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10 Habits for a Healthier Back by Dr Stuart McGill
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Back pain will affect most of us at some point. Mainly because we’re more sedentary than before. Daily routines now revolve around waking up, commuting to work in the car or on public transport — or moving to our home office space. Then, we sit at our desks until we travel home and spend the evening sitting or lying down to hope for rest. And then the cycle repeats itself.
See how easy it is? This is why good movement habits are crucial to prevent back pain.
It’s naturally hard to always feel motivated to exercise or keep up with simple everyday habits that look after us. Despite that, it doesn’t mean we should let ourselves escape the duty to keep active and look after our bodies.
And luckily, the best thing about creating healthy habits is it doesn’t need to be time-consuming or tedious. There are many ways to make small steps that invite a positive difference in how we feel, move and live each day.
One of the best practitioners for this is Dr Stuart McGill, a professor and “Godfather” in treating low back pain. I first heard about Dr McGill at university while suffering from chronic low back pain myself for years. His work helped me resolve it.
The problem with today’s advice is nobody knows who or where it comes from. People believe they have a reliable opinion on how others should treat and look after their bodies when they don’t practice what they preach. They think the same solution works for everyone. Of course not. There is “no one size fits all” to fixing back pain or one exercise that can be a panacea to all our problems.
The guiding principle needs to remain around choosing what works for you. And with sound direction, you can choose from the top methods in what that is. Here are some of Dr McGill’s teachings on improving your back health.
1. Add variety to Your Movements
“Perhaps the most important guideline should be this: don’t do too much of any one thing. Both too much and too little loading are detrimental.”
Repetitive stress wears your tissues. By varying your movements and posture, you’ll use different muscles and evenly spread the pressure, avoiding excess strain on your spine.
If you’re at the desk, make sure you change your position and stretch — even if you sit with good posture. When I go out on my bike for two, three, four hours, it means I could spend too long in the same position — which can still cause back problems even if I’m exercising. So, I alternate between riding out of the saddle or stretching on the bike from time to time. This helps relieve pressure, stretch my lower back and rest muscles such as my glutes.
2. Sitting for long periods is never worth it
It’s the easiest habit to avoid, but the one most people struggle with. No matter what someone says or how busy you are, never stay seated for hours without moving and stretching. It’s never a good idea as prolonged sitting is linear to an increased risk of disc herniation.
Dr McGill recommends adjusting your position frequently and standing up at least every 50 minutes to extend your spine and walk for a few minutes. A case study he once shared involved a worker at a radio centre whose job required them to sit for 12-hour shifts. Despite this, there were no back pain reports. And the most likely reason was the employees had to get up every 10 minutes to check certain readings. But the company later renovated the room and made it easier for employees to monitor things without getting up. After that, back pain was an issue for all staff.
Remember to stand up every 10 minutes during work and try overhead stretching for 10–20 seconds. It’ll give you enough time to extend, decompress your spine and relax at the same time.
3. Avoid strenuous exercise straight after sitting for a long time
Prolonged flexion — like when leaning forward at a desk — can push the nucleus in the vertebral disc to the back. And when you hold this position for a long time, your ligaments and nucleus can change shape and adapt, resulting in an increased risk of herniation or disc damage if you then do strenuous exercise straight away.
It’s best to avoid exercise after you’ve been sitting for a while; your spine needs time to return to its original state. If you spend all day sitting at your desk and then go to the gym or do exercise after work, leave some time for a break before your workout session. If you can’t wait, make sure to do a proper warm-up beforehand, and be slow and progressive with your lifting.
4. Minimise lifting or bending after getting out of bed
We’re shorter in the evening than in the morning by as much as half an inch.
The reason is, throughout the day, gravity compresses the discs of your spine. Then at night, as you lay down, these discs rehydrate and decompress.
Think of a bike tyre losing air as you ride. Every night, your body “refills” for tomorrow. And, like a fully-pumped, rigid bike tyre, your spine is at a higher risk of popping if you thrash it about straight away.
When you wake up, your spinal discs are like a filled tyre vulnerable to damage or injury. The stress from forward bending on your discs and ligaments are higher soon after you get out of bed, which can hurt increase the risk of damage to your spinal discs.
Dr McGill recommends no lifting or spinal bending when you wake up. Instead, wait an hour for the disc to decompress. Do some walking, and your spine can relax in as little as 30 minutes.
5. Take many rest breaks
Your core muscles allow everyday movement and exercise. They provide total stability and protection for your spine. Throughout the day or during an activity, these muscles fatigue. And as they fatigue, it becomes difficult to provide support. So, your larger muscles tend to over-compensate, and your posture weakens. You tire, and the threshold it takes to damage your spine lowers.
