Protocols to Strengthen & Pain Proof Your Back

00:00:00.000 | - Welcome to the Huberman Lab Podcast,

00:00:02.240 | where we discuss science

00:00:03.720 | and science-based tools for everyday life.

00:00:05.920 | I'm Andrew Huberman,

00:00:10.240 | and I'm a professor of neurobiology and ophthalmology

00:00:13.220 | at Stanford School of Medicine.

00:00:15.240 | Today, we are discussing how to build

00:00:16.720 | a strong, pain-free back.

00:00:18.780 | Having a strong, pain-free back has numerous advantages,

00:00:21.800 | not the least of which is you're not in pain,

00:00:24.300 | as well as the fact that you can carry out

00:00:26.120 | your daily activities,

00:00:27.440 | any exercise or sports you might play,

00:00:29.440 | interactions with family members,

00:00:31.000 | like picking up a kid,

00:00:32.200 | leaning down to get things out of a cupboard,

00:00:34.480 | or reaching up to get things out of a cabinet

00:00:36.800 | without any pain.

00:00:38.740 | And back pain is one of those things

00:00:40.280 | that even if minor, and certainly if severe,

00:00:43.700 | severely impedes our ability to do most everything,

00:00:46.720 | even to just sit still or lay still.

00:00:49.480 | And one of the things about pain,

00:00:50.920 | in particular back and neck pain,

00:00:53.480 | is that it also has an effect on our emotional self.

00:00:56.700 | It makes us more irritable.

00:00:58.280 | It makes any activity, even the most mundane activities,

00:01:01.480 | that much more distressing to carry out.

00:01:04.160 | So during today's discussion,

00:01:05.440 | we will talk about how to ameliorate pain.

00:01:07.880 | However, pain as a general topic

00:01:10.000 | was already covered on this podcast

00:01:11.920 | with an expert guest, Dr. Sean Mackey,

00:01:13.980 | who's a medical doctor at Stanford.

00:01:15.620 | He's actually the director of our pain clinic.

00:01:18.520 | And on that episode,

00:01:19.680 | which we provide a link to in the show note captions,

00:01:22.240 | he talks about the various ways to address pain,

00:01:25.040 | everything from pain medication, to epidurals,

00:01:28.720 | to electrical stimulation,

00:01:30.560 | and importantly, the biopsychosocial model of pain,

00:01:34.160 | whereby our thoughts and our perceptions about pain

00:01:37.120 | actually influence the severity

00:01:39.120 | and the duration of that pain.

00:01:41.240 | So if you're interested in pain

00:01:42.580 | and the treatment of pain per se,

00:01:44.120 | I highly recommend that episode.

00:01:46.120 | Today, we will certainly talk about

00:01:47.720 | ways to deal with back pain,

00:01:49.240 | ways to reduce it,

00:01:50.600 | and perhaps even eliminate it altogether.

00:01:53.320 | But we are also going to talk a lot about

00:01:55.360 | how to pain-proof your back

00:01:57.080 | and how to build a really strong back,

00:01:59.420 | not just for pulling things,

00:02:01.180 | because the back muscles are involved in pulling things,

00:02:04.000 | but also just for generating a really strong, stable core,

00:02:08.360 | strong spinal erectors,

00:02:09.980 | making sure that your pelvis and your spine

00:02:12.000 | are interacting correctly,

00:02:13.320 | that your shoulders, neck, and spine, and pelvis,

00:02:15.680 | and even your lower limbs and feet

00:02:17.560 | are working together in the proper manner

00:02:20.040 | to make sure that you have the strongest

00:02:21.720 | and most pain-free back possible.

00:02:24.120 | So what I'm going to do

00:02:25.360 | is first I'm going to describe

00:02:26.840 | a bit of back anatomy and physiology.

00:02:29.580 | I'm going to talk about the neuromuscular components

00:02:32.240 | as well as the spinal and disc components.

00:02:34.660 | I promise, even if you don't have a background in biology,

00:02:37.040 | I'm going to make this all very accessible

00:02:39.040 | to any and all of you.

00:02:40.400 | And then I'm going to go into

00:02:42.140 | the 10 or 12 specific things,

00:02:43.860 | in particular, six things that take very little time

00:02:47.420 | that require no equipment,

00:02:48.720 | no purchase of anything whatsoever,

00:02:50.600 | and involve a very minimal time investment

00:02:53.160 | that will allow you to build a really strong, pain-free back.

00:02:57.080 | What's covered are protocols

00:02:58.560 | from three of the world's foremost experts in back pain,

00:03:02.000 | but also back strengthening

00:03:03.800 | and building resilience into the back.

00:03:05.560 | So they include a medical doctor,

00:03:07.320 | expert in back strengthening and rehabilitation,

00:03:10.480 | a PhD researcher who has spent decades

00:03:13.760 | researching the spine

00:03:15.320 | and ways to strengthen the core and spine,

00:03:17.760 | and a world-class PhD physical therapist

00:03:20.420 | who is expert not just in the spine,

00:03:22.200 | but in fact, in the movement, rehabilitation,

00:03:24.800 | and strengthening of the entire body.

00:03:26.960 | They are the MD, Dr. Sean Miller,

00:03:30.280 | the PhD, Dr. Stuart McGill,

00:03:33.040 | and also the PhD, Dr. Kelly Starrett.

00:03:35.920 | I provide links to them

00:03:37.200 | and resources that they provide in the show note captions.

00:03:39.840 | And indeed, I plan to host all three of them separately

00:03:43.440 | on the Huberman Lab Podcast

00:03:44.840 | as expert guests in the not too distant future.

00:03:47.280 | Before we begin,

00:03:48.120 | I'd like to emphasize that this podcast

00:03:49.820 | is separate from my teaching and research roles at Stanford.

00:03:52.640 | It is however, part of my desire and effort

00:03:54.760 | to bring zero cost to consumer information

00:03:56.740 | about science and science related tools

00:03:58.740 | to the general public.

00:04:00.080 | In keeping with that theme,

00:04:01.140 | I'd like to thank the sponsors of today's podcast.

00:04:03.920 | Our first sponsor is AeroPress.

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00:04:23.880 | I started using AeroPress over 10 years ago,

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00:05:11.680 | Today's episode is also brought to us by Juve.

00:05:14.560 | Juve makes medical grade red light therapy devices.

00:05:17.860 | Now, if there's one thing I've consistently emphasized

00:05:20.040 | on this podcast,

00:05:21.080 | it's the incredible role that light can have on our biology.

00:05:24.640 | And of course, I'm always telling people

00:05:26.160 | that they should get sunlight in their eyes

00:05:27.760 | as soon as possible after waking

00:05:29.240 | on as many days of their life as possible

00:05:31.680 | for sake of setting circadian rhythm,

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00:05:36.320 | Now, in addition to sunlight,

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00:06:42.740 | Today's episode is also brought to us by Waking Up.

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00:07:57.340 | Okay, let's talk about the back.

00:08:00.100 | The back for many people simply means the spine,

00:08:03.740 | the bony stuff that runs down your middle.

00:08:06.340 | Now, of course your spine doesn't just run down your middle.

00:08:08.720 | You've got your cervical spine, up near your neck.

00:08:10.860 | Don't ever forget that.

00:08:11.780 | Your neck is the upper part of your spine.

00:08:14.780 | You've got the thoracic spine,

00:08:17.460 | which is essentially through, you know,

00:08:18.860 | in insects we think of the thorax.

00:08:20.580 | Remember that from biology class

00:08:22.020 | in middle school or high school?

00:08:23.460 | But through your region here, you know,

00:08:26.540 | basically down from the neck through the chest,

00:08:28.780 | and then you've got your lumbar spine,

00:08:30.820 | which is the part right below that.

00:08:32.180 | And then you have the sacral spine,

00:08:33.540 | which is the area of the spine that is in the pelvic region.

00:08:36.780 | And then of course there's the bottom region of that,

00:08:38.900 | which is called the coccyx spine,

00:08:40.720 | which is the very lowest part

00:08:42.420 | of the sacral region of the spine.

00:08:44.340 | Now, of course, that's the bony stuff.

00:08:45.940 | And if you've ever seen a spine on a, you know,

00:08:48.560 | a skeleton of any kind or a drawing of a skeleton,

00:08:51.380 | you know that it's a bunch of segments.

00:08:52.860 | It's a bunch of bony segments.

00:08:54.820 | It's important to understand that the back is made up

00:08:57.060 | not just of bony stuff,

00:08:58.660 | but it's got stuff in between, which are the discs.

00:09:01.860 | The discs are the soft tissue

00:09:03.740 | that sit between the vertebrae, right?

00:09:05.620 | The vertebrae are the bones.

00:09:06.780 | And those discs have some durability to them.

00:09:10.260 | They're not easily squished, but they can be squished.

00:09:13.720 | That is, they can move.

00:09:14.720 | They're a soft tissue that allows for mobility

00:09:18.640 | of the bony stuff.

00:09:20.160 | So you've got basically bone disc, bone disc,

00:09:23.520 | bone disc, bone disc.

00:09:25.640 | And it's those discs that allow for movement of the spine

00:09:29.240 | from side to side.

00:09:30.160 | And it actually allows for some compression

00:09:32.120 | along the length of the spine as well.

00:09:34.200 | What sometimes today I'll refer to as vertical compression,

00:09:37.320 | but actually vertical isn't the correct anatomical term.

00:09:40.160 | So in anatomical terms, we talk about anterior-posterior.

00:09:42.840 | We talk about rostral caudal,

00:09:44.640 | which is just different language for anterior-posterior.

00:09:47.340 | I'm going to try and avoid using fancy nomenclature

00:09:49.880 | as much as possible.

00:09:51.240 | But the point here is that those discs

00:09:52.760 | allow for movement of the vertebrae.

00:09:54.980 | But keep in mind that the vertebrae and the discs

00:09:58.600 | have a hole down the middle.

00:10:00.200 | They look like doughnuts, basically.

00:10:01.640 | They're not perfectly round like doughnuts,

00:10:03.140 | but for the time being,

00:10:04.200 | just think of them as doughnuts, right?

00:10:06.420 | Some are bony doughnuts

00:10:07.880 | and others have more pliability to them,

00:10:10.300 | but there's a hole down their middle.

00:10:11.860 | Why?

00:10:12.700 | Well, within that hole is a long snake-like piece

00:10:17.700 | of the nervous system called the spinal cord,

00:10:20.920 | which is the neural stuff, the neurons.

00:10:23.200 | Now, within the spinal cord, it's not just neurons,

00:10:25.840 | nerve cells, okay, neurons means nerve cells.

00:10:28.160 | It's also glia, which are another cell type

00:10:30.920 | that provides, yes, support to the neurons,

00:10:33.080 | but also do some really important things on their own,

00:10:35.100 | like clearing out a metabolic waste.

00:10:37.160 | They actually regulate communication between neurons.

00:10:39.840 | If you've ever heard that the glia are just glue,

00:10:42.680 | and that's actually the Latin translation of glia, glue,

00:10:46.160 | it implies that they're not doing much actively,

00:10:48.260 | that they're just sort of a passive participant

00:10:50.020 | keeping things together.

00:10:50.860 | The glia are really doing important things as well.

00:10:53.320 | But keep in mind that the spinal cord

00:10:54.840 | is this long snake-like process of the nervous system

00:10:59.440 | that extends down through the vertebrae

00:11:01.520 | and down through the discs.

00:11:03.060 | Or if you prefer, you can think about

00:11:05.040 | the long snake-like process of the spinal cord,

00:11:09.360 | and then around it, all along its length,

00:11:11.920 | you have bony vertebrae, disc, bony vertebrae, disc,

00:11:15.280 | bony vertebrae, disc, going all the way

00:11:17.320 | from the neck region down to that coccyx region

00:11:20.040 | within the pelvis.

00:11:21.200 | Now, the thing about neural tissue is it's very soft.

00:11:23.520 | It's very fragile.

00:11:24.960 | And one of the reasons we have vertebra

00:11:26.800 | is to give the spinal cord some rigidity

00:11:29.500 | and protection from damage.

