Seek a healthcare provider who focuses on understanding the specific mechanical mechanism of your back pain, as this knowledge can empower you, alleviate psychological distress, and guide effective mitigation strategies.
When seeking help for back pain, ensure your assessment includes dynamic observation of your movement, palpation of muscles, and testing specific postures to identify the precise mechanical triggers of your pain, rather than relying solely on static imaging.
Incorporate the McGill Big Three exercises (modified curl-up, side plank, bird dog) into your routine to build core stiffness and stability, which can enhance athletic performance, prevent injury by reducing energy leaks, and provide temporary pain relief.
Prioritize developing core stability to prevent ’energy leakage’ during movement, as this not only enhances performance but critically reduces the predisposition to injury, especially as you age.
Read ‘Back Mechanic’ by Stuart McGill to conduct a self-assessment, understand the specific mechanism of your back pain, and learn strategies to mitigate it, as it guides you through identifying pain triggers and appropriate exercises.
Avoid excessive simultaneous load and motion, especially at end ranges, to prevent delamination of disc fibers, which can lead to disc damage and pain.
Do not mix adaptation schedules for spinal training; if you train for powerlifting, focus on torso stiffness, and for yoga, focus on flexibility, to prevent specific injury patterns.
For middle-aged individuals, re-evaluate deadlift goals; prioritize sustainable athleticism for long-term joint health and the ability to perform daily tasks over setting personal bests, which can cause micro-fractures and lead to joint issues.
Shift your fitness mindset from maximizing every strength, mobility, or endurance metric to achieving ‘sufficient’ levels in each, which promotes sustainable joint health and overall well-being, avoiding both rust-out and wear-out.
If experiencing a disc herniation, consider allowing the natural inflammatory response to occur for about two weeks, as recent data suggests it helps the immune system clean up extruded disc material, potentially making anti-inflammatory drugs counterproductive in the long term.
For low-grade back aches, explore postural adjustments and targeted relaxation techniques (e.g., lying on tummy, deep breathing, specific hand placement under hips) to address micro-movements and muscular tension, potentially avoiding the need for muscle relaxants.
Practice subtle postural cues like softening your knees, pulling your chin back (ears over shoulders, shoulders over hips), and opening your hips to achieve muscular relaxation and reduce spinal load, which can alleviate chronic tension.
When performing core exercises like the McGill Big Three, use the Russian descending pyramid approach: repeated 10-second intervals to build endurance and stiffness without reaching fatigue or breaking form, allowing for higher training levels.
If the McGill Big Three provides temporary pain relief, schedule 12-minute sessions mid-morning and mid-afternoon to maintain core stiffness and manage pain throughout the day.
Incorporate alternative leg strength training methods like sled work, backwards walking up hills, and monster walks to build sustainable athleticism and endurance, sparing joints from the high axial loads of traditional squats and deadlifts.
Develop and maintain strong grip strength through activities like carrying heavy objects or chopping wood, as it serves as an excellent proxy for longevity and reflects overall body work and stability.
If advised surgery for back pain, consider ‘virtual surgery’ by strictly adhering to forced rest, strategically desensitizing your pain mechanism, and gradually re-tuning your body with specific mobility, stability, and movement skills to avoid replicating the initial problem.
If experiencing nerve pain or sciatica, seek an assessment that can determine if the pain can be ‘moved’ (made worse or better) through specific movements or postures, as this indicates a mechanical component that can often be successfully treated conservatively without surgery.
Understand that surgery is often most effective for severe spinal stenosis (encroachment from front and back), significant spondylolisthesis causing nerve compression, or post-traumatic instability, where mechanical decompression or stabilization is critical.
Be aware of ‘red flag’ symptoms (e.g., unexplained weight loss, fever, bowel/bladder changes, severe progressive neurological deficits) that warrant immediate medical investigation, as these indicate serious conditions requiring surgical or urgent medical intervention, not conservative back pain management.
Recognize that MRIs are static images and may not reveal dynamic pain triggers like spinal instability or ‘clunking’ movements; a dynamic assessment (e.g., with a skilled clinician) is crucial to understand the true mechanism of pain.
To control spinal instability and ‘clunking’ that causes pain, activate deep flexor muscles by pushing your tongue hard to the roof of your mouth behind your front teeth and grimacing down, maintaining this controlling stiffness during movement.
Understand that some degree of arthritis can actually contribute to joint stability, particularly in the spine, and may lead to a reduction in pain over time, even if it results in decreased mobility.
Be aware that the lower lumbar spine (L4/L5/S1) is more susceptible to bending stresses due to its thickness and disc shape, making it crucial to minimize excessive bending, especially under load.
If engaging in heavy deadlifts, ensure at least a week of rest between sessions to allow for bone callus formation and prevent the accumulation of micro-fractures, which can lead to more severe injuries if training too frequently.
Understand how different biological structures in the spine (e.g., bone, disc) respond to various loads (tension, compression, shear) to avoid specific types of damage, as tissues deform differently under these forces.
Understand that disc damage can lead to the growth of new nerves and blood vessels into the disc, making it more sensitive to pain, highlighting the importance of preventing initial injury.
Recognize that the human spine is a perfectly engineered structure with inherent trade-offs between flexibility and load-bearing capacity, meaning certain movements or loads may lead to damage if not respected.
Do not dismiss insights from elite athletes’ training, as their movement efficiency and strategies for managing load can be adapted to improve mobility, strength, and injury prevention for people of all ages and conditions.
Learn and practice fundamental movement patterns, such as proper squat mechanics for sitting and standing, to restore function, prevent injury, and maintain independence, especially for daily activities like getting off a toilet.
Be mindful that sedentary work, particularly prolonged sitting, can lead to a decline in health and fitness; proactively integrate physical activity and movement breaks throughout your day to counteract this.
Recognize that motivating significant behavioral change, especially for long-term health benefits like spinal longevity, often requires a personal realization stemming from sufficient discomfort or a compelling reason, as short-term sacrifices are difficult without immediate pressing needs.
If self-assessment is insufficient, seek out certified or master clinicians trained in Stuart McGill’s methods via backfitpro.com, as they are equipped to conduct thorough mechanistic assessments of back pain.
To potentially improve blood markers and overall health, consider adopting a more restrictive lifestyle, similar to Peter Attia’s, by reducing alcohol consumption and adhering to a disciplined diet for a trial period, as Stuart McGill did to test its impact on his genetics.