- Calm down your muscles
- Release hyperactive muscles
- Eliminate trigger points
- Analyze and correct your habits
- Find your pain triggers
- Learn to move without pain
- Implement new habits
- How to hip hinge
- How to sit
- How to stand
- Walk
- Stiffen the spine
- The real function of the core
- McGill Big 3
- Optimize the body
- Core strength
- 4 levels of lower back strength
- Hip strength
- Mobility standards
The 5 steps I took to eliminate my chronic, excruciating back pain and return to a pain free, high impact life. This system is catered to the back pain sufferer with no major medical diagnosis (MRI looked fine, doctor flippantly referred PT, PT gave you corrective stretches and exercises, the underlying back pain still comes and goes - or worse - it stays, sound familiar?), is healthy on the outside, and suffered no single major back injury event. If you fit the previous 3 criteria, you are in the right place.
1. Calm Down Your Muscles
If you are in chronic low back pain, chances are high there are multiple muscles that have shortened and developed trigger points (knots in lower back). These muscles initially tighten and knot in order to protect the spine from injury, but after a while they just become a nuisance.
The first thing you want to do is to get these muscles to calm the fuck down, so your body can correct itself. I recommend buying a few self massage tools - or just the QL Claw, which can hit every muscle I am about to list - to go to war with your tense muscles.
You will want to massage the Quadratus Lumborum in the low back, the Iliacus and Psoas hip flexors, and the Piriformis and Gluteus Medius in the rear-end. See hyperlinks for tutorials.
2. Analyze and Correct Your Habits
Your pain is a product of your habits. Read that again, it is the key to success with your pain. In order to STAY out of pain, you will need to take an honest, hard look at how you bend over, sit, and stand.
Learn to stay out of pain. Your pain actually gets MORE sensitive the more you aggravate it, like hit your thumb with a hammer every 30 seconds - each repetitive blow feels worse. Every movement out of pain is a win and a step closer to pain free lifestyle.
3. Implement New Habits
Proper hip hinging is essential to low back pain relief. Frustratingly natural to some people, back pain sufferers tend to bend forward at the lumbar spine while pain free folks use the hips and glute muscles. The proper hip hinge uses the glutes to drive the hinge, and lats and abs to stabilize the spine. Having an open stomach with space between your hips and ribs is also key.
Sitting is not a natural human position. The human body was designed to walk, run, squat, and lay down - and we frigged ourselves by designing chairs. Learn to sit with a neutral spine. A nice neutral spine as a hollow lumbar spine, slightly kyphotic thoracic spine, and lordotic cervical spine. Do no sit for too long at once, and do not sit through pain.
Standing posture is the most overlooked factor by physical and massage therapists treating back pain. Like the sitting posture, you should maintain a neutral, naturally curved spine while standing. A great test for this is to make sure your lumbar spinal erectors are off in your natural standing position.
"If you do not walk every day, you deserve your pain" - Stuart McGill. Walking is a natural movement that provides light lubrication to the spine and keeps it healthy. I recommend two walks per day of 10+ minutes in duration.
4. Stiffen the Spine
The core and lumbar spine are NOT supposed to move. They are supposed to OPPOSE movement, while the limbs and hips move the body around. Think of your spine like a metal chain link, around 25 links long. Now imagine one of the chains near the bottom is made of rubber. When you twist the entire chain so that it is taught, then twist it past its threshold, which link is going to be the problem? Problem links lead to annular tears, disc issues, and muscle spasms. Stiffen your spine.
Stop doing Sit-ups and Russian Twists. Now.
Dr. Stuart McGill spent his 30+ year career treating back pain, and created the simplest, most elegant 3 exercise solution to increasing spine stiffness. It is as follows:
- Modified Curl-Up
- Side Plank
- Bird Dog
Now, if you stop right here and start cranking these movements out on your own you will probably do all 3 wrong. Dr. McGill has precise methods for each of these movements - check out our tutorial for his account of each exercise here.
5. Optimize the Body
If you made it here, you should now be performing daily activities pain free. But you were built for more than soft "daily activities". Follow these core, back, hip, and mobility workouts and tips to get into high percentage shape.
Core: Keep doing McGill big 3, adding more complicated stiffening movement. Avoid Sit-ups and Russian Twists at all costs. Include movements that resist spinal torsion, flexion, and extension.
Back: The low back comprises of 4 major muscle groups: Quadratus Lumborum (QL), Latissimus Dorsi (Lats), Spinal Erectors (Erectors), and Spinotransverse muscles (Multifidus). Make sure you work all 4 to have a strong, functional back.
- QL: Side Hyperextensions, Suitcase Carry
- Lats: Cable Pulldowns, Bird Dogs
- Erectors: Reverse Hyperextensions
- Multifidus: Med ball Bird Dogs
Hips: Seated Good Mornings, Glute bridges, RDLs, Clamshells
Mobility: Stretch those hamstrings, glutes, hip flexors, adductors, shoulders, traps, pectorals, and neck. Work up to sitting in a full squat pain free for 10 minutes.