00:11:31.240 | And that's really important because the spinal cord,

00:11:33.180 | this long tube of neural tissue that sits inside

00:11:36.160 | of the vertebrae and the discs,

00:11:38.800 | it's central nervous system tissue, CNS tissue.

00:11:42.760 | And as CNS tissue, it does not regenerate after injury.

00:11:47.080 | It may be a tiny bit in certain conditions

00:11:49.480 | and in very young people,

00:11:51.140 | but if the spinal cord is damaged,

00:11:53.440 | typically there's a lot of scar tissue that forms,

00:11:56.240 | but there is no renewal of the neurons that are damaged.

00:12:00.600 | So it's very important that the spinal cord be protected

00:12:03.160 | which is one of the reasons why it is encased

00:12:05.560 | by those vertebrae and the discs.

00:12:07.720 | Now, the other thing to understand is that the spinal cord

00:12:10.680 | is indeed a snake-like extension out the back of the brain.

00:12:15.480 | So the brain and spinal cord make up

00:12:17.400 | what we call the central nervous system, the CNS.

00:12:19.400 | We just talked about that a moment ago.

00:12:21.240 | But now I want you to think about the brain.

00:12:23.720 | Your brain, of course, is encapsulated within the skull,

00:12:26.240 | the cranial vault.

00:12:27.060 | There are only two pieces of your brain

00:12:28.600 | that reside outside of the cranial vault.

00:12:30.600 | They are your neural retinas that line the back of your eyes

00:12:33.120 | I know many of you have heard me say this before,

00:12:35.000 | but it's so cool that I can't help

00:12:36.880 | but share it again and again,

00:12:38.400 | which is that you have two pieces of your brain,

00:12:40.800 | literally your central nervous system

00:12:43.060 | that were extruded out from the cranial vault

00:12:46.600 | during development while you were in utero.

00:12:48.440 | This happens in the first trimester when you were an embryo

00:12:51.940 | that line the back of your eyes like a pie crust.

00:12:54.180 | And those linings of the back of your eye like a pie crust

00:12:57.640 | are made up of three layers of neurons

00:12:59.480 | and a bunch of glia, and they are your neural retinas.

00:13:02.160 | They are two pieces of brain that literally look out

00:13:05.400 | into the world and are activated by what?

00:13:09.320 | By light, by sunlight, by edges and objects,

00:13:12.120 | by the photons in the outside world.

00:13:14.840 | And that's what gives rise to vision.

00:13:16.520 | So starting at the front of your head

00:13:18.160 | and working down through the spinal cord,

00:13:19.760 | we can do this very quickly to give you a complete picture.

00:13:22.660 | You've got your neural retinas

00:13:23.800 | that line the back of your eyes.

00:13:25.240 | They are central nervous system.

00:13:26.460 | They are brain.

00:13:27.760 | They communicate with the rest of your brain

00:13:29.320 | through the optic nerves.

00:13:30.280 | Then you've got your brain.

00:13:31.680 | You've got the brain parts that respond to hearing,

00:13:34.120 | the brain parts that allow you to think,

00:13:35.720 | imagine, learn, remember, et cetera.

00:13:37.840 | And then at the back of the brain, you have the brain stem.

00:13:40.800 | And then extending out from the brain stem,

00:13:43.340 | you have the spinal cord, this tube-like neural structure

00:13:46.420 | that extends down through the vertebrae,

00:13:49.140 | down through the discs, all the way to your pelvic region.

00:13:53.400 | Now, why am I telling you all this neuroscience?

00:13:55.200 | If we're talking about strengthening the back,

00:13:56.840 | why am I talking about the spinal cord?

00:13:58.760 | Why am I talking about neurons in the brain?

00:14:00.900 | Well, just as your brain has the cranial vault,

00:14:03.640 | your skull, to protect it,

00:14:05.580 | your spinal cord has the vertebrae to protect it

00:14:08.000 | and the discs to protect it,

00:14:09.360 | but the discs allow for some movement of the spinal cord.

00:14:12.720 | In fact, quite a bit of movement.

00:14:14.120 | If you just lean forward in your chair,

00:14:15.960 | you lean back, arch your back, or you twist to the side,

00:14:18.880 | your spinal cord is actually twisting in that way.

00:14:22.120 | Okay, this would be akin to your brain

00:14:23.840 | actually moving within the skull.

00:14:25.800 | It can move a little bit,

00:14:26.640 | but it doesn't move nearly as much as your spinal cord does.

00:14:30.480 | So your back has, of course, many functions.

00:14:32.900 | It's there to stabilize your body.

00:14:34.780 | It's there to provide stiffness

00:14:36.220 | in order to be able to move your limbs in very dynamic ways.

00:14:38.740 | We're going to talk about back and core stiffness

00:14:40.600 | as such a key feature of having a strong back.

00:14:43.300 | When you hear the word stiffness,

00:14:44.460 | you probably think, well, that can't be good.

00:14:46.180 | I don't want a stiff back, ah.

00:14:47.580 | But you actually want to be able to generate rigidity

00:14:49.900 | within your core and spine

00:14:51.400 | in order to move your limbs, to throw a ball,

00:14:53.340 | or to do a martial arts punch, or to even dance gracefully,

00:14:56.660 | or even just move up some stairs without falling.

00:14:59.900 | So basically when we talk about the brain and spinal cord

00:15:03.500 | as extending down through the vertebrae

00:15:05.260 | and through the discs,

00:15:06.260 | we're doing that to set up the other piece

00:15:07.980 | of this whole story,

00:15:09.060 | which is that the neurons that reside in the spinal cord,

00:15:12.780 | in particular, what we call the ventral spinal cord,

00:15:15.800 | which if we're going to imagine this

00:15:17.800 | in kind of more real-world terms,

00:15:19.600 | they're sitting in the part of the spinal cord

00:15:22.020 | that's kind of on your front, okay,

00:15:23.980 | that's facing the front of the world.

00:15:27.300 | There are neurons that are called motor neurons.

00:15:29.400 | The motor neurons themselves,

00:15:30.900 | what we call the cell bodies, reside in the spinal cord,

00:15:33.660 | in the so-called ventral horn of the spinal cord.

00:15:35.420 | You can look this up if you like,

00:15:36.540 | although you don't need to know that.

00:15:37.700 | And they extend little wires that we call axons

00:15:41.160 | out to the muscles.

00:15:42.580 | And through the release of neurotransmitters,

00:15:44.340 | they allow our muscles to move,

00:15:46.460 | our flexors to flex, like our bicep,

00:15:48.320 | our extensors to extend, like our tricep.

00:15:51.100 | Could think quadricep, hamstring, calf, abdominal muscles,

00:15:54.860 | all the movement of those muscles is controlled

00:15:57.180 | by neurons that reside within the spinal cord.

00:15:59.920 | Some of the movements that we generate

00:16:01.800 | are unconscious movements,

00:16:03.080 | especially movements that are required for breathing,

00:16:05.760 | although you can consciously take care

00:16:07.080 | of your breathing as well, right?

00:16:08.540 | You can breathe unconsciously.

00:16:10.920 | You're always doing that, even in sleep,

00:16:13.120 | or you can take conscious control of your breathing.

00:16:15.360 | You can generate limb movements consciously,

00:16:17.400 | or you can generate limb movements unconsciously.

00:16:19.840 | Typically, once you know how to walk

00:16:21.220 | and you get up and you walk across the room,

00:16:22.640 | you're not thinking right foot, left foot,

00:16:23.980 | right foot, left foot.

00:16:25.080 | All of that's handled by motor neurons

00:16:26.880 | and what are called central pattern generators

00:16:28.600 | in the spinal cord, and to some extent, the brainstem.

00:16:31.760 | But the commands for specific deliberate movements

00:16:33.900 | that you're thinking about,

00:16:34.920 | especially when you're trying to learn a movement

00:16:36.500 | or you're trying to be very deliberate in a movement,

00:16:38.980 | those come from what are called upper motor neurons

00:16:41.640 | in the brain.

00:16:42.480 | They communicate with lower motor neurons,

00:16:44.140 | which then communicate with the muscles, okay?

00:16:46.980 | So that's one neural outflow pathway

00:16:49.320 | from spinal cord out to muscles.

00:16:51.600 | Some of it's conscious, some of it's unconscious.

00:16:54.200 | And then there are the neural pathways from skin,

00:16:57.320 | from the tendons and insertions of the muscles onto bone,

00:17:02.040 | within the muscles that register how much stretch

00:17:04.200 | are on our muscles.

00:17:05.720 | And those are the so-called sensory inputs

00:17:08.000 | that come into the dorsal part of the spinal cord,

00:17:10.440 | the part that is facing toward our back.

00:17:12.800 | And that sensory information tells our spinal cord,

00:17:16.160 | which then informs our brain,

00:17:18.120 | whether or not our limbs are extended too far

00:17:20.620 | and about to snap,

00:17:21.760 | or whether or not a muscle is loaded too heavy

00:17:23.600 | and is about to be pulled off the bone.

00:17:25.940 | And in that case, the brain and spinal cord

00:17:27.760 | have these magnificent mechanisms to shut down the neurons

00:17:30.800 | so that we drop the load,

00:17:33.000 | so that we don't overwhelm the muscle

00:17:34.680 | and rip it off the bone,

00:17:35.560 | or we don't stretch our limbs too far.

00:17:37.620 | Now, keep in mind that the neurons within the spinal cord

00:17:39.960 | that communicate with muscles,

00:17:41.720 | or the neurons that innervate, as we call it,

00:17:45.060 | the skin or the tendons or different parts of the body

00:17:48.800 | and go into the spinal cord,

00:17:51.340 | those little wires, those axons,

00:17:53.480 | literally leave the spinal cord

00:17:55.480 | and they go out into what's called

00:17:56.660 | the peripheral nervous system.

00:17:58.640 | Now, a big source of pain in back pain

00:18:01.400 | is when those nerve roots, as they're called,

00:18:03.640 | they're little bundles, okay?

00:18:04.760 | Bundles of nerves are sometimes called fascicles,

00:18:06.880 | sometimes called nerve roots.

00:18:08.720 | The nomenclature kind of depends

00:18:10.440 | on where you are in the nervous system,

00:18:12.160 | but I'll call them nerve roots or bundles of nerves.

00:18:14.720 | Those bundles of nerves are sometimes impinged on,

00:18:18.540 | they're physically pressed on by say a bulging,

00:18:21.440 | what's also called a herniated disc.

00:18:23.760 | The discs can sometimes bulge out

00:18:25.500 | from the side of the spine a little bit too much, okay?

00:18:28.680 | Maybe by compression from the overlying vertebrae,

00:18:31.280 | maybe from some inflammation.

00:18:32.620 | We'll talk about the various sources today.

00:18:34.280 | And oftentimes the source of back pain or neck pain,

00:18:37.080 | or even pain in the pelvic region

00:18:38.760 | is because of a compression of the nerve roots

00:18:41.180 | that are going into and out of the spine, okay?

00:18:44.940 | So when we talk today about back pain,

00:18:47.880 | and when we talk today about building a strong back,

00:18:49.960 | we need to focus on two major themes.

00:18:52.000 | One is the extent to which those nerve roots

00:18:54.640 | are free and clear of any physical pressure

00:18:57.320 | from say herniated discs, from compressed vertebrae,

00:19:01.800 | from inflammation in those regions, maybe all three.

00:19:05.260 | And what we're really trying to do

00:19:06.860 | when we talk about relieving back pain often

00:19:08.960 | is creating space, creating room for those nerve roots

00:19:12.400 | to travel in and out of the spine,

00:19:14.360 | for those messages to come in from the periphery,

00:19:17.200 | the skin, the tendons, the muscles, et cetera,

00:19:20.280 | up into the brain because the brain needs that information

00:19:23.080 | to know where our limbs are, still needs to keep us safe,

00:19:25.720 | as well as the nerve pathways traveling out of the spine

00:19:28.480 | that control our musculature for deliberate movements,

00:19:31.360 | unconscious movements, and so on.

00:19:33.200 | And so much of what you'll hear about today

00:19:34.880 | when thinking about how to build

00:19:36.080 | a really strong pain-free back

00:19:38.340 | is about creating the kind of stability around the spine

00:19:42.300 | so that we can engage in the different limb movements

00:19:44.520 | that we need to, but to do so in a way

00:19:47.240 | that doesn't create compression of those nerve pathways.

