Like many people reading this blog, along with bulging discs and Spinal Stenosis, I have Degenerative Disc Disease. It’s hard to pinpoint exactly how this contributes to my overall level of chronic pain, but generally speaking, DDD causes a lot of stiffness and instability. I wake up with an achey lower back, and spend most of my day trying to minimize the amount of bone on bone (vertebrae – L5/S1) pounding it takes.
Category - Exercise
I first heard about Stu McGill on a podcast about the rehabilitation of high-performance athletes. He was describing how some world class performers trained to get back into top form after injury. He was reaching peak academic nerd-speak with ‘muscle activation’ this, ‘motor pattern development’ that, when he mentioned his “Big 3” for the everyday back pain sufferer. My ears perked up as he distilled all physio stretches into just three simple exercises.
As a professor and researcher at the university of Waterloo (Canada), McGill is an expert in the field. At his Spine Biomechanics Laboratory, he focuses on a few core objectives involving how the back functions, how it gets hurt, and how to fix it and prevent further injury.
The four quadrants of muscles that support the spine are the rectus abdominus at the front, the obliques at the sides and the extensors at the back . As McGill states, ‘true spine stability is achieved with a “balanced” stiffening from the entire musculature’ within the load tolerance (pain threshold) of each individual. The “Big Three” exercises strengthen these muscle groups and help to increase endurance during lifting, pushing or pulling.
Remember to never over-exert yourself doing these movements and if pain persists, please check with your physiotherapist to ensure that proper form is being used.
Stu McGill’s ‘Big 3’ Exercises
1. Modified Curl-Up
Laying on your back, one knee is bent and one knee straight. Your hands are placed under the arch of your lower back and begin by bracing your abdominal muscles and bearing down through your belly. While keeping this brace, breath in and a breath out. With your spine in your neck and back joined together, pick a spot on the ceiling and focus your gaze there, lift your shoulder blades about 30° off the floor and slowly return to the start position.
2. Side Bridge
Laying on your side, prop yourself up on your elbow with your elbow directly under your shoulder to avoid straining. With your legs straight, place your top foot on the ground in front of your bottom foot. Place your top hand on your bottom shoulder – be sure that your upper body does not twist or lean forward, brace abdomen, squeeze through your butt muscles, and lift hips up off the ground. Hold for 8-10 seconds, repeat 3 times. As the exercise becomes easier, increase the number of repetitions as opposed to the length of time.
3. Stirring the Pot
This exercise starts on your hands and knees, with your hands shoulder width apart directly under your shoulders, and knees hip width apart directly under your hips. Brace through your abdomen and squeeze your gluteals. Ensure you can maintain this while you take a breath in and out. Lift your right arm in front until it’s level with your shoulder, squeezing the muscles between your shoulder blades as you do so. At the same time, extend your left leg straight back until it is level with your hips, squeezing your gluteals, and keeping your hips square to the floor. Return to the starting position in a slow and controlled manner, and perform the same action with the left arm and right leg. That is one repetition. Perform 3 sets of 8-10 repetitions.
McGill also advises full-time desk jockey’s like me, who have a ‘flexion intolerant back’ to not focus on range of motion with back exercises. His Big 3 have just as much to do with which exercises you shouldn’t do, than with what you should do. McGill makes us keenly aware “that the spine discs only have so many numbers of bends before they damage”. In a nutshell, he bluntly states that it’s better to do less of the thing that’s hurting you, flexion in many cases, rather than take medications to treat a strained back, or worse, protruding discs.
As always, check with your health care expert before attempting these exercises to prevent further injury…and take care.
In May of 2015, the Sciatic pain down my left leg was so intense that I couldn’t get out of bed for three weeks. I had surgery for a herniated disc (the root cause of Sciatica) at L4/L5 in June of 2015, and here’s an update a year and a half later.
I started playing piano when I was 22, and by 24, I had severe tendonitis on both arms because of poor technique. My wrists were locked, elbows too bowed, shoulders too tight and I basically white knuckled it all the way towards early retirement from the concert stage (I was never really on the stage, but you get what I mean).
Ted talks are at the top of the list when it comes to expert advice on Science and Technology delivered in a way that everyone can understand. Here’s my Top 5 talks from medical and engineering research leaders who discuss the root causes of back pain and how to alleviate (or at least cope with) a sore, achy or damaged spine.
After six years of research and over 600 interviews, author Cathryn Jakobson Ramin has released what I would describe as the laymen’s comprehensive guide to navigating the murky waters of back pain remedies. As a human guinea pig, Ramin explores dozens of treatments from acupuncture, chiropractors, osteopathy, to finding the perfect office chair, all in an effort to relieve pain from herniated discs and degenerative disc disease.
Ramin’s exhaustive investigative research uncovers some of the dubious motives at the centre of traditional healthcare modalities, and provides statistical data that backs up her claim which strongly suggests that those with back pain need to think twice before signing up for multiple sessions of chiropractic / physiotherapy treatment, epidural steroid injections or far more invasive procedures such as spinal fusions. Though some of these treatments may help, her advice is to start with the far more obvious routines such as exercise, constant movement, and innovative often un-reported practices such as Rolfing, Feldenkrais and the Alexander Technique. Oh, and my personal hidden gem in preventive spine-aching office furniture…something called the Locus Workstation.
Ramin says that “People in pain are poor decision-makers” and her book helps us understand the real limitations of the medical systems approach to back problems and that most overlook the obvious solutions such as diet and exercise. She points to Stuart McGill’s encouraging results on the “Big Three” exercises that many back pain sufferers can do daily to increase their chances of rehabilitation.
Buy it Here on Amazon: Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery
In late May of 2015, I distinctly remember laying on the floor of my condo watching Youtube videos on my iphone. I was in a lot of pain and couldn’t really move without horrible nerve shocks shooting down my right leg into my ankle. And while I lay there I just kept watching self published videos of people recovering from a discectomy. These videos gave me some comfort in knowing that surgery could stop the excruciating Sciatic pain I was enduring. So, I would like to thank these five people who took the time to tell their story of overcoming herniated disc pain through surgery.
I just passed the 6-month mark of my L4/L5 Discectomy so I thought now would be a good time to discuss my progress. Just a quick recap before getting into how things are today: In early June 2015, during a routine tying-of-the-shoe I badly tweaked my lower back. By the next day, a crippling Sciatica had set-in which confined me to a bed for weeks. Luckily, I had an up to date MRI so an Orthopedic surgeon quickly diagnosed a herniated L4/L5 and I was wisked off to the operating room for a lumbar Discectomy. Fast forward six months and here I am, resting fairly comfortably typing out an update.
Some professions come with a much higher risk of physical injury and often the wear and tear endured by top athletes is centered around the spine. It’s not surprising then that many pros that have had back injuries undergo surgery of some sort – especially Micro-discectomy. Here are some of the more high profile pro athlete with herniated discs and various other back related injuries.
Treating back pain with painkillers has become a controversial topic. And there’s a particular stigma against people that regularly use opiates to treat back pain. The media reports on the use and misuse of drugs such as Oxycontin and morphine almost daily, backed with statistics of rising rates of overdose.