<p>Here’s an 80 minute audio interview with McGill, along with an article he wrote with videos:</p>
<p>[Dr</a>. Stuart McGill - Teleseminar Interview 5](<a href=“Dr. Stuart McGill - Teleseminar Interview #5 | Online Continuing Education for Physical Therapists”>Dr. Stuart McGill - Teleseminar Interview #5 | Online Continuing Education for Physical Therapists)</p>
<p>iDad- How are you doing side plank? I was confused by how he describes it in the article. I thought you lift your whole body up from a side lying position and either support with a straight arm or on the forearm with bent elbow.</p>
<p>Now, I do side plank on my forearm and stacked feet – basically the edge of my bottom foot takes the force. For the first several months, I did the beginner version on my forearm and knees (with my legs bent to the back).</p>
<p>When I do the side bridge with a twist, I don’t stack my feet, but rather put the top foot in front of the rear foot so the inside edge of the front foot and the outside edge of the back foot are taking the force. That allows me to pivot the top arm (and dumbbell) from straight up to the ceiling, all the way down reaching under my chest. I believe that McGill teaches this two foot version.</p>
<p>There’s a video of side plank in the [Dr</a>. Stuart McGill - Teleseminar Interview 5](<a href=“Dr. Stuart McGill - Teleseminar Interview #5 | Online Continuing Education for Physical Therapists”>Dr. Stuart McGill - Teleseminar Interview #5 | Online Continuing Education for Physical Therapists) link.</p>
<p>pugmakate:</p>
<p>What was your back injury? Herniated disc? What’s the prognosis?</p>
<p>One herniated (between L4 and L5) and the discs directly above and below it are bulging. Oddly, while they first saw the herniated disc back in March when my back troubles started, this time the MRI showed that the disc had not gotten longer, as is typically, but wider. I said, “Great, even my discs are spreading.” My doc laughed. He’s a good guy.</p>
<p>My prognosis is good but the exact path is still unknown. I’m doing everything in my power to avoid surgery. It’s not that I’m against back surgery, it’s that I don’t do well with anesthesia nor pain meds. In fact, after my sister picked me up in Boston (that’s where this happened) and drove me to the ER near her house, the first thing they did was give me a shot of morphine and that’s how we found out I’m allergic to it. Typical for me! </p>
<p>As is, I’m already facing a surgery because this second MRI that I had last month showed a 10cm cyst on my ovary and that has to come out. I’m hoping to put off the surgery until the new year but we’ll see what my doc says next week. </p>
<p>I’m also weary to go back to my beloved PT because he had me doing nothing like the Dr McGill stuff and now I wonder if that wasn’t the reason for my second time of going down with this back injury. He did great things for my knee two years ago but when I showed my spine doc in MA some of what I was doing at home, he told me to stop immediately and showed me a few exercises involve no crunches or trying to lift my pelvis off the ground.</p>
<p>Sorry your short questions got such a long answer!</p>
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<p>I’m not a doctor or a physical therapist, but I know that the current state-of-the-art in exercise and PT, for everyone, especially anyone with a lumbar back injury, is to do NOTHING that rounds the spine forward. The whole problem is that we, as a society, spend too much time sitting with our spines bent foward. The last thing we need to do is crunches and leg lifts and situps that intentionally round the spine forward. If I had lower back pain or a bulging disc or a herniated disk, I would say "thanks, but no thanks, to any PT who asks me to do a sit-up or a crunch or a pelvic lift. Trainers like Mike Boyle and Eric Cressey are fanatical about this these days. If Boyle won’t allow the 22 year old college football players he trains for the NFL to do a crunch or sit-up, there’s no way in heck I’m doing ‘em. I’m an ol’ fat guy, not a young limberback. Spine injuries are usually repetitive stress, over-use injuries where the discs have just worn out from flexing too much. So, stopping the over-use seems to be an obvious place to start.</p>