00:19:50.400 | Now, with all that said, it's really important

00:19:52.400 | to also understand that not all of back pain

00:19:55.840 | is neural in nature.

00:19:57.920 | Now, technically all pain is neural

00:20:01.400 | in the sense that it's a perception, okay?

00:20:03.720 | If you listen to the episode with Dr. Sean Mackey,

00:20:05.760 | which includes a deep description

00:20:07.380 | of the biopsychosocial model of pain,

00:20:10.880 | it will tell you, or I'll just tell you now,

00:20:13.360 | that indeed pain involves a lot of different things.

00:20:15.680 | It involves psychology, it involves prediction,

00:20:17.820 | it involves history, it involves inflammation,

00:20:19.920 | it involves a lot of things.

00:20:21.720 | And yes, ultimately it's neural.

00:20:24.060 | It is the firing of nerves

00:20:25.400 | that create the perception of pain,

00:20:26.920 | and your perception of pain is also the firing of neurons

00:20:30.140 | in your brain and spinal cord.

00:20:31.760 | However, what you'll also learn today

00:20:33.920 | is that there are many things that you can do,

00:20:36.000 | including creating stability of your feet,

00:20:39.080 | your toes, believe it or not,

00:20:40.920 | the position of your pelvis, your neck, your chin,

00:20:44.360 | all these things,

00:20:45.540 | as well as the spinal erector muscles in your lower back,

00:20:48.600 | as well as your abdominal region, your so-called core,

00:20:51.400 | all of those things combine to create a milieu

00:20:54.880 | for the spine and back to function at its best.

00:20:58.160 | So if by now you're getting overwhelmed,

00:20:59.680 | you're thinking, "Oh my goodness,

00:21:00.640 | we have to learn about the entire bodies,

00:21:02.440 | physiology and anatomy,

00:21:03.600 | in order to understand back pain and strengthening."

00:21:06.320 | To some extent that's true,

00:21:07.840 | but really all we've said so far,

00:21:09.240 | and all you need to know or keep in mind that is,

00:21:12.220 | is we have the vertebrae,

00:21:13.960 | the bony segments that surround the spinal cord,

00:21:17.480 | in between those we have the discs,

00:21:19.160 | the soft tissue that also have a hole through them,

00:21:21.720 | the spinal cord travels through that,

00:21:23.520 | so that the vertebrae can move,

00:21:25.940 | so that we have some pliability and mobility

00:21:28.520 | of our spine forward, flexion,

00:21:30.680 | so your chin closer to your belly, extension,

00:21:33.320 | your chin back and away from your belly,

00:21:34.900 | sort of arching of the lower back,

00:21:36.040 | you can twist a side to side to some extent.

00:21:38.740 | You have all that stuff,

00:21:40.320 | and through the middle is the spinal cord and the brain,

00:21:43.620 | and then you have sensory information

00:21:45.040 | going into the spinal cord,

00:21:46.840 | from the body, from the muscles, from the skin,

00:21:49.640 | and then you have motor commands

00:21:51.640 | going out the bottom of the spinal cord,

00:21:53.600 | so literally traveling out past those vertebrae and discs,

00:21:57.200 | out to the muscles to control those muscles

00:21:59.040 | for involuntary and voluntary movement.

00:22:01.520 | If you can understand that,

00:22:03.240 | and you can envision it just a little bit,

00:22:05.460 | even just a little bit,

00:22:07.140 | you're going to be able to think about

00:22:08.940 | all of the various protocols that we talk about next

00:22:11.680 | in the most functional way,

00:22:13.400 | meaning as you learn about and hopefully incorporate

00:22:16.320 | the various protocols for strengthening

00:22:18.080 | and pain-proofing your back,

00:22:19.800 | that you'll occasionally think back to,

00:22:21.200 | okay, it's my spinal cord

00:22:22.580 | that I'm bending in my lower back region.

00:22:24.980 | I'm allowing the discs to kind of move forward,

00:22:27.400 | and they likely are kind of bulging out a little bit.

00:22:29.700 | They're not necessarily herniating, let's hope not,

00:22:31.760 | but they're bulging a little bit in that direction,

00:22:33.360 | then back in the other direction,

00:22:34.660 | and if you happen to have herniated,

00:22:36.360 | that is bulging discs, which many people do.

00:22:38.920 | In fact, I've had that.

00:22:39.880 | I've got a sort of an L3, a kind of lumbar 3/4 bulge

00:22:42.960 | that got activated a few years ago.

00:22:44.920 | I'll tell you what allowed me

00:22:47.040 | to very quickly fix that permanently

00:22:50.280 | with no medication, no surgery whatsoever,

00:22:52.320 | and it was extremely debilitating.

00:22:54.240 | There's some simple movements that one can do

00:22:56.720 | if done in the proper direction and in the proper way

00:22:59.680 | that can allow you to push that bulge,

00:23:01.800 | that herniated disc back under,

00:23:04.680 | or I should say closer to the spinal cord.

00:23:07.480 | Okay, moving it from the kind of bulging out

00:23:09.540 | from between the vertebrae

00:23:10.920 | to closer again toward the center point of the spine.

00:23:15.320 | By doing that, one can take pressure off of the nerve roots

00:23:18.240 | that are traveling out to the muscles

00:23:19.640 | and in from the skin and other sensory information

00:23:22.560 | coming into the spinal cord

00:23:23.940 | and allow yourself relief from back pain.

00:23:26.280 | And then by building up stability in the abdominal region,

00:23:29.880 | the lower back region, you can create a nice firm core

00:23:34.680 | that will allow you to protect all of that

00:23:36.400 | with plenty of space so the nerve roots are not impinged.

00:23:39.280 | And then of course, by focusing on some of the stabilizers

00:23:43.180 | that exist really distal,

00:23:44.840 | which means far from all of that,

00:23:46.640 | further from all of that, such as the feet,

00:23:49.380 | literally how you position your feet,

00:23:50.680 | the ability to spread your toes, believe it or not,

00:23:53.080 | as a way to provide support for your back,

00:23:55.280 | not just when doing exercise, but also at rest.

00:23:58.580 | There are some things you can do about neck positioning,

00:24:01.040 | strengthening of the front of the neck,

00:24:03.300 | strengthening of various muscles.

00:24:04.720 | Again, that involves no equipment whatsoever

00:24:07.340 | that allows you to have a pain-free strong back,

00:24:10.100 | both at rest and during movements of different kind,

00:24:13.480 | different dynamic sport movements

00:24:15.000 | like tennis or golf, et cetera,

00:24:16.660 | as well as if you're into it, resistance training,

00:24:18.920 | if you're putting yourself under heavy loads,

00:24:20.840 | all of that pain-free and moving through life

00:24:23.960 | with a tremendous amount of mobility and versatility.

00:24:26.980 | Now, before we get into the specific protocols

00:24:29.200 | and exercises for strengthening and pain-proofing your back,

00:24:32.200 | it's worth mentioning something

00:24:33.380 | that really was first told to me by Dr. Stuart McGill.

00:24:36.160 | Again, he's going to be a guest on this podcast.

00:24:38.360 | Dr. Stuart McGill is a world expert

00:24:40.360 | in spine physiology and anatomy,

00:24:43.040 | and he's worked with a lot of athletes,

00:24:44.740 | but his work is not specific to athletes.

00:24:46.840 | It's really for the everyday person as well.

00:24:48.880 | And in discussions with Stu,

00:24:50.200 | he raises some really important points.

00:24:52.320 | First of all, if you have back pain,

00:24:54.620 | you need a proper assessment and diagnosis.

00:24:57.720 | It's really impossible for me in this format

00:25:00.520 | to try and diagnose your back pain,

00:25:02.720 | or for you to try and diagnose your back pain.

00:25:04.440 | That would just be irresponsible of both of us.

00:25:06.680 | There's just so many things

00:25:07.640 | that are specific to each circumstance.

00:25:10.240 | For instance, some people get back pain

00:25:12.200 | or neck pain or both

00:25:13.960 | because of overuse of certain motor patterns.

00:25:17.160 | Maybe they are avid golf players

00:25:18.840 | and they're always swinging a certain way

00:25:20.640 | with one foot forward.

00:25:21.560 | That's typically the way it works.

00:25:23.600 | And they built up some strength in certain pathways,

00:25:27.280 | both muscular strength and neural strength,

00:25:29.880 | but they have a weakness

00:25:31.880 | in the opposite side muscles and nerves,

00:25:34.400 | and they need to rehabilitate those

00:25:36.000 | in order to eliminate the back pain.

00:25:37.840 | Other people have an injury, right?

00:25:39.360 | They have a spinal compression injury.

00:25:40.760 | They don't just have a herniated disc,

00:25:42.080 | they have a ruptured disc.

00:25:43.380 | Oftentimes ruptured discs need surgery.

00:25:45.880 | I don't want to give the impression

00:25:47.580 | that all back pain can be resolved without surgery.

00:25:50.500 | There are cases where surgery is necessary, okay?

00:25:53.220 | So it's very important that if you have severe back pain

00:25:56.340 | or persistent back pain,

00:25:57.780 | and you're not able to alleviate it

00:25:59.580 | with non-surgical methods,

00:26:01.080 | that you talk to a back expert, perhaps even a surgeon.

00:26:04.800 | There are cases for epidurals, for painkillers,

00:26:08.900 | for different types of rehabilitative approaches.

00:26:11.860 | But Dr. Stu McGill has also pointed out

00:26:14.320 | that there are a number of things

00:26:15.320 | that any and all of us can do

00:26:17.600 | by just self-assessing

00:26:19.080 | that I think are appropriate for today's discussion

00:26:21.840 | that relate to whether or not we are likely

00:26:23.940 | to have a thick spine or a thin spine, okay?

00:26:26.540 | This isn't a psychological feature,

00:26:28.020 | at least not to my knowledge.

00:26:29.320 | But if you look at different body types,

00:26:31.080 | you know, what in the old days used to be called

00:26:33.100 | the ecto, endo, and mesomorphic body types, okay?

00:26:36.440 | This nomenclature isn't used quite as much anymore,

00:26:38.700 | but just to kind of return to it,

00:26:40.960 | the ectomorphic body phenotype

00:26:43.340 | is one in which people are typically kind of light boned,

00:26:46.500 | meaning thinner wrists, smaller knees, smaller ankles.

00:26:50.020 | So not really thick bones and thick wrists.

00:26:52.200 | So that's the ectomorphs.

00:26:53.240 | These are people that tend to be pretty thin,

00:26:55.080 | sometimes referred to as people that have, you know,

00:26:57.280 | very low body fat, less muscle mass,

00:26:59.120 | although that's not always the case.

00:27:00.640 | Just think lighter, thinner skeleton versus mesomorphs,

00:27:03.960 | which tend to be people with kind of thicker wrists,

00:27:06.440 | thicker knee joints, kind of thicker overall.

00:27:09.760 | And then endomorph, which was at the time used to describe

00:27:12.720 | people that are carrying more body weight

00:27:14.400 | in the form of body fat.

00:27:15.640 | I don't know how often the endomorph phenotype language

00:27:18.400 | is used anymore.

00:27:19.520 | But what Dr. Stumagill has pointed out

00:27:21.260 | is that people in general tend to be more ectomorphic

00:27:23.960 | or mesomorphic.

00:27:25.400 | They tend to be more thick through the torso

00:27:27.320 | or thin through the torso.

00:27:28.500 | They tend to have thinner wrist or smaller wrists

00:27:30.820 | as compared to their age matched,

00:27:33.240 | sex matched counterparts, okay?

00:27:35.840 | But in general, so these are generalizations,

00:27:38.900 | people who have thicker wrists

00:27:40.640 | generally are going to have thicker spinal segments, okay?

00:27:44.040 | In terms of the circumference

00:27:45.460 | of the spinal segments and discs.

00:27:47.540 | Whereas people with smaller wrists, smaller joints,

00:27:50.120 | smaller ankles are going to have thinner spine.

00:27:53.120 | So thinner vertebrae, thinner discs between them and so on.