To delay fatigue and keep your body moving for longer, train for core endurance over core strength; it’s more important to resist moderate force for a long time than resist high forces for a short time when it comes to everyday activities. You’re more likely to injure yourself from low-intensity but continuous stress than one big impact.
6. Lessen the work your spine needs to do
Like all parts of your body, your spine has a limit to the stress it can take before faltering. If you exceed that threshold too much, you’ll get injured.
Dr McGill says that as power is the product of force and velocity (speed), high spine power can induce a disc injury. Your spine isn’t meant to bear weight as heavy as your glutes, lats or thighs.
So, be wary of moving too much weight — or moving too rapidly — and be especially careful of combining the two.
If the spine force is high, perform your movement or exercise slowly and focus on control.
If you’re moving quickly, keep the force low.
7. Learn to brace
As I mentioned before, your core muscles are for stabilisation and support. Dr McGill recommends lightly pre-stressing and stabilising your spine — even during a light task — through warm-ups or light activity.
And when lifting heavy objects, it is crucial to brace and create tension before you move to protect your spine. This means tightening your abdominal belt and feeling the tension in your stomach.
When lifting smaller objects, your core should naturally feel braced and engaged. This process should be automatic and reflexive.
If you have weak core endurance or poor engagement, you may need to brace consciously and learn how to reflexively engage your core first until it becomes second nature.
8. Drive through your hips and maintain a neutral spine
Whenever you bend or do forward movements, push through your hips. The muscles around the hips are big and powerful mechanisms that help you shift great amounts of power without burdening your spine.
When squatting, bend at your hips. When you lean forward, push your hips back. When you walk, drive through your hips.
The spine can handle pressure and force when it is straight. But when the spine is bent under load, it’s another story.
When under load, maintain a stiff, neutral spine, and use your hips and legs to generate locomotion and force. Rounding your back when you lift or move heavy weights is only asking for injury.
Granted, it’s not always possible to manifest this posture all the time — such as when lifting awkwardly shaped objects. In that case, brace your core and lock it in position before you bend.
9. Avoid excess joint stress
Rotation can be broken into two categories: creating rotation and resisting rotation.
When moving or producing force through exercise, you should generate most of your power through your hips and limbs while relaxing your spinal muscles.
Every joint is built for either mobility or stability. For instance, your low (lumbar) back centres around stability, while your upper (thoracic) back is for mobility. Therefore, the mobility in your postural movements should come from your upper back than your low back.
The role of the spinal muscles is to resist motion. If the spine moves when it shouldn’t, injury is likely. This is why your core muscles are made to resist motion, not create it.
To minimise the force your back is put under each day, here are Dr McGill’s recommendations:
Keep the load close to your body. It’s easier to hold, control and move a weight when it’s closer to you.
Hold heavier weights with both arms. If you’re carrying something heavy, use both arms to do so. Imagine the difference when you hold a heavy object, like a full shopping bag, at your side compared to in both arms.
When pushing or pulling, make sure the lever is close to you. Imagine shovelling snow or sweeping the floor. If the handle is close to your centre of gravity, it’ll help you avoid overworking your low back.
10. Focus on your fitness
There is a difference between fitness and health. You could be the fittest person in the world and still suffer every day from pain and injuries. I’ve known professional cyclists to ride tens of thousands of miles a year and still pull out of races because of back pain.
It’s also for this reason Dr McGill makes says it’s better to be undertrained than overtrained.
We often vie for the idea that “more is better”. More weight. More reps. More stress. That only puts too much pressure on our bodies without allowing us to recover.
Exercises like sit-ups or weighted ab machines are likely to do more harm than good. More is certainly not better. While they may define your six-pack, they can also come at a cost to your long-term spinal health. I had this very problem from my early teens up until the last five or six years. Something I wrote more about in my book on core training.
That said, a good exercise regime, one which emphasises proper technique and spine-saving exercises, can do a lot of good for your back and keep you strong and pain-free for a long time.
Move well, move often.
Brace your spine and use your hips.
Train your core muscles often.
Continuous movement is continuous improvement.
Health starts with how you think and move. If you want to live well, looking after your well-being should be above everything else.
If you suffer from back pain, these suggestions can go a long way in helping you resolve it. If you’ve never had back pain, that’s fantastic. And I want to do what I can do help you keep it that way.
Back pain can be a debilitating affliction. Most of our lives now involve things that promote further pain. But if we can take just a short amount of time every day to nurture our back and train our core, the benefits will last longer than any shortcut anyone else can recommend you.