McGill’s Big Three for Low Back Pain
- August , 2021
- Fitness Guru
Low Back Pain
Something the vast majority of Americans and even rest of the world’s population can relate to is the feeling of low back pain. It’s almost inevitable that at some point an individual will seek guidance on how to treat low back pain from a medical professional. If that medical professional seen is a physical therapist then most will classify the patient into one of four categories of treatment. Most patients are classified into the “stabilization” category.
Stabilization essentially entails strengthening muscles surrounding the low back including muscles on the front and sides of the trunk. There are almost an infinite number of ways to strengthen these areas. The important principle to keep in mind is that core strength is not just flex/extend (forward/back). There is also trunk rotation as well as side bending. Based on these principles we’ve laid out three simple exercises that don’t require anything but a flat surface to perform.
Core on the Floor
A famous researcher named Stuart McGill has written many books on rehabilitation for low back pain. Since we’re choosing three core strengthening exercises it feels like we would be insulting him if we didn’t use his “big 3”. The exercises listed below have been chosen due to their likelihood of being safe for most people to perform as well as effectiveness. They will also ensure that your core is being strengthened from all directions and planes.
The first exercise is a McGill crunch. This one will work your trunk flexors including the glamorous 6 pack muscle (rectus abdominis) as well as an important stabilizer muscle called the TA or transverse abdominis. To perform a McGill Crunch you will need to: 1) Lay on your back with one knee bent and one leg straight. 2) Place one hand underneath the small of your back. 3) Perform a chin tuck (draw chin back to give yourself a “double chin”). 4) Squeeze your abdominals to pull shoulders off the floor. 5) Hold for at least 2-3 seconds and then lower. 6) Repeat for another set on other side with other leg straight.
Exercise number two is the side plank. The side plank is an isometric (no muscle length change) exercise. It will primarily work your lateral trunk flexors including your obliques and a long back muscle called your quadratus lumborum. To perform a Side Plank you will need to: 1) lay on your side with knees bent or straight, your call. 2) Raise your hips into the air so that your forearm and knee (or foot) are the only two points of contact with the floor. 3) Maintain a straight line between your neck, trunk, and legs. 4) Repeat on the other side
Next up in core stabilization exercises is the Bird Dog. The core’s challenge with a bird dog is maintaining a neutral and stationary position while moving the arms and legs around it. To perform the Bird Dog you will need to: 1) Get into a 4 point position on hands and knees as if you were about to crawl. 2) Next simultaneously raise your arm forward while kicking the opposite side’s leg backwards 3) Hold this few at least 2-3 seconds where your only points of contact are your hand, the opposite knee, and opposite foot 4) Return to start position where both hands and legs are in contact. 5) Alternate sides and be sure to avoid letting your trunk move from its neutral spine position.
Back Pain is Tricky
Low back pain is complicated and difficult to treat. There are many avenues that can be used to see results. These three exercises are just a small piece to the whole puzzle. Many people don’t strengthen their core from all directions or at all so this may be a good starting point. The safest bet before trying any of these exercises is to consult a medical professional to make sure they’re safe. They are three well-known and supported exercises typically used to treat low back pain. However, if the pain seems to be worsening when performing or afterwards then it may be best to discontinue.