00:27:56.760 | Now, neither is good or bad.

00:27:58.320 | They are just different.

00:27:59.400 | And they create a situation

00:28:00.560 | where people have different needs

00:28:01.920 | in order to build a strong pain-free spine.

00:28:04.800 | So for instance, people who have thick spinal segments,

00:28:07.320 | so these are people who tend to be more barrel chested,

00:28:10.000 | thick through the torso,

00:28:11.080 | maybe thicker wrists and ankles and knees

00:28:13.360 | have thicker spinal segments

00:28:15.240 | and therefore may not need quite as much buildup

00:28:19.420 | of the musculature around their spine

00:28:21.160 | in order to handle vertical loads, okay?

00:28:23.540 | Compression along the spinal length

00:28:25.180 | because they have those big thick spinal segments and discs.

00:28:28.080 | It's not to say that they don't need

00:28:29.140 | to do any spinal strengthening, they do,

00:28:31.500 | but they are generally going to be very stable along the,

00:28:35.500 | I'm calling it the vertical axis,

00:28:36.820 | but along the length of the spine.

00:28:38.520 | Those people, perhaps not surprisingly,

00:28:40.380 | are not going to be as mobile

00:28:42.320 | in terms of the twisting and bending of the spine,

00:28:45.020 | meaning spine mobility along the different axes

00:28:48.340 | apart from that vertical axis that I was referring to

00:28:51.220 | along the length of the spine.

00:28:52.500 | But twisting and bending is going to be harder for them.

00:28:55.180 | Now at the opposite extreme,

00:28:56.260 | you're going to have people with smaller wrists,

00:28:58.540 | smaller ankles, smaller knees,

00:29:00.380 | and they in general are going to have a thinner spine,

00:29:02.680 | meaning vertebrae and discs

00:29:04.780 | that are smaller in circumference.

00:29:07.100 | And they are not going to have the capacity

00:29:09.500 | to sustain as much vertical compression

00:29:11.780 | along the length of the spine

00:29:13.220 | as somebody with thick spinal segments,

00:29:15.540 | but they are going to be more "bendy," if you will.

00:29:18.980 | Now, that doesn't always mean more flexibility.

00:29:21.180 | What I'm referring to here is a capacity or a potential

00:29:24.940 | for the ability to generate movements

00:29:27.340 | in which the spine is twisting from side to side

00:29:30.020 | with more ease than would be the power lifter.

00:29:32.860 | So imagine at the extremes,

00:29:34.840 | the thick torso and spine of the power lifter,

00:29:37.660 | of the shot putter, somebody like that,

00:29:40.060 | versus the spine of, say, the yoga teacher, the dancer.

00:29:44.740 | They have these smaller wrists, smaller pelvis,

00:29:47.740 | smaller knees, et cetera,

00:29:49.420 | but they're going to have more ability

00:29:51.300 | to twist themselves, their spine.

00:29:53.140 | So imagine just kind of like bending over to the side

00:29:55.060 | a little bit while looking up.

00:29:56.460 | The spine is going to do that very easily

00:29:58.940 | as compared to the person with a thicker torso and spine.

00:30:01.780 | These two distinctions,

00:30:02.920 | and here I'm really making them polarized distinctions,

00:30:05.380 | and in reality, there's a whole distribution of thick spine,

00:30:08.380 | very thick spine, moderately thick spine, thin spine,

00:30:11.220 | ultra thin spine, and so on.

00:30:13.300 | But at these two extremes,

00:30:15.000 | you can start to imagine that each of those spines,

00:30:17.780 | each of those backs probably has different requirements

00:30:20.540 | in order to make it strong and pain-proof

00:30:23.060 | depending on the activities

00:30:24.340 | that those people are engaged in.

00:30:26.260 | Now, of course, a thin spine person can decide to power lift.

00:30:30.000 | That can be very good for them.

00:30:31.100 | And indeed, one of the things

00:30:32.340 | that somebody with a thin spine should do,

00:30:34.740 | according to Dr. Stu McGill,

00:30:36.020 | and I'll reiterate this several times today,

00:30:37.680 | is build up the musculature around the spine

00:30:39.800 | so that they can stabilize that otherwise bendy spine

00:30:42.900 | along both the vertical and side-to-side axis

00:30:45.300 | so they don't injure it.

00:30:46.460 | They want to make it strong.

00:30:48.000 | As well as the person with the thick spine

00:30:49.780 | who can tolerate heavy loads around one axis,

00:30:52.340 | but maybe needs to generate more mobility of that spine

00:30:54.860 | so that they don't go reaching for a glass

00:30:56.660 | up in the cupboard and all of a sudden

00:30:58.500 | they have compression of a nerve root coming out the spine

00:31:01.860 | because they just twisted it to the side

00:31:03.420 | by about five to seven degrees.

00:31:05.140 | Both groups have specific needs,

00:31:07.140 | meaning specific protocols that they can emphasize

00:31:09.640 | to a greater or lesser degree

00:31:11.100 | in order to strengthen and pain-proof their spine.

00:31:13.620 | So while we can't do an assessment of spinal pain

00:31:16.180 | and your exact needs for your particular body type

00:31:19.460 | in this kind of format through the tunnel of the internet,

00:31:23.140 | you can take a look at yourself

00:31:25.180 | or just think about yourself and think,

00:31:26.260 | oh, do I tend to have thicker wrists,

00:31:27.580 | knees, elbows, et cetera?

00:31:28.980 | Am I more of a thick torso person

00:31:31.340 | or do I tend to be someone who's more lithe,

00:31:33.740 | who's more small-wristed?

00:31:36.060 | Somebody who can move from side to side with a lot of ease,

00:31:38.740 | but probably can't handle as much

00:31:40.380 | what I was calling vertical load

00:31:41.820 | along the length of the spine.

00:31:43.300 | And some people have a kind of mixed phenotype,

00:31:45.260 | not purely ecto, not purely mesomorphic.

00:31:48.780 | I can say that about myself.

00:31:50.060 | I have fairly long limbs.

00:31:51.580 | In fact, I have like almost a sort of like gibbon arms.

00:31:53.900 | I have this kind of really long reach.

00:31:55.820 | So more kind of ectomorphic arms.

00:31:59.700 | And at the same time, I have a short torso

00:32:02.780 | and I am fairly thick through the circumference of my torso.

00:32:05.780 | I've always been like that.

00:32:06.780 | Even before I started doing any kind of resistance training,

00:32:09.140 | my legs are somewhere in between, okay?

00:32:10.780 | So I don't have small knees or small ankles.

00:32:12.620 | They're kind of moderate in that way.

00:32:14.220 | My wrists and my arms, probably a bit more ectomorphic,

00:32:18.100 | not strong ectomorphic phenotype,

00:32:20.020 | but then my torso is a short torso

00:32:22.460 | and it's kind of thick through the circumference.

00:32:24.140 | That's just the way that my genetics

00:32:25.860 | landed me into the world.

00:32:27.900 | You have genetics that landed you into the world

00:32:30.140 | in a particular way.

00:32:31.280 | You can take a look at these kind of external phenotypes

00:32:34.140 | about joint size and how to do an assessment,

00:32:36.660 | just thinking about it.

00:32:37.980 | And by doing that, you'll be able to know which protocols,

00:32:40.880 | which we're about to talk about,

00:32:42.160 | you may want to emphasize or de-emphasize

00:32:44.620 | in order to best strengthen and pain proof your back.

00:32:47.560 | So a good analogy that Dr. Stuart McGill offers

00:32:50.420 | when thinking about this thin spine

00:32:52.060 | versus thick spine thing,

00:32:53.780 | is if you think about a willow tree,

00:32:56.180 | which has essentially a thin trunk and thin branches

00:33:00.820 | relative to say an oak tree or redwood tree,

00:33:04.760 | the willow tree trunk and branches can bend

00:33:07.640 | to quite a considerable degree without breaking.

00:33:10.780 | So it's just very bendy from side to side,

00:33:13.100 | but they're thin and they can't sustain

00:33:15.620 | a lot of vertical pressure,

00:33:17.500 | a lot of loads from top to bottom,

00:33:20.060 | or else they'll simply collapse.

00:33:22.100 | They might not snap to the point of breaking,

00:33:24.380 | but they will definitely bend to the point

00:33:26.420 | of not being able to bend back.

00:33:28.360 | As opposed to the trunk and branches

00:33:29.900 | of a full grown oak tree or redwood tree,

00:33:32.760 | which are very thick and very strong

00:33:34.420 | and can sustain a lot of loads from top to bottom

00:33:37.500 | along this vertical axis.

00:33:39.620 | But if they bend even just a tad too far

00:33:43.580 | from one side to the next,

00:33:45.680 | they're going to snap and essentially break off.

00:33:48.300 | So while that analogy isn't a perfect one

00:33:50.240 | to explain the situation with thin spines

00:33:52.220 | versus thick spines,

00:33:53.540 | I think it gives you a mental image

00:33:55.260 | of the general situation for which some people

00:33:58.580 | who have the more willow like spine

00:34:01.580 | probably need to build more musculature around the spine

00:34:05.380 | in order to stabilize it,

00:34:06.940 | but probably don't have to do quite as much work

00:34:09.380 | in order to generate more side to side flexibility,

00:34:12.500 | as opposed to people who have a thicker spine,

00:34:14.780 | who probably don't need to do quite as much work

00:34:17.220 | to develop the musculature of the spinal erectors,

00:34:20.580 | of the abdominals.

00:34:21.620 | It's not to say they don't need to develop those at all,

00:34:23.660 | they do, but that they don't need to do quite as much work

00:34:26.100 | to build the musculature around the spine

00:34:27.800 | in order to stabilize it for vertical loads,

00:34:30.580 | but they perhaps want to do more work

00:34:33.180 | aimed at generating more flexibility

00:34:35.380 | in these planes of motion from side to side

00:34:38.100 | and at different angles, you know,

00:34:40.100 | relative to the vertical axis.

00:34:42.260 | And again, most people don't fall at either extreme

00:34:44.480 | of willow like or redwood like,

00:34:46.620 | most people are going to fall somewhere in the middle.

00:34:48.540 | And as I mentioned before,

00:34:49.500 | many of us, including myself,

00:34:51.020 | have a sort of combination of more thin musculature

00:34:54.920 | and thick musculature,

00:34:56.140 | depending where in the body you look.

00:34:58.220 | I'd like to take a brief break

00:34:59.400 | and acknowledge our sponsor, AG1.

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00:35:08.240 | And indeed that's true.

00:35:09.680 | I started taking AG1 and I still take AG1

00:35:11.960 | once or twice a day

00:35:13.320 | because it gives me vitamins and minerals

00:35:15.120 | that I might not be getting enough of

00:35:16.520 | from whole foods that I eat,

00:35:18.160 | as well as adaptogens and micronutrients.

00:35:21.080 | And those adaptogens and micronutrients are really critical

00:35:23.440 | because even though I strive to eat most of my foods

00:35:26.080 | from unprocessed or minimally processed whole foods,

00:35:29.000 | it's often hard to do so,

00:35:30.040 | especially when I'm traveling

00:35:31.240 | and especially when I'm busy.

00:35:32.920 | So by drinking a packet of AG1 in the morning

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00:35:53.040 | and brain health.

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00:36:01.400 | towards one specific outcome,

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00:36:29.320 | So now let's discuss the protocols

00:36:31.000 | that allow you to strengthen your back.

00:36:33.600 | The first three of these protocols

00:36:35.720 | are the so-called McGill's Big Three,

00:36:38.040 | named after Dr. Stuart McGill,

00:36:40.280 | who again has done a tremendous amount of work

00:36:42.440 | in the research and practical realm,

00:36:44.820 | and has developed a number of different protocols

00:36:46.840 | for strengthening and de-painting the spine,

00:36:49.920 | but has distilled down three specific protocols

00:36:53.400 | that everyone I spoke to in the PT community,

00:36:56.820 | in the MD community, for those that specialize on spine,

00:37:00.460 | and in the sports community,

00:37:02.220 | as well as people who don't play sports,

00:37:04.360 | but are simply interested in having a healthy spine

00:37:06.900 | for sake of daily mobility,

00:37:08.460 | all agree are extremely useful for everybody to carry out.