<p>Curl up and listen to the interview with McGill. You might have to google some of the muscle names he throws out there to follow everything he’s saying, but you will get a good idea of his overall approach. He even walks through evaluating someone with a lower back injury to figure out how to approach their rehab. He says that he can often eliminate their pain with some movements, just by teaching them to brace their core muscles, which holds the spine straight and by teaching them the fundamentals of bending and lifting and even getting up off a chair or the toilet correctly (using the hips, not the back). I learned a lot from his interview; it reinforced the idea of paying very close attention to the lower back when exercising.</p>
<p>If I were you, I would seriously consider his textbook and/or DVD on back injuries and exercises. Looks like this one is more for the lay person:</p>
<p>[Amazon.com:</a> Ultimate Back Fitness & Performance 4th Ed: Sports & Outdoors](<a href=“http://www.amazon.com/gp/product/B002C9ERUG]Amazon.com:”>http://www.amazon.com/gp/product/B002C9ERUG)</p>
<p>And this one more for the health professional, although it might be a good read for someone in your shoes:</p>
<p>[Amazon.com:</a> Low Back Disorders, Second Edition (9780736066921): Stuart McGill: Books](<a href=“http://www.amazon.com/gp/product/0736066926]Amazon.com:”>http://www.amazon.com/gp/product/0736066926)</p>
<p>Or, go the DVD route:</p>
<p>[Amazon.com:</a> The Ultimate Back McGill’s Techniques DVD: Sports & Outdoors](<a href=“http://www.amazon.com/gp/product/B002C9GMSG]Amazon.com:”>http://www.amazon.com/gp/product/B002C9GMSG)</p>
<p>PMK: I just read about your back issues, and I also had a herniated disc about 8 years ago. No surgery but it took a long time to get better. For better or worse, pain meds did not help in the least. The only thing that did help was steroids, but too much of those are not good either. The way my doctor explained it, the pain results from the thick fluid that should be in the disc pressing against the nerves. The fluid will dry up and stop pressing against the nerves but that takes time. The first three months were completely horrible, partly because of the pain and partly because I could not sleep–lying down in any position was torture. I have not been as good as I should about keeping up with the exercises but one thing that I did do was learn to sleep on my back. Whether or not that has helped prevent a recurrence I can’t say for sure, but I used to sleep on my stomach and I have read that that is very bad for your spine.</p>
<p>Idad: Thanks for posting the links to the books. Once the semester ends I’m going to join the gym at the hospital near my office, and I’ll start with a few PT sessions (with a $40 copay it’s probably about the same as a personal trainer) and I do think not all of them are up on the no-bending thing.</p>
<p>Not all forward bends are bad, if you do it correctly it can be very good for your spine. Most people don’t have enough flexibility in their hamstrings and hips so end up overstretching with their lower back instead. But is Dr. McGill is referring to crunch type actions?</p>
<p>McGill is adamant about not doing crunches or sit-ups. More generally, the two buzzwords are:</p>
<p>a) maintain a neutral spine (with just a slight concave curve as you would have with a lumbar support pillow behind your back in a chair) at all times with all exercises. The spine itself should, ideally, never bend or round forward during exericse.</p>
<p>b) The bending comes from a “hip hinge”, bending at the hips, not the spine. Most of us, especially men, have insufficient flexibility in the hips, so a lot of exercises focus on correcting this. For example, the squat that is so much a part of exercise programs, is all about pushing the hips back and lowering down while maintaining that neutral spine curve. Any rounding forward of the back is bad technique. This move gets at the heart of “lifting with your legs, not your back” and it’s also the proper way to get up out of a chair. The weight is on the heels, not the toes. Quite literally, if granny can learn how to squat and use the big muscles of her legs instead of her back, she won’t need to go to assisted living because she’ll be able to get up out of a chair or off the toilet.</p>
