Reject the idea of ’non-specific low back pain’ and seek a truly individualized assessment before any therapy to understand your specific pain mechanism.
Actively seek a healthcare provider who focuses on understanding the specific physical mechanism of your pain, as this empowers you to address the underlying cause.
Be aware of common movement triggers for low back pain, such as prolonged sitting, excessive flexion, shearing motions, and heavy lifting, and avoid them to guide effective rehab.
Incorporate the modified curl-up, side plank, and bird dog exercises to build core stability, transmit force efficiently, and prevent energy leaks that invite injury. Scale them using the Russian descending pyramid (10-second intervals) for pain relief and performance.
Develop proximal stiffness in your core to effectively transmit force distally, preventing energy leaks and enabling more powerful and efficient movements while sparing the spine.
For long-term spine health, prioritize achieving ’enough strength,’ mobility, and endurance rather than continually chasing lifetime personal records (PRs) in heavy lifting, as extreme efforts can lead to micro-fractures and joint wear.
Practice simple daily habits like walking, posture tweaks (ears over shoulders, shoulders over hips, soften knees), and hip hinge practice to calm pain flares quickly and maintain spine resilience for decades.
Learn and practice efficient movement patterns, such as spreading feet apart, leaning forward, and pulling hips through (like a squat) to stand up from a seated position, to prevent injury and maintain independence.
While deadlifting can be valuable, be cautious of overzealous training, especially for middle-aged individuals, as continually pushing for PRs can compromise long-term joint health. Consider alternative, lower-axial-load exercises for muscle activation.
After setting a true personal best in heavy lifts, take a couple of months off or at least a week, as the body experiences micro-fracturing in trabecular bone that requires time for healing and callus formation.
Shift focus from maximum effort squats and deadlifts to a well-rounded and sustainable athleticism (e.g., sled work, backwards walking up hills) that spares joints, maintains training capacity, and ensures fitness for daily life tasks into older age.
Recognize grip strength as a crucial proxy for longevity and overall fitness, indicating consistent physical work and stability. Engage in activities that build grip strength, such as carrying heavy objects or chopping wood.
In the acute phase of a disc injury, consider dispensing with anti-inflammatories for two weeks, as the inflammatory response brings in the immune system to help reduce the long-term disc bulge.
For minor flare-ups, a light muscle relaxant (like baclofen) can help break the cycle of tension in paraspinous muscles, allowing for deep breathing and relaxation, rather than focusing on inflammation.
If experiencing low-grade aches, try lying on your tummy with hands under hips and melt into the table with each exhale to relax muscles and realign micro-shearing movements. Then, stand with ears over shoulders, shoulders over hips, and softened knees to shut down erector spinae activity.
Perform the Big Three exercises prior to physical activity to create residual neural stiffness in the core, which can lead to faster running and cutting, and greater punching impulse.
Avoid mixing adaptation schedules; if you train for powerlifting, focus on hip/shoulder mobility and torso stiffness, avoiding excessive bending, while flexibility training should avoid very heavy loads.
To keep a healthy spine, focus on maintaining healthy end plates by avoiding damage to the joints, as this is crucial for long-term spine health and mobility.
If told surgery is needed for disc issues, consider ‘virtual surgery’ by mimicking post-surgical behavior, including forced rest and strategic desensitization, to potentially avoid the actual procedure.
Be aware of obvious red flags (e.g., aortic aneurysm, cancerous tumors, cauda equina syndrome symptoms) that indicate a need for immediate surgical referral, as these are not amenable to conservative management.
For nerve pain, sciatica, or brachial plexus nerve traps, try conservative management and voluntary skill-building (e.g., specific movement patterns, stabilization programs) before resorting to surgery, as these often resolve with patience and skill.
For cervical instability (e.g., whiplash patients with ‘clunking’ pain), practice light deep flexor activation (tongue to roof of mouth) and anti-shrugging to create controlling stiffness and arrest the clunking movement, which can reduce pain over time.
The number of pillows used at night can be a high correlate for joint instability; more pillows may indicate a need to address micro-movements in the spine.
For individuals seeking to understand and address their back pain, read ‘Back Mechanic’ by Stuart McGill to go through a series of self-tests and pattern recognition exercises.
If self-assessment from ‘Back Mechanic’ is insufficient, seek out certified or master clinicians listed on backfitpro.com who are trained in McGill’s methods for a comprehensive assessment and personalized treatment plan.
If your job involves a lot of sitting, ensure you are not sitting longer than an hour at your computer without a break, as prolonged sitting can be detrimental to spine health.
Incorporate daily walks, even short ones (e.g., 30 minutes in the morning), into your routine to counteract the negative effects of a sedentary lifestyle and improve overall health and fitness.
If sitting causes pain, use a lumbar support to maintain a neutral spine posture, which can help mitigate disc stress.
For athletes with specific pain triggers, identify and avoid movements that set off back pain, even seemingly minor ones like tying skates, by having someone else perform the action.
For athletes in sports like Jiu-Jitsu that involve positions stressing the spine, limit mat time and incorporate other training (e.g., stand-up) to minimize accumulative stress on disc bulges causing sciatica.