00:37:11.920 | Now, the one caveat is that Stuart McGill himself

00:37:14.420 | has told me that he doesn't want the Big Three

00:37:17.340 | to be viewed as the be-all end-all

00:37:19.720 | of back strengthening and pain relief.

00:37:21.920 | By no means is it exhaustive to do just the Big Three.

00:37:25.240 | So I'm also going to include a bunch of other protocols

00:37:28.160 | that are gleaned from other practitioners,

00:37:30.160 | and that Dr. McGill often offers himself in his books,

00:37:32.880 | and I'll certainly put links

00:37:33.760 | in the show note captions to his books,

00:37:35.000 | and again, he'll be a guest on this podcast.

00:37:37.340 | But for sake of clarity and simplicity,

00:37:39.820 | the Big Three are as follows.

00:37:42.160 | The first is called the Curl Up.

00:37:43.880 | The Curl Up is in many ways a replacement for the Sit Up.

00:37:47.540 | Most people are familiar with ab crunches and sit ups,

00:37:50.200 | where you lie down, typically people will bend their knees,

00:37:52.780 | although not always,

00:37:53.820 | they'll often put their hands behind their head

00:37:56.140 | or on their chest,

00:37:56.980 | and then they'll essentially sit up

00:37:58.640 | to contract the abdominals.

00:38:00.860 | Turns out that if you have back pain,

00:38:03.380 | and even if you don't,

00:38:04.780 | that is probably the least efficient

00:38:07.480 | and perhaps even the worst thing

00:38:08.940 | that you can do for your back pain.

00:38:10.320 | And if you think about the discs

00:38:11.660 | that sit between those vertebrae,

00:38:12.940 | remember those soft tissue discs

00:38:14.280 | that allow for some mobility of the spine?

00:38:16.800 | Well, if you happen to have a disc

00:38:18.160 | that's bulging even slightly,

00:38:20.080 | that is it's herniating,

00:38:21.240 | it's getting pushed out from between the vertebrae,

00:38:24.440 | and it's impinging on a nerve and there's some pain.

00:38:28.000 | If you are crunching,

00:38:29.880 | you can imagine that's essentially

00:38:31.560 | bringing the vertebrae together

00:38:33.080 | in the front of that sandwich

00:38:34.920 | that is vertebrae, disc, vertebrae.

00:38:37.320 | And what it's going to do

00:38:38.660 | is it's going to have that disc bulge out even further.

00:38:41.880 | It's going to herniate even further

00:38:43.440 | and impinge on those nerves even further.

00:38:45.720 | So what's required in a situation

00:38:48.040 | where you want to strengthen the back

00:38:49.420 | or try and eliminate or reduce pain of the back

00:38:53.300 | is a way in which you can strengthen the abdominals

00:38:55.600 | because the abdominals and the abdominal wall

00:38:57.820 | is very important for stabilizing the spine.

00:39:00.640 | And you want a stable spine.

00:39:02.180 | That's a very important point.

00:39:03.620 | But you want to do it in a way

00:39:05.040 | where you're not adding to the herniation

00:39:07.920 | of the disc in any way.

00:39:09.500 | So the curl-up is an excellent exercise

00:39:11.600 | for people who have back pain

00:39:13.620 | and who don't have back pain

00:39:15.500 | to strengthen the abdominal wall.

00:39:17.060 | And it's done as follows.

00:39:18.520 | You lie down,

00:39:20.560 | you put one knee up,

00:39:22.580 | meaning one leg is bent,

00:39:23.860 | the other leg is extended.

00:39:26.220 | You put your hands,

00:39:27.500 | both hands below the lower portion of your back.

00:39:31.320 | So in the arch of your back,

00:39:32.740 | and you actually want to maintain the arch of your back.

00:39:34.960 | That's one of the reasons your hands are there.

00:39:37.260 | The head is in a neutral position, okay?

00:39:39.340 | So your chin isn't tucked toward your chest.

00:39:41.900 | The chin is in a neutral position.

00:39:43.820 | And this is important.

00:39:44.940 | Your tongue is on the roof of your mouth.

00:39:47.260 | This is something I talked a little bit about

00:39:49.080 | in my description of neck exercises in a previous video.

00:39:52.220 | We're going to get back to this.

00:39:53.180 | But tongue on the roof of the mouth

00:39:54.480 | often puts the head into a safe default position.

00:39:58.180 | It also allows for breathing,

00:39:59.980 | in particular nasal breathing to be done very easily.

00:40:02.980 | So you've got your tongue on the roof of your mouth.

00:40:06.200 | The mouth is typically closed.

00:40:07.740 | And then what you do is you raise your elbows off the ground

00:40:12.260 | and then while maintaining that small of the back,

00:40:15.660 | you're going to just raise your upper chest.

00:40:18.060 | You're going to lead with the upper chest,

00:40:19.620 | not with the chin and head,

00:40:21.180 | although of course the head will follow.

00:40:22.860 | You're going to raise the upper chest,

00:40:24.460 | meaning raise the upper torso.

00:40:25.580 | So the head's going to move forward

00:40:26.780 | and you're going to exhale and contract the abdominals

00:40:31.160 | for anywhere from eight to 10 seconds, okay?

00:40:33.500 | So you get a very strong contraction of the abdominals,

00:40:36.860 | but you're not doing a full sit up.

00:40:38.480 | You're only coming up maybe about, I don't know,

00:40:40.760 | somewhere between five to 10 degrees.

00:40:43.460 | So your back is coming up, the head is coming up,

00:40:45.360 | and the chin is not moving towards the chest.

00:40:47.380 | It's staying in a neutral position.

00:40:49.320 | You're going to repeat that.

00:40:50.880 | So meaning you're going to go up,

00:40:52.160 | contract for eight to 10 seconds.

00:40:53.940 | You're going to contract the abdominal walls.

00:40:55.780 | If you want to exhale,

00:40:56.840 | you can usually get a stronger contraction

00:40:58.620 | of the abdominal walls.

00:40:59.620 | And then you're going to go back down

00:41:01.700 | and relax on the floor.

00:41:04.020 | Maybe rest 10 to 30 seconds, maybe a minute,

00:41:07.220 | and then repeat, okay?

00:41:08.980 | So that's the basic movement.

00:41:10.300 | And then you would switch to the other side,

00:41:12.940 | meaning you're then going to extend the leg that was bent.

00:41:16.480 | You're going to bend the other leg

00:41:17.620 | and you're going to repeat.

00:41:19.020 | In terms of sets and repetitions,

00:41:21.820 | typically the best way to do this

00:41:23.420 | is to do anywhere from three to five sets,

00:41:27.300 | starting with 10 second contractions

00:41:30.780 | done five times for the first set.

00:41:33.160 | So it'd be 10 second hold,

00:41:34.880 | then relax, 10 second hold,

00:41:37.820 | then relax doing that five times, maybe four times,

00:41:40.780 | but five would be ideal.

00:41:42.580 | That would be one set.

00:41:43.900 | And then on the next set,

00:41:45.000 | you're going to do four repetitions,

00:41:46.940 | meaning four 10 second holds with rest in between.

00:41:50.940 | And then on the next one, three,

00:41:52.820 | on the next one, two,

00:41:54.060 | and the next one, one 10 second hold or so.

00:41:57.500 | These are just rough guidelines.

00:41:58.900 | You certainly don't have to do

00:42:00.620 | quite as long holds as those.

00:42:02.220 | If you can't do those,

00:42:03.480 | you don't have to do all of those sets

00:42:05.280 | if you find you're fatiguing.

00:42:06.960 | One of the advantages, however,

00:42:08.500 | of doing these brief 10 second holds

00:42:10.360 | and really focusing on the contraction of the abdominals

00:42:13.620 | hard or as hard as you can,

00:42:15.720 | and then releasing is that

00:42:17.600 | as opposed to doing a long hold,

00:42:19.600 | just trying to hold as long as you can

00:42:21.000 | and building a lot of endurance in the abdominals,

00:42:23.720 | when you repeatedly contract a neuromuscular connection,

00:42:27.560 | you build the pathways.

00:42:29.400 | You basically allow the pathways

00:42:31.900 | that can engage those strong muscular contractions

00:42:34.540 | to a greater degree

00:42:35.460 | than if you're trying to just statically hold

00:42:37.540 | that particular position for a very, very long time,

00:42:40.220 | like 30 seconds or 60 seconds or longer, okay?

00:42:43.340 | Now, there are a bunch of different variations

00:42:44.820 | of the curl up.

00:42:45.660 | You can do the curl up

00:42:46.500 | with the extended leg elevated slightly to make it harder.

00:42:49.960 | You can do the curl up

00:42:50.980 | with your elbows positioned closer to the ceiling.

00:42:53.780 | So you're really lifting your elbows

00:42:55.580 | and arms far off the ground

00:42:57.780 | as opposed to having them just hovering

00:42:59.520 | right above the ground.

00:43:00.720 | There are a bunch of different variations of these.

00:43:02.760 | We include links to a few short videos

00:43:05.320 | in the show note captions

00:43:06.320 | so you can see the different variations of the curl up.

00:43:08.800 | Has me doing these on the floor in my typical street clothes

00:43:12.760 | so you don't need to get into workout gear to do these.

00:43:14.720 | And I should mention that the curl up

00:43:16.760 | is something that you can do every day

00:43:18.940 | if it occurs to you and if you have the time.

00:43:20.960 | It's something that you would certainly benefit

00:43:22.800 | from doing every day,

00:43:24.020 | but it's also something that even if you do once

00:43:26.040 | or twice a week for even just a couple of sets,

00:43:28.420 | you're going to see some benefit

00:43:29.820 | in terms of strengthening your back

00:43:31.260 | and probably relieving some pain of your back as well.

00:43:34.300 | The other terrific thing about the curl up

00:43:35.620 | is if you have back pain

00:43:37.740 | and doing the curl up doesn't aggravate it,

00:43:40.100 | you are most certainly doing things

00:43:41.500 | to strengthen the musculature around the back

00:43:43.780 | that's going to help you avoid more back pain

00:43:46.100 | as you work through the different rehabilitative practices

00:43:48.540 | that hopefully you're doing with a PT

00:43:50.400 | or with a excellent MD who specializes in back pain relief

00:43:55.020 | as the pain dissipates,

00:43:57.060 | you're going to be building up the musculature

00:43:58.820 | of the abdominals

00:43:59.740 | that's going to then further protect your spine,

00:44:02.100 | especially if you're one of those people

00:44:03.900 | that has a thinner spine

00:44:05.740 | that needs more muscular support around the spine

00:44:08.300 | in order to support it.

00:44:09.420 | Just as a final note about the curl up,

00:44:11.100 | two of the most common errors that people make

00:44:12.900 | when doing the curl up

00:44:14.320 | is to make it more like a sit up

00:44:16.660 | and generate a chin to chest movement first

00:44:20.020 | and let the chest follow.

00:44:21.060 | You really want the chest to lead

00:44:22.500 | and keep the head in a neutral position,

00:44:24.100 | tongue on the roof of your mouth,

00:44:25.540 | try and breathe through your nose.

00:44:27.020 | And if you find that you can't do the big exhale

00:44:29.960 | as you bring it up to the top, don't worry about it.

00:44:31.700 | It's perfectly fine to hold your breath as you come up

00:44:34.260 | and then just maybe release a little bit of air

00:44:36.420 | to enhance the intensity of that abdominal contraction.

00:44:40.900 | The second exercise in the McGill Big 3 is the side plank.

00:44:45.060 | I confess, and I don't know why, I hate doing side planks.

00:44:48.760 | I don't know why I hate doing side planks.

00:44:49.980 | I just hate doing side planks,

00:44:51.580 | which tells me I should do side planks.

00:44:54.060 | So I've started doing some side planks recently

00:44:56.100 | after talking to Dr. McGill.

00:44:57.860 | I'm fortunate that right now I don't have back pain.

00:45:00.300 | I haven't for a while.