<p>Here is the ultimate “hip hinge” exercise:</p>
<p>[Mike</a> Boyle Single-Leg, Straight-Leg Deadlift STACK TV](<a href=“http://stacktv.stack.com/video.aspx?videoID=13591899001_430]Mike”>http://stacktv.stack.com/video.aspx?videoID=13591899001_430)</p>
<p>I can’t do it at all. I fall over. I’m working on the elementary school version. No weight, just reaching out towards a wall with both hands (or a very light dumbell held in both hands) as I bend at the hips. That’s what Boyle refers to as a “reaching deadlift”. Notice that the Harvard fooball player is maintaining a neutral spine throughout this entire bend. He’s not rounding his back at all.</p>
<p>Amesie wrote
</p>
<p>I was very, very lucky in that it was walking/standing that was torture for me, which meant I could lie down so long as I had pillows supporting me; first I could only lie on my back with pillows under my legs then eventually I got to where I am now which is being able to side sleep so long as I keep a pillow between my knees. First I could only crawl but after only about a week I could walk with assistance, then on my own and, most recently, walk standing upright. Ah, what a relief that has been! </p>
<p>Also, heat. In the past I’ve been very partial to ice but this time after using ice for the the first few days of the injury, it was heating up my lower back that allowed me to move around at all. Interestingly, now that I can stand upright again, the heating pad is not such a help. </p>
<p>Kate, who is starting her day with two new mantras, “neutral spine” and “hip hinge.”</p>
<p>Poor NorthMinn! Hope you’re feeling better soon!</p>
<p>Thanks chintzy. I think the stomach virus has passed this morning…thank heavens! Still have the major cold symptoms. I am at a very low weight at the moment but don’t know if it will hold once I start increasing fluids and solid foods today. Terrible way to drop weight! 
Several friends commented that I looked terrible this morning…gee thanks. Both of my Ds now have the stomach bug and H is dreading that he may get it.</p>
<p>nMinn:</p>
<p>Get well soon! Sounds like you better plan on taking the week off from the gym. Trying to exercise when sick is no fun and probably doesn’t do much good. Take an extra day to fully recover. The last time I was sick, I was able to get right back up to speed after just a couple of days back in the saddle. If anything, it may be good to take a regenerate break after months of hard exercise like you’ve been doing.</p>
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<p>I’m surprised you can’t do this one, I-dad. I can do it with a light (8 pound) weight–probably couldn’t have done it without holding on to something when I first started in January. To me, this straight-leg dead lift requires good balance as much as anything else. In pilates mat class and reformer too, the instructors are always, always making sure people have a neutral spine. I found it’s a good thing to remember for other kinds of exercises as well.</p>
<p>I can’t even begin to do the one-legged squat video you posted–the one with the really muscular Russian lady–Svetlana?. I tried and got my leg up but could only go down about an inch. I asked my trainer today if she could do it and she did, but she didn’t get down nearly as far as Svetlana.</p>
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<p>Yep. Balance is the problem. That’s why I’m workin’ on it! Men don’t hip hinge or balance worth a damn. My back goes round and when I focus on the hip hinge, my leg doesn’t come up properly. And then, I fall over! I’ll get there. I can do the exercise, by my form is just atrocious, so I’ve backed the truck up and am following Boyle’s advice to progress from the easier version. Adding weight to bad form is generally not productive for me.</p>
<p>If you want to work on the single leg squat, stand on the edge of a step and let your other leg hang down off the step (or box). It’s much better posture than trying to stick it straight out to the front, easier on the back. I can only go down about about an inch, too. But, I’m making big progress on split squats and lateral squats, so I’ll get there. All in due time.</p>
<p>nMinn, I hope everyone is on the mend soon.</p>
