McGill Big 3: Bulletproof your Lower Back

Dealing with a low back injury? If so, you are certainly not alone. Statistics show that up to 85% of working people can expect to experience some form of lower back injury in their lifetime (1). Although experts agree that there is no such thing as “non-specific back pain” and that each case is individual, there are a few exercises that, if performed correctly, the general public would benefit from with regard to rehabbing lower back disorders. Additionally, these exercises can help increase resiliency and improve the strength and performance of your lower back to prevent future injuries.

Firstly, we must differentiate the concept of core stability/stiffness vs core strength.

Strength is the ability of a muscle(s) to produce force through a given movement. 

Stability is the ability of a muscle(s) to resist movement through a particular joint and maintain position and balance.

Although an individual may have sufficient core strength through performing loaded spinal movements such as abdominal crunches, russian twists, and lumbar extensions, they may still present with poor core stability and are, therefore, prone to low back injuries (2). In order to stabilize and decrease the risk of injury/re-injury to the lower back, we must learn to create stiffness through our core musculature in a neutral lumbar position.

Dr. Stuart McGill of Waterloo University, a leading back expert who has written extensively on the topic over the last few decades outlines three exercises that, although are not a “one size fits all”, are a good starting point to help individuals build resiliency and bulletproof their lower backs for both sport and daily life (3).

Each of these three exercises helps build core stiffness and stability through the three anatomical planes of the body. The first build stiffness through the frontal plane, the second through the lateral plane, and the third through the torsional plane.

 

The McGill “Big 3”

The curl up

• Lie on your back with one knee straight and one knee bent, place your hands under your lower back to ensure your spine remains in a neutral, slightly arched position (not flat). Unlike a traditional sit-up, the lower back should not bend to prevent increased compressive force through the lumbar spine.

• Lift the head and shoulders a few inches off the ground (maintaining your neck in a neutral position). The goal is to slightly bend only through the thoracic spine while preventing any movement through the lumbar spine.
• Hold the position for at least 5 seconds and repeat for 2 sets of 10 repetitions

The Side Bridge

• Lie on your side with your legs bent and your upper body supported through your elbow. Place your free hand on your opposite shoulder.
• Raise your hips off the ground and push them forward (no movement through the lower back, only extending forward through the hips) so that only your knee and arm support your bodyweight. Press your shoulder away from your ear by bracing through your lats (muscles through the mid-back)
• Hold the position for at least 5 seconds and repeat for 2 sets of 10 repetitions per side

The Bird Dog

• Get into an ‘All 4’s’ position (quadruped) with your back in neutral alignment (hands under your shoulders, knees under your hips)
• Without allowing any movement to occur at the low back, kick one of your legs backward while simultaneously raising the opposite side arm until both extremities are fully straightened. In order to prevent the low back from over-arching, think about kicking the heel of your foot straight back and squeezing your glute. 
• Make a fist and contract your arm/shoulder muscles as you hold it in the extended position to help increase muscle activity of the core (especially of the erector spinae muscles).
• Hold the position for at least 5 seconds and repeat for 2 sets of 5 repetitions per side

There are, of course, variations of these exercises that can progress the difficulty. However, the most simple way is to slowly progress the duration of the holds while reducing the number of repetitions. Ultimately, a guided and structured program by a Kinesiologist is ideal to ensure safe progression to get you back to performing at your best and/or carrying out daily activities pain-free.

 

References:

(1) Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun;64(6):2028-37. doi: 10.1002/art.34347. Epub 2012 Jan 9. Review.

(2) Lee BC, McGill SM. Effect of long-term isometric training on core/torso stiffness. JSCR. 215;29(6):1515-1526

(3) McGill SM. Ultimate Back Fitness and Performance (4thed). Waterloo, Canada: Backfitpro Inc, 2009. (www.backfitpro.com)