00:45:01.140 | I'll talk about how I alleviated my back pain,

00:45:03.060 | but I spend a lot of time as a 48-year-old

00:45:05.620 | thinking about having a strong spine,

00:45:07.620 | being able to jump off things and land with confidence,

00:45:11.480 | all the sorts of things that set one up

00:45:13.000 | for both healthspan and lifespan,

00:45:15.100 | as has been taught to us by Dr. Peter Attia.

00:45:18.220 | Some of you may know Dr. Peter Attia

00:45:19.700 | because he's been a guest on this podcast.

00:45:21.220 | He wrote the incredible book "Outlive"

00:45:22.620 | and he talks about how having a strong spine,

00:45:24.700 | having the ability to break falls

00:45:27.100 | by virtue of training your ability to jump down things

00:45:29.780 | and step down things with confidence

00:45:31.680 | is essential to offset the aging process.

00:45:34.080 | So I've decided I'm going to do side planks.

00:45:36.300 | I'm going to embrace the spine strengthening exercises

00:45:39.860 | that Stu McGill has put forward as the big three,

00:45:43.020 | and that includes side planks.

00:45:44.300 | So how do you do side planks?

00:45:45.300 | Well, most people think that a side plank

00:45:46.940 | is just getting on your side, essentially on the floor,

00:45:50.460 | then putting one arm down

00:45:51.660 | and stacking your feet on the other side

00:45:53.140 | and trying to make yourself as stiff as a plank

00:45:54.880 | as you possibly can.

00:45:55.800 | And while that is certainly one way to do it,

00:45:58.400 | most people find that they are going to get the most

00:46:01.680 | in terms of strengthening their spine

00:46:04.260 | and preventing back pain

00:46:06.620 | and maybe even alleviating back pain

00:46:08.540 | if they build up through a set of incremental steps,

00:46:11.660 | making sure that the form on each of the steps

00:46:14.120 | is absolutely perfect.

00:46:15.620 | So the way to really start doing side planks,

00:46:18.360 | and if you think you can already do side planks

00:46:20.820 | to assess whether or not you're doing them properly,

00:46:23.420 | is to start with knees slightly bent.

00:46:26.340 | So maybe at about a 30 or 40 degree angle.

00:46:29.580 | So you're on your side, your knees are bent,

00:46:31.660 | the feet are stacked.

00:46:33.220 | You're of course going to push one arm down.

00:46:35.940 | Although many people find that putting their hand in a fist

00:46:39.180 | as opposed to a flat hand is going to be best.

00:46:42.780 | I don't know if most of you are aware of this,

00:46:44.580 | but anytime that we generate a fist in either hand,

00:46:47.740 | it sets in motion a number of different neural pathways

00:46:51.440 | that allow for a firmer contraction of muscles,

00:46:55.280 | not just within the fist, but elsewhere in the body.

00:46:57.740 | Okay, if you've ever heard the great teachings

00:47:00.380 | of Pavel Sutsulin,

00:47:01.400 | who I hope to have on this podcast as a guest,

00:47:03.420 | he's talked about how if you were say,

00:47:05.020 | to try and squeeze a metal bar,

00:47:07.140 | or think about just trying to give your friend

00:47:08.780 | the firmest handshake you possibly can,

00:47:10.340 | you're having that handshake squeeze competition.

00:47:12.540 | If you make a fist with your other hand,

00:47:14.860 | you're actually going to be able to generate

00:47:16.620 | a harder contraction of the shaking hand, okay,

00:47:20.100 | or the squeezing hand.

00:47:21.140 | And this is because of the way that we have

00:47:22.740 | these bilaterally wired nerve to muscle connections

00:47:26.460 | and the fact that neural activation on one side

00:47:29.300 | is related to neural activation on the other side

00:47:30.880 | and so forth.

00:47:31.720 | But basically what you're going to do for the side plank

00:47:33.320 | in order to generate the strongest

00:47:35.720 | and most efficient side plank for strengthening

00:47:38.060 | and hopefully deepening your back

00:47:40.620 | is to get on the side, bend those knees,

00:47:42.780 | put the hand down in a fist position, okay?

00:47:46.380 | Then you're going to push the hips off the ground.

00:47:48.380 | So the upper body is indeed in a plank position.

00:47:50.940 | Then you're going to raise the hips up

00:47:53.380 | and you're going to have to put some considerable effort

00:47:56.000 | into pushing the floor away from you.

00:47:57.860 | That's really the key here,

00:47:59.020 | pushing the floor away from you.

00:48:00.780 | Now, if you find that you can do that

00:48:02.460 | and you can hold that position for a good eight to 10 seconds

00:48:06.140 | with a strong degree of rigidity,

00:48:08.300 | so you're not quaking and you're not feeling

00:48:10.280 | as if the hips want to collapse down to the floor,

00:48:12.420 | something you really want to avoid,

00:48:14.180 | especially if you already have some back pain

00:48:16.480 | or even a subtle back injury,

00:48:18.060 | you want to make sure that your spine is straight, okay?

00:48:21.180 | And that those hips come off the ground

00:48:22.520 | and you're really in a plank position, right?

00:48:24.740 | No bend.

00:48:25.780 | If you find that you can do that

00:48:27.260 | and it's fairly straightforward for you,

00:48:29.180 | well then feel free to then extend your feet out further,

00:48:33.480 | put the top foot on top of the other foot

00:48:36.380 | and out to the front, okay?

00:48:37.460 | So you're not stacking the feet

00:48:38.620 | right on top of one another,

00:48:39.740 | we're just shoe on top of shoe,

00:48:40.940 | but you've got our foot on top of foot.

00:48:42.740 | If you're doing this barefoot or in socks,

00:48:44.440 | but you've got one foot in front of you for some stability

00:48:47.380 | and then you're generating that long side plank pose

00:48:50.100 | and holding that for eight to 10 seconds,

00:48:52.720 | then pause for 10, maybe 30 seconds if you have to,

00:48:56.020 | and then repeat again, all of that part of one set,

00:48:58.520 | just as we talked about for the curl up previously.

00:49:01.860 | So you're working through the progression from bent legs

00:49:04.680 | to straightening your legs.

00:49:06.180 | If the top foot is placed in front of the other foot

00:49:08.960 | with legs straight and that's something that you can do

00:49:12.140 | for say anywhere three to five repetitions

00:49:15.460 | of those eight to 10 second holds, which make up one set,

00:49:18.420 | well then you have the option

00:49:19.540 | to make the whole thing more difficult

00:49:21.460 | by doing a sort of roll forward

00:49:23.740 | where you actually take the part of your shoulders,

00:49:26.100 | which is on the side of your free arm,

00:49:27.940 | so the hand that is not pressing into the floor

00:49:31.140 | and you rotate forward

00:49:33.140 | so that your chest is now aiming toward the floor,

00:49:35.400 | maybe not to a full pushup position, but maybe close,

00:49:37.780 | and then back again to the side plank.

00:49:39.540 | What you're doing there is you're activating

00:49:40.780 | some of the musculature that is for rotation of the spine.

00:49:44.660 | Okay, and as you do that,

00:49:46.100 | you're getting closer and closer to a front plank.

00:49:48.340 | And of course, front planks are also an excellent way

00:49:50.860 | to generate spine stability.

00:49:52.740 | Most people can do a front plank

00:49:54.220 | by resting on their forearms.

00:49:55.980 | Why start with the side plank?

00:49:57.340 | Well, there are a lot of different reasons for that.

00:49:59.220 | But what you'll realize is that

00:50:00.420 | when you're doing a side plank,

00:50:01.540 | you're actually only really loading

00:50:03.540 | half of the spine maximally.

00:50:05.300 | The other half of the spine is not being loaded maximally

00:50:08.220 | 'cause it's the side of the spine that's up.

00:50:10.180 | And of course, that's a reason why you want to do these

00:50:12.520 | on both sides of your body, right?

00:50:14.660 | So what's the sets and repetition scheme

00:50:16.220 | that's going to work here?

00:50:17.280 | Well, if you're like me and you loathe doing side planks

00:50:20.500 | and you find that they do take a lot more effort

00:50:22.660 | than perhaps you would like,

00:50:23.940 | either psychologically or physically,

00:50:26.020 | then for me, what I've been doing is

00:50:28.500 | one set consists of three 10-second holds.

00:50:32.260 | I've been doing these with knees bent,

00:50:33.780 | although I've now progressed to the point

00:50:35.180 | where I can do one foot over the other

00:50:37.340 | and resting that top foot across the bottom foot,

00:50:41.260 | so legs straight,

00:50:42.300 | doing that for three 10-second holds to make up one set,

00:50:45.420 | and doing that for two or three sets on one side of my body,

00:50:48.300 | two or three sets on the other side of my body.

00:50:50.280 | So slightly different than as I described for the curl-up,

00:50:52.780 | where it was descending repetitions,

00:50:54.360 | where the first set you're doing five 10-second holds,

00:50:57.260 | next one, four 10-second holds, next one, three, two, one.

00:51:00.500 | For the side planks, I don't like them enough

00:51:03.220 | that I just prefer to do two or three sets

00:51:05.860 | of three 10-second holds on each side,

00:51:08.240 | although I'm starting to enjoy them just enough

00:51:11.300 | that I might progress to the kind of

00:51:12.780 | what's called reverse pyramid,

00:51:13.940 | where you go five, five, four, three, two, one,

00:51:16.800 | this sort of thing, increasing the number of sets.

00:51:19.020 | And again, I have a link in the show note captions

00:51:21.000 | that shows you how the side planks are done

00:51:22.660 | in these different variations.

00:51:24.380 | I should mention that the most common mistake

00:51:26.500 | with side planks is letting the hips sag.

00:51:29.160 | So if you don't push the floor away from you enough,

00:51:32.300 | if you're not stable enough through the foot contact

00:51:35.720 | with the floor or the leg contact with the floor,

00:51:37.700 | if you're doing these with knees bent,

00:51:39.860 | even if you go to like straight

00:51:41.780 | and you consider yourself very, very strong

00:51:43.540 | in the side plank, if the hips start to sag,

00:51:46.340 | you can imagine based on what you now know

00:51:48.780 | about back anatomy, right?

00:51:50.540 | The spinal cord being this kind of snake-like extension

00:51:54.420 | out the back of the brain with the vertebrae as segments

00:51:57.500 | and the discs in between them, if that's sagging,

00:52:00.660 | well, especially if you have an issue with a disc bulge

00:52:03.740 | and some impingement on one of those nerve roots,

00:52:06.160 | either coming into or out of the spinal cord,

00:52:08.360 | you're going to get into some trouble,

00:52:10.440 | meaning it's going to cause some pain

00:52:11.740 | or at least some aggravation.

00:52:12.780 | So the goal is to get that spine really straight

00:52:15.760 | as you're doing the side planks,

00:52:17.520 | regardless of whether or not you're doing that

00:52:19.200 | with knees bent or you're doing it with legs straight.

00:52:21.440 | In fact, that's the reason I went through

00:52:22.840 | all of that anatomy earlier,

00:52:24.440 | so that as you're doing these exercises,

00:52:26.600 | whether or not it's the big three

00:52:27.520 | or the other protocols I'll talk about,

00:52:29.280 | you can really envision the major components of the spine

00:52:32.400 | that are getting engaged, okay?

00:52:33.760 | It's not just about the abdominals and the obliques

00:52:36.120 | and the lower back, of course, it's about all of that.

00:52:38.760 | That's what you're exercising,

00:52:40.080 | but you're also getting the neural engagement

00:52:42.120 | within the spine.

00:52:43.200 | You should think about the vertebral segments, the discs,

00:52:46.640 | the fact that those nerve roots need to run in and out

00:52:48.820 | of the spinal cord, out past the bony and disc material,

00:52:52.920 | and to do that without impingement.

00:52:54.780 | So as you do these movements, it can be very beneficial

00:52:57.200 | to think about the different anatomical features

00:52:59.800 | of the back, including spinal cord, vertebrae, discs,

00:53:02.480 | nerves, et cetera, but mainly those.

00:53:04.920 | And as you're doing that,

00:53:06.320 | you'll not just be strengthening your back,

00:53:08.360 | you'll also be strengthening your learning

00:53:11.280 | of neuroanatomy.

