The following blog post is based on fifteen years of research, trial and a lot of error! The errors include all the old wives tales such as: stretching the hamstrings, massage, acupuncture, yoga, McKenzie exercises, traction and so much more. The one and only, one-stop-shop, an absolute expert in low back pain is Dr. Stuart McGill. His thirty years of research are a blessing to so many. All the information you need about McGill and his research may be found here.
In the last week of 2017, I hurt my back. I am currently experiencing pain in the middle of my lower back and a tingling sensation down my left leg. If I went to an orthopedic surgeon I would be diagnosed with bulging discs at L5 & S1. They would say the bulge is pressing on my sciatic nerve causing the sensation down my leg. This is not a nice sensation, but it is very common. In this blog post, I am going to share how to get from this place back to being pain-free.
The goal is to get back to correct mobility as soon as possible. To do this, you need to determine the right amount of resistance (training/exercise) that the body can handle. This is then increased over time. Before anything else the most important concept here is movement. Now I know that there is a day or two when you need to lie in bed with the hot water bottle, pain killers, heat patch or whatever you do but you need to get back to movement as soon as possible. Too much rest actually leads to back pain. Learn the hip hinge, ways for picking things up, getting up about of chairs and all of the extremely important movement patterns involving activation the hips and glutes (bum). All found in McGill's work.
Exercise Program - Week 1 - In Pain
10 x Cat/Camel - Warm-Up
3 x Side Plank on Knees (3 on each side)
3 x Bird Dog (Leg Only, 3 on each side)
6 x McGill Curl (3 on each leg)
Please click on the links to the videos to see the correct form. These exercises have been tested with sensors and have been found to put the minimal load on the back. They are the best possible exercises to build up support around the back and core and to begin to train the correct movement.
7.1.2018
After just over a week I am pain-free and have moved to the Russian descending pyramid. 5, 3, 1. This means I am still doing the above exercises but am now doing 3 sets. The first set is 5 reps on each side holding for 10 seconds. The second set is three reps and the final set is one repetition.
10.1.2018
Too easy so have moved to full side plank which you can see in this video. The difference here is that the contact point with the ground is the feet now instead of the knees. I am not transferring into the plank position at this stage. The other two exercises remain the same. You should also walk for 15 minutes three times a day from the very start but I did not incorporate that in this program due to work commitments. I am also ready at this stage to increase the intensity of the bird dog by raising an alternative arm. It may be seen here in this video (coming soon). I am still doing the Russian descending pyramid 5, 3, 1.
23.2.2018
I am now almost two weeks into the program. I have moved to the advanced level of McGill's Big 3. I am also slowly increasing the number of repetitions. My current program with videos is below. I warm up with the cat/camel and knee hip-hinge every day throughout the whole program.
The McGill Big 3 - Intermediate
Note: When I try the advanced level a slight pain returns to my back to I stop and return to intermediate.
Curl-up - 5, 4, 1
Side Plank - 5, 3, 1
Intermediate Bird-dog - 5, 3, 1
I have decided that as I am not two months into the program I am going to return to the gym. It is very difficult to leave my ego at the door and continue with my program, but I must do. One step backward to hopefully take two forward. The below exercises are designed to train the correct movement as I am now pain-free and am planning to set a new goal for myself. I am going to stick to this program until the end of June, then work towards 5 reps of 100kg in the bench press, deadlift, and squat. This is something I have never done before in my life. I currently weigh 75 kg.
In their book The Gift of Healing, Dr. McGill and Brian Carroll write at length at the importance of correcting the wrong movement. The following workout I am planning to do 2-3 times a week on top of doing the above program each day.
Kettlebell squats - 5, 5, 5
Bottoms-up kettlebell press - 5, 5, 5
McGill Pull-up - 1x10
15 min walk on the treadmill
Farmers walk
The goal in all of these exercises is to learn to brace by back correctly and to maintain perfect form throughout the exercises. Before each exercise, I engage my lats, brace my stomach and employ the other techniques advised in the book. You must learn this as it goes further to protect the back under loads.
Advanced Bird-dog 5,3,1
Side bridge to plank 5,
Note: After 3 months of doing great I decided to try squatting and deadlifting again. I immediately hurt my back and have been out for a month. I am starting at the top from scratch again:-( Dr. McGill recommended I stay out for 6 months but I did not listen. This time I will, hopefully...
3.8.2018
I have been pain-free for a couple of months now and have decided to give the weight training a go again. I am well on my way towards my goal of 5x100kg on the big three. At the moment I am at 70 kg and have been incorporating the Hex Deadlift. This video shows the correct form. It is extremely important when lifting anything to:
1. Engage your lats and abs
2. Tuck your chin
3. Take a deep breath and hold it, pushing on the belt
4. Grip the floor with your toes, but push through the heels
5. Always begin with the hip-hinge
I am experiencing a slight amount of pain today but whether this subsides or not will determine whether or not I continue with the program.
Note: I did not give the 6 months that Dr. McGill suggested. This is extremely foolish and I highly recommend 6 months of McGill's exercises before returning to lifting.
22.9.2019
I am hoping this will be the final entry in this blog. I have learned so much about my body and by back through this journey. A recent MRI has shown that the discs are extremely degenerated. The surgeon who saw me did not recommend surgery, suggested I can eventually go back to kickboxing (he was Thai:) and lifting but suggested I not do any squatting or anything that loads the spine.
So I got back to it again and worked my way up to 5-3-1 on The McGill Big 3 in their strictest forms as shown here, here and here. I decided to stay at 5-3-1 this time as when I tried to increase in the past along with the weight program have hurt myself. I did this for two months then began a new training program doing a push session based around the bench, pull session based around chins and the hex deadlift and a leg session where I tried numerous different exercises to replace the squat. Every time my ego kicked in and I tried a variation of the squat slight pain returned. The penny has finally dropped.
1.10.2019
I started this journey two years and one month ago, and completed it today.
