, a highly effective psoas stretch, abdominal stabilization, breathing techniques, and protocols to reinforce essential supports for the back, including the neck, pelvis, feet, and toes.  I also explain how you can reduce and potentially eliminate back pain and sciatica using a specific type of bar hang, “cobra push-ups,” medial-glute strengthening exercises, and more.  Back pain greatly impedes one’s ability to enjoy daily activities; this episode provides zero-cost, minimal time-investment protocols to improve your back strength and stability and allow you to move through life pain-free and with ease and mobility.  For show notes, including referenced articles and additional resources, please visit hubermanlab.com.
Actionable Insights

1. Seek Professional Back Assessment

If you have severe or persistent back pain, consult a back expert or surgeon for proper assessment and diagnosis, as some conditions may require medical intervention like surgery, epidurals, or painkillers.

2. Self-Assess Spine Type

Determine if you have a ’thick spine’ (thicker joints, barrel-chested, stable vertically) or ’thin spine’ (smaller joints, more bendy) to understand your body’s natural predispositions and emphasize appropriate strengthening protocols.

3. Perform McGill Curl-Up

Lie down with one knee bent, hands under your lower back to maintain its arch, tongue on roof of mouth, and gently raise your upper chest (not chin) for 8-10 seconds, exhaling to contract abdominals strongly; this strengthens the abdominal wall without exacerbating disc herniation.

4. Practice McGill Side Plank

Start on your side with bent knees (or progress to straight legs), supported by a fisted hand, and push your hips off the ground to form a straight plank, actively pushing the floor away from you for 8-10 seconds to build spine stability.

5. Execute McGill Bird Dog

On all fours, extend one arm forward (fist) and the opposite leg backward, keeping your torso parallel to the floor without arching your lower back, while actively pushing the ground away with your planted hand and knee for 8-10 seconds to strengthen spinal stabilizers.

6. Address Posterior Disc Bulge

If experiencing back pain from a posterior disc bulge, perform ‘Cobra’ or ‘Up Dog’ pushups by lying on your stomach and pushing up with your hands while keeping hips on the floor, which helps push the disc back into alignment and relieve nerve impingement.

7. Activate Medial Glutes

Lie on your side, keep the bottom leg on the floor, and with your top toe pointed down, bring your top leg forward, then extend it back with the heel towards the ceiling, holding the final extension for 10-20 seconds to activate and de-spasm the medial glute, which can relieve low back pain.

8. Spinal Decompression Hang

Gently hang from a bar with your toes, feet, or heels lightly touching the floor for 10-30 seconds, creating length along the spine to relieve disc compression and nerve impingement, being cautious not to twist.

9. Maintain Lumbar Arch When Seated

If you have a posterior disc bulge and sit or drive frequently, place a rolled-up towel in the arch of your lower back to prevent rounding and maintain a beneficial spinal alignment.

10. Stretch Psoas Muscle

Perform a lunge with the arm on the same side as the extended back leg reaching overhead, palm parallel to the ceiling and pinky pointing towards your head, to stretch the psoas muscle and relieve hip/spinal tension.

11. Strengthen Front Neck Muscles

Place fists under your jaw and push your chin down against their resistance for 10-second static contractions, with your tongue on the roof of your mouth, to strengthen the front of your neck, improve posture, and support nasal breathing.

12. Enhance Foot & Toe Mobility

Practice spreading your toes independently and lifting each toe separately to strengthen the feet, improve overall body stability, and support the entire kinetic chain up to the spine.

13. Practice Belly Breathing at Rest

When not exercising, consciously relax your abdominals and practice nasal breathing where your belly expands on inhalation and contracts on exhalation, promoting relaxation and optimal respiratory patterns.

14. Incorporate Anti-Rotational Training

During resistance exercises like dumbbell curls or overhead triceps extensions, adopt a staggered stance with one foot forward and insist on keeping your belly button facing directly forward to train anti-rotational core strength.

15. Develop Movement Pattern Awareness

Consciously observe your daily posture, breathing habits, and movement patterns (e.g., leaning, foot placement) to identify and correct imbalances or habits that contribute to back pain or limit mobility.