00:53:12.840 | So the last of Stu McGill's big three, again,

00:53:16.120 | Stu kind of cringes every time people say,

00:53:18.160 | "Okay, it's just McGill's big three."

00:53:20.200 | And that's back strengthening and pain relief.

00:53:23.520 | And he always just kind of, oh,

00:53:25.200 | I can tell it pains him, no pun intended,

00:53:27.860 | because he knows, and it's true,

00:53:29.560 | that there's a lot more involved in strengthening

00:53:31.760 | and pain-proofing the back,

00:53:33.240 | but always good to have a great place to start,

00:53:35.560 | a simple place to start,

00:53:36.720 | and something that's really tractable

00:53:37.960 | without equipment or any cost.

00:53:39.560 | And so we're very grateful that Stu is willing

00:53:41.720 | to kind of resist his temptation

00:53:43.860 | to be beyond nuanced and thorough, which he always is,

00:53:47.880 | and offer us the curl-up, the side plank,

00:53:50.520 | which we've covered, and now the third,

00:53:52.240 | which is the bird dog.

00:53:54.100 | The bird dog, as some of you may know,

00:53:55.680 | is where you get into all fours on the ground.

00:53:58.460 | You extend one arm forward,

00:54:01.620 | and you extend the opposite one leg backward, okay?

00:54:06.460 | So if you're down on all fours

00:54:07.820 | and you extend your right hand in front of you,

00:54:11.420 | you're going to extend your left leg behind you.

00:54:14.580 | Now, there are a couple of key things about this.

00:54:16.160 | One is, again, have the extended hand in a fist.

00:54:21.100 | Why?

00:54:21.940 | Because you want to generate a strong neural contraction

00:54:24.540 | so that you don't forget, and in fact,

00:54:26.820 | facilitate keeping your upper body parallel to the floor.

00:54:30.580 | So no tilting from side to side, as best you can.

00:54:33.940 | And you also want the neural activation

00:54:37.300 | to allow you to then engage the lift of the leg

00:54:39.860 | in a way that's also very strong and stable, okay?

00:54:42.620 | So nothing floppy, no leaks, as they say.

00:54:45.500 | A key point is to make sure

00:54:46.820 | you don't raise the leg too high.

00:54:48.820 | You're not trying to arch your lower back.

00:54:50.940 | In fact, what you want to do

00:54:51.860 | is raise the hand in front of you,

00:54:54.140 | generate that fist.

00:54:55.100 | It can even just be out in front of your eyes at first,

00:54:58.340 | maybe a little bit higher.

00:54:59.780 | And then the leg that's extending toward the back,

00:55:02.780 | feel free to either point the toe toward the ground,

00:55:05.460 | or if you want to extend the toe a little bit,

00:55:07.580 | like you're doing a little bit of calf raise in the air,

00:55:09.900 | pointing your toe, that is, that's fine too.

00:55:12.700 | But don't get that heel up too high

00:55:15.320 | or even the upper thigh up too high

00:55:16.820 | that you're getting a really big arch in the back.

00:55:19.180 | The idea is to envision one long line

00:55:22.260 | between the extended arm and fist

00:55:25.380 | all the way back across the midline,

00:55:27.820 | because it's to the opposite leg

00:55:29.220 | and to the foot behind you.

00:55:30.700 | Again, it's about creating a strong, stable reach,

00:55:34.980 | a strong, stable lift of the foot, but not too high.

00:55:38.460 | And this is very important,

00:55:40.260 | with the hand that remains planted

00:55:41.940 | and the knee that remains planted,

00:55:43.220 | pushing the ground away from you.

00:55:45.060 | Okay, that's as important as is the lifting of the arm,

00:55:49.740 | the clasping of the fist, and the raising of the leg.

00:55:53.300 | In all of these movements,

00:55:54.340 | the pushing of the ground away from you,

00:55:56.580 | the resistance to gravity is as important

00:55:58.980 | as whatever movement you happen to be doing.

00:56:01.380 | Again, this is a terrific movement

00:56:02.780 | for strengthening the spine that most people can do,

00:56:05.380 | because you're only working one half of the musculature

00:56:09.420 | on either side of the spine.

00:56:11.060 | Okay, there's of course,

00:56:12.020 | activation of the musculature on the other side

00:56:13.700 | to some degree in order to balance things out.

00:56:16.360 | But by emphasizing only one half of the musculature,

00:56:19.160 | A, you can really focus on the contractions.

00:56:21.260 | Again, you can really put a lot of mind

00:56:23.200 | into the pushing of the floor away.

00:56:24.760 | You can put your mind into where the fist is

00:56:26.920 | and your foot is.

00:56:27.940 | And of course, you can generate

00:56:29.660 | the kind of hard contractions

00:56:30.940 | that are really going to strengthen

00:56:32.300 | those lower back muscles,

00:56:33.740 | as well as the upper back and shoulder muscles

00:56:36.020 | that are required for generating stability of the spine.

00:56:39.260 | Again, that's really what this is all about.

00:56:40.760 | Again, it's going to be maybe three to five repetitions

00:56:43.660 | of eight to 10 second holds for one set,

00:56:46.020 | done for repeated sets,

00:56:47.180 | maybe for a descending number of repetitions,

00:56:49.100 | where you're going five holds,

00:56:50.740 | four holds, three holds, two holds, one hold.

00:56:53.680 | All of that being done repeatedly

00:56:55.300 | and with the greatest amount of intensity and focus

00:56:57.780 | so that those nerve pathways

00:56:59.380 | can be engaged over and over again very easily,

00:57:02.260 | generating a lot of strength of contraction

00:57:04.100 | that then of course carries over

00:57:05.860 | into your exercise activities

00:57:07.440 | and even just your passive activities throughout the day,

00:57:09.540 | and even stability of the spine while at rest,

00:57:13.100 | which is something that we're going to talk about more

00:57:15.220 | as we get into some of the other protocols.

00:57:17.300 | Now, of course, with the bird dog exercise,

00:57:18.980 | you also need to train the opposite side of your body.

00:57:21.060 | So after doing, say, two to five sets

00:57:24.580 | of those two to five repetitions

00:57:28.900 | of eight to 10 second holds on one side,

00:57:31.740 | you're going to want to switch to the other side

00:57:33.340 | and do the same thing, or you could alternate.

00:57:35.300 | You could do right hand extended, left leg extended,

00:57:37.780 | do one set, then switch to the other side,

00:57:39.580 | left hand extended, or I should say left fist extended,

00:57:44.180 | right leg extended, do those repetitions,

00:57:47.360 | call that one set, and then shift back to the other side,

00:57:50.020 | and so on and so forth.

00:57:51.220 | Really depends on how much time you have,

00:57:53.180 | how frequently you're doing this throughout the week.

00:57:55.480 | Again, right now I'm striving to do all of Stumagil's Big 3

00:57:58.540 | at least once a week, maybe twice a week.

00:58:01.220 | I know many of you will say, "Oh, that's pretty wimpy.

00:58:04.060 | "You know, you should be doing this every single day

00:58:05.780 | "or five times a week."

00:58:06.700 | Well, I have a busy schedule just as many of you do,

00:58:09.540 | and it's something that I'm trying

00:58:11.140 | to incorporate more and more.

00:58:12.400 | Typically at the end of a workout,

00:58:13.820 | although some people decide to do this

00:58:15.060 | at the beginning of a workout,

00:58:16.180 | right now, fortunately, I'm not dealing with any back pain,

00:58:19.120 | knock on wood, but it's something that for many people

00:58:22.400 | who have back pain, they find that if they do this

00:58:24.920 | at the beginning of a workout,

00:58:26.000 | it allows them to then move into the workout warmed up

00:58:28.920 | and to avoid a lot of the back pain

00:58:30.640 | they would otherwise experience.

00:58:32.240 | With that said, I want to be very clear

00:58:34.680 | that if any of these movements exacerbate your back pain,

00:58:38.300 | then you should definitely avoid doing them.

00:58:41.280 | And of course, if you have back pain,

00:58:42.720 | you should be working with a licensed professional

00:58:44.800 | to figure out how to treat that back pain.

00:58:46.440 | You may very well need pain meds and or surgery.

00:58:49.220 | I don't know because I don't know

00:58:50.420 | your specific circumstance.

00:58:52.000 | But for most people who are just trying

00:58:53.780 | to strengthen their back, who perhaps are dealing

00:58:55.820 | with a little bit of nagging back pain,

00:58:58.980 | the big three are often very, very accessible,

00:59:01.220 | meaning they don't exacerbate back pain.

00:59:02.980 | And in many cases, they alleviate it,

00:59:04.960 | sometimes partially, sometimes completely.

00:59:06.940 | There are a lot of wonderful anecdotes out there

00:59:09.260 | of people who have benefited from doing the big three

00:59:11.560 | in all of those categories.

00:59:13.120 | Now, again, we have a link in the show note captions

00:59:15.100 | showing how the bird dog exercise is done.

00:59:17.700 | There are a couple of variations

00:59:18.860 | that you can do to make it harder.

00:59:20.900 | One is to draw boxes with the extended fist

00:59:24.020 | and the extended foot.

00:59:25.640 | That's actually a coordination issue too, for some people.

00:59:28.660 | So some people choose to do a box with their hand,

00:59:30.900 | maybe they do it clockwise,

00:59:32.380 | then they do it counterclockwise.

00:59:33.540 | Some people choose to do the hand and foot

00:59:35.460 | moving in a box together, meaning simultaneously.

00:59:38.360 | Sometimes they'll alternate foot than hand,

00:59:40.780 | this sort of thing.

00:59:41.680 | Any kind of movement that you're doing

00:59:43.020 | with the extended fist and or foot

00:59:46.580 | is going to add some degree of difficulty to this,

00:59:49.640 | but you want to make sure

00:59:50.820 | that if you're going to add those movements,

00:59:52.500 | those progressions,

00:59:53.380 | that you're keeping the pushing away of the floor

00:59:56.820 | constant throughout,

00:59:58.220 | and that you're keeping your torso parallel

01:00:00.360 | to the floor as you go.

01:00:01.320 | Now, when I say parallel,

01:00:02.340 | I realize that as you do an extension

01:00:05.020 | of one fist or the other fist,

01:00:06.940 | as you kick out that back leg,

01:00:09.140 | it's going to be near impossible for most people

01:00:11.100 | to stay perfectly parallel to the floor.

01:00:13.180 | What you're trying to do, however,

01:00:14.580 | is to make sure that you're not rolling

01:00:15.980 | from one side to the next.

01:00:17.620 | You're trying to make sure that you don't get tilted

01:00:19.340 | onto the stabilizing shoulder hand side, okay?

01:00:22.740 | So that's, what's really important.

01:00:24.520 | You can also, if you really want to make it difficult,

01:00:26.540 | you can start to take the extended hand,

01:00:30.480 | fist that is,

01:00:31.320 | and reach back and then touch the knee

01:00:33.580 | that was a few seconds ago extended.

01:00:35.920 | So you can do that in kind of a kind of reaching back,

01:00:38.360 | touching the knee, then re-extending the leg.

01:00:41.420 | You can do that for one side, both sides, et cetera.

01:00:43.420 | Again, there are a number of different progressions

01:00:45.060 | that I do in the video.

01:00:47.100 | I must say these are challenging for me,

01:00:49.020 | especially doing more than three sets.

01:00:51.160 | After you've contracted your muscles really hard

01:00:53.620 | in the way that you're supposed to

01:00:54.700 | for these exercises in the big three,

01:00:56.760 | you're not going to have the sort of fatigue

01:00:58.240 | that you experience after sprinting

01:00:59.780 | or after doing heavy deadlifts or something of that sort,

01:01:02.280 | but it's a certain kind of fatigue

01:01:03.740 | that prevents you from performing the movements properly.

01:01:07.140 | And so the whole point here

01:01:08.600 | is to perform the movements properly,

01:01:10.340 | to build a pattern, what's sometimes called an engram,

01:01:13.160 | but basically it's an activation pattern of nerve to muscle

01:01:16.240 | and the resulting limb movements

01:01:18.000 | that allow you to do the movements perfectly.

01:01:19.840 | So don't be in a big rush to do tons of this stuff

01:01:22.620 | right out the gate.