<p>I met with the personal trainer at my new gym. It was a pre-work out meeting and it was interesting. I explained my limitations, including not doing crunches. He seemed surprised by that, telling me that anything good for the core would be good for stabling my back. I think I’m just going to have him show me how to use the weight machines; I put as one of my goals “Michelle Obama’s arms.”</p>
<p>I’m also finding doing my laps and stretches to be a bit harder now that I’m thinking “neutral spine” all the time. It seems every time I mentally check if my belly button is pulled it, it is not. At least it distracts me from how many more laps I have to do!</p>
<p>Now, today was a hard workout. Probably pushing the ol’ (formerly) fat guy a little too hard.</p>
<p>Mike Boyle’s mobility warm up plus some unweighted rear-foot elevated split squats and reaching single leg dead lifts (two I’m working on for balance and form).</p>
<p>Then, four supersets, three sets of each:</p>
<p>*1) Split squat with opposite arm dumbbell lateral raise
2) Plank on ball, lifting one leg at a time off the ball, alternating legs.</p>
<p>Repeat for 3 sets, then:</p>
<p>Jogging in place
2 minute rest</p>
<p>1) Squat with dumbbells curl and press
2) Single arm dumbbell stability ball bench press</p>
<p>Repeat for 3 sets, then:</p>
<p>Burpees
2 minute rest</p>
<p>1) Lunge walks with dumbbell lateral raises
2) Pushups with feet on stability ball (supposed to be one-legged, but I was only able to do a couple of those in each set, barely)</p>
<p>Repeat for 3 sets, then:</p>
<p>Jumping Jacks
2 minute rest</p>
<p>1) Reverse flys on stability ball
2) Ab wheel rollouts (nice and easy!)</p>
<p>Repeat for 3 sets, then:</p>
<p>Mountain climbers
5 minute Airdyne cool down*</p>
<p>56 minutes, average heart rate 79%, max heart rate 96%. Tired arms: 2 Tired legs: 2</p>
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<p>Well, the part about strenghtening your core is true. Best analogy I’ve heard is that the spine is like one of those 1000 foot tall TV antennas, held up by guy wires extending out. Break the guy wires and the tower falls. The core muscles, on the front, sides, back of the abdominal wall along the butt muscles (“glutes”) are the guy wires that support the spine. The bulk of your exercise program should be strengthening those core muscles, as it should be for anyone starting out. That’s where Mike Boyle starts his NFL players. These are not, however, muscles that move a lot like your arms or legs. These muscles work by tensing and stabilizing. They form the rigid core tha your hips, legs, and arms work against and through. There is really no legitimate reason for doing exercises that bend or flex these muscles. I think I’ve now seen just about every “core” exercise in the book from Yuri Elkaim, Mike Boyle, Alwyn Cosgrove, and Robin Cosgrove - alll core fanatics – and I can’t think of a single one that involves bending the spine. There are a few (like the t-pushup) that involve twisting the torso, but even those are done with a neutral spine.</p>
<p>Stuart McGill’s “big three” would probably be where he would start you: </p>
<p>McGill curl up
side plank
bird dog</p>
<p>I suspect that he would add a progression of front plank to stability ball plank to stability ball “stir the pot” as your back allows. If you don’t have the core strength to do front plank properly, it can be painful to the lower back, so he’d probably want to see you on bird dog and curl up for a while. I think you’ll find a PT who is in sync with this approach. </p>
<p>Those are the four exercises in that NY TIMES video.</p>
<p>PMK:</p>
<p>Above all else, I would take Mike Boyle’s advice to heart:</p>
<p>[Does</a> it Hurt?](<a href=“http://www.strengthcoach.com/public/1602.cfm]Does”>http://www.strengthcoach.com/public/1602.cfm)</p>
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<p>Am trying to catch up on all the posts since last weekend.</p>
<p>In the meantime, here’s a fabulous article to give you inspiration.</p>
<p>This woman puts all of us to shame! Good for her!</p>
<p>The Incredible Flying Nonagenarian
<a href=“Olga Kotelko, the 91-Year-Old Track Star - The New York Times”>Olga Kotelko, the 91-Year-Old Track Star - The New York Times;