01:01:23.600 | Be in a rush to do as much of it as you can perform properly

01:01:27.920 | and consider it a progression

01:01:29.720 | and something that you're going to keep up,

01:01:31.520 | not just for a week, not just for a year,

01:01:33.360 | but it's something that you're going to do

01:01:34.560 | for the rest of your life.

01:01:36.000 | Even if that means doing it just once a week

01:01:38.220 | or once in a while, learn the movements properly.

01:01:41.180 | That's the most important thing.

01:01:42.660 | And of course, I'd be remiss

01:01:43.940 | if I didn't mention the common mistakes

01:01:45.420 | that people make when they do the bird dog.

01:01:47.280 | One is people often raise that front fist way too high.

01:01:51.540 | Okay, as they're reaching for the sky

01:01:52.820 | or they're kicking way too high in the back,

01:01:55.980 | they're generating a sort of bow shape

01:01:57.700 | from extended fist to extended back foot.

01:01:59.920 | That's not good.

01:02:00.800 | You really want to raise these things up

01:02:02.340 | as stiff, straight levers,

01:02:05.340 | while also maintaining as much as you can

01:02:07.620 | parallel to the floor stance and pushing the floor away.

01:02:11.420 | This is about generating strength of contraction.

01:02:14.260 | And I know the word sounds bad, but rigidity.

01:02:17.380 | It's about generating stiffness in the spinal muscles

01:02:21.120 | and in the abdominal muscles and in the upper back muscles

01:02:24.660 | and the other muscles that are required for this.

01:02:26.900 | And when I say stiffness,

01:02:27.920 | I don't mean a lack of ability for the muscles to move

01:02:31.700 | once you're in sport

01:02:33.540 | or once you're about your daily activities.

01:02:35.300 | What I'm talking about is an ability

01:02:37.100 | to generate a really firm muscular contraction

01:02:39.540 | so that those nerve pathways are strong

01:02:41.500 | so that you can stabilize the spine

01:02:43.140 | in any number of different dimensions

01:02:45.980 | and planes and orientations

01:02:47.620 | as you embark on your daily activities,

01:02:49.980 | sports activities, et cetera.

01:02:51.180 | That's what all of this big three stuff is about.

01:02:53.240 | It's about strengthening the musculature of the abdominals,

01:02:55.980 | of the lower back, of the shoulders,

01:02:57.940 | and everything that connects it neurally.

01:02:59.980 | Again, these are pathways.

01:03:01.100 | It's something that I should have said earlier and didn't,

01:03:03.820 | which is we often experience pain in a given location

01:03:06.600 | like lower back pain or pain in the lower back

01:03:09.420 | and down the hip into the leg.

01:03:11.060 | But pain is always the consequence

01:03:13.260 | of a pathway being irritated or a pathway being activated.

01:03:17.900 | And in order to strengthen the components around the back,

01:03:21.960 | to strengthen the components of the back to avoid pain,

01:03:25.400 | you want to work pathways.

01:03:26.860 | And so the big three that Stu McGill has developed

01:03:29.140 | is really about generating the kind of muscular strength

01:03:31.300 | and stability, the neuromuscular activation patterns,

01:03:34.140 | and doing it in a way that is generally safe

01:03:36.980 | for most people to perform

01:03:38.620 | to get the strongest and most pain-free back possible.

01:03:41.180 | And what I just described

01:03:42.060 | might sound like a lot of exercise.

01:03:43.660 | It's actually something that if you decide

01:03:45.700 | to just include one or two sets of each of those,

01:03:48.260 | curl up, side plank, bird dog,

01:03:50.980 | you could complete in anywhere from five to 10 minutes.

01:03:53.140 | Again, if done once a week or twice a week,

01:03:55.420 | or as a warmup before weightlifting

01:03:58.380 | or at the end of, say, a cardiovascular training session,

01:04:00.780 | maybe even while watching TV

01:04:02.140 | or listening to a podcast or something of that sort,

01:04:04.620 | it actually doesn't take that much time at all.

01:04:06.300 | And of course, it doesn't require any equipment

01:04:08.100 | and it can be done in essentially work or street clothes.

01:04:10.780 | I'd like to take a quick break

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01:04:54.320 | I've been using a plunge for several years now,

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01:04:59.780 | I do agree that doing cold water plunging

01:05:01.840 | after a workout designed to generate hypertrophy

01:05:04.660 | or strength gains is not a good idea,

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01:05:37.980 | Okay, so before I get into some of the other protocols

01:05:40.420 | for strengthening the back,

01:05:42.020 | which largely center around building strength

01:05:44.860 | into the stabilizing muscles and parts of the body

01:05:47.660 | that allow the spine to move

01:05:49.580 | through different planes of motion safely,

01:05:51.900 | I want to talk about two protocols

01:05:54.380 | that one can use to alleviate back pain

01:05:56.980 | that many people find beneficial.

01:05:58.720 | Now, all of this goes back to this thing

01:06:00.300 | about vertebrae, disc, vertebrae, right?

01:06:03.480 | That's the alternating sequence

01:06:04.940 | along the length of the spine.

01:06:06.740 | And again, the vertebrae are bony tissue,

01:06:09.140 | so it's hard stuff.

01:06:10.660 | The discs are a softer, right?

01:06:12.980 | It's got some durability to it, but it's a softer tissue,

01:06:16.200 | but it allows for pliability of the spine

01:06:18.660 | because it's a soft tissue.

01:06:20.640 | So imagine an Oreo cookie,

01:06:22.140 | something that I'm not a fan of eating.

01:06:24.920 | I don't like the way they taste,

01:06:25.920 | and I'm told they're probably not good for us.

01:06:27.740 | But in any case, if you like Oreos or you don't,

01:06:30.420 | it's a good analogy here

01:06:31.360 | where you've got the two cookies in the cream center.

01:06:33.340 | So the two cookies are analogous to the vertebrae here,

01:06:35.820 | and the cream center is analogous to the disc.

01:06:39.460 | If you squeeze the cookies evenly from top to bottom,

01:06:41.960 | the cream center is going to move out towards all sides

01:06:44.900 | along the full circumference, right?

01:06:47.060 | So all the white stuff is going to move

01:06:48.500 | towards the edges more or less equally.

01:06:50.680 | If you squeeze just on one side, right,

01:06:52.880 | the cream filling is going to move out toward one side.

01:06:55.480 | If you squeeze on the other side,

01:06:56.500 | cream filling will move out toward the other side.

01:06:58.120 | And of course, if you were to crush the cookies

01:07:01.040 | from top and bottom,

01:07:02.120 | or even just the top cookie or the bottom cookie,

01:07:04.300 | the cream filling is going to go up and through.

01:07:06.280 | That will be equivalent to the rupturing of the disc

01:07:08.200 | along that dimension, okay?

01:07:09.720 | Why am I mentioning this?

01:07:10.660 | Well, as I said before, a lot, not all,

01:07:13.600 | but a lot of back pain has to do with compression

01:07:17.620 | or impingement of nerves at some point along a pathway,

01:07:20.960 | sometimes multiple points along a pathway.

01:07:23.840 | And one of the most common sources of back pain

01:07:26.260 | is when those discs are bulging, they're herniating,

01:07:29.400 | and they're impinging on a fascicle of nerves,

01:07:32.340 | a bundle of nerves.

01:07:34.000 | So two of the things that many people find beneficial

01:07:37.240 | when they're experiencing back pain are first,

01:07:40.720 | if you can find a bar or something that you can hang from,

01:07:44.740 | but don't worry,

01:07:45.580 | you're not going to have to actually hang

01:07:47.080 | in a full dead hang position

01:07:48.600 | if you don't have the strength for that,

01:07:49.760 | or even if you do,

01:07:50.600 | the idea here is to get your arms overhead onto a bar,

01:07:53.760 | you're holding onto the bar,

01:07:55.360 | and your legs are going to drape down

01:07:56.800 | and your toes are going to be in contact with the floor.

01:08:00.240 | So we're not talking about a dead hang here, okay?

01:08:03.260 | Which actually requires that you engage some muscles

01:08:05.920 | that can actually aggravate back pain.

01:08:08.160 | What you're doing here is you're going to hold onto the bar,

01:08:10.080 | you're in more or less a hang,

01:08:11.760 | except that your toes are supporting you or your feet,

01:08:14.560 | or sometimes your heels are supporting you.

01:08:16.460 | What you're trying to do is get lengthening of the spine.

01:08:19.220 | Basically what you're doing is the opposite

01:08:21.300 | of pressing down on those spinal discs.

01:08:24.020 | And you're going to do that

01:08:24.940 | for anywhere from 10 to 30 seconds.

01:08:27.740 | You're not going to twist, okay?

01:08:29.500 | You could imagine how twisting of the spine could be bad,

01:08:31.900 | depending on where the bulge is

01:08:33.460 | and which nerves are being impinged.

01:08:35.180 | What you're trying to do is just create length

01:08:37.760 | along the spine to relieve some of that disc bulging,

01:08:41.340 | which is impinging on the nerves.

01:08:42.660 | Again, without knowing the source of your back pain,

01:08:44.940 | it's impossible to know whether or not this will help

01:08:46.900 | or it won't,

01:08:47.740 | but many people get some degree of pain relief

01:08:50.180 | by doing this.

01:08:51.020 | Of course, you need to be cautious in how you do it.

01:08:53.220 | You don't want to hang for a long time

01:08:55.080 | if you don't have the strength to do that

01:08:56.400 | while trying to find the distance to the floor

01:08:58.700 | with your toes,

01:08:59.540 | you're going to want to progress toward this very carefully.

01:09:01.740 | But this is something that many people find beneficial.

01:09:04.260 | It's also the kind of logic behind, you know,

01:09:07.220 | inversion tables and these kind of look more like

01:09:12.580 | kind of chair apparati

01:09:14.100 | where people have designed chairs that then can invert

01:09:17.340 | so that people can relieve some of the pressure

01:09:18.980 | on their spine.

01:09:20.100 | I've personally never tried those inversion chairs.

01:09:22.640 | I did use to have an inversion table

01:09:24.940 | that I had out on my deck in the morning.

01:09:26.540 | And I like to, you know,

01:09:28.060 | lock my ankles in and invert on that thing.

01:09:30.460 | It was kind of fun.

01:09:31.280 | Keep in mind, if you're going to do any kind of inversion,

01:09:33.360 | you are going to generate intracranial pressure.

01:09:35.680 | If you're somebody,

01:09:36.700 | and I feel obligated to say this

01:09:38.180 | because I'm a vision scientist

01:09:39.460 | and I worked on glaucoma for a number of years,

01:09:41.260 | which is intraocular pressure.

01:09:43.020 | If you have glaucoma or you're predisposed to glaucoma,

01:09:45.460 | you're going to increase ocular pressure

01:09:47.700 | if you're inverted in that way or any way.

01:09:49.940 | So keep that in mind,

01:09:50.980 | you would want to avoid that in those cases.

01:09:54.200 | But for many people,

01:09:55.040 | just generating some degree of lengthening of the spine

01:09:59.700 | by hanging from a bar

01:10:01.400 | or from some other physical object that's sturdy

01:10:04.120 | while keeping your toes or your feet

01:10:05.980 | or your heels in contact with the floor.

01:10:08.160 | So you're just kind of lightly touching there

01:10:09.620 | so that you can keep that going

01:10:11.040 | for anywhere from 10 to 30 seconds

01:10:12.660 | and then just kind of relax, let go.

01:10:15.420 | You walk around a little bit

01:10:16.800 | and then repeat doing that two or three times.

01:10:18.580 | Many people experience some degree of pain relief

01:10:20.940 | from doing that for all the reasons

01:10:22.640 | that now should be logical and obvious to you

01:10:25.020 | based on your understanding of spine anatomy

01:10:27.260 | and physiology that we talked about earlier.

01:10:29.220 | And the general theme of just trying to relieve compression

01:10:32.060 | that is herniation of the discs.

01:10:34.060 | Now, what about reversing herniation of the discs?

01:10:36.500 | Okay, so this is something I'm very familiar with.

01:10:38.580 | And I have an anecdote here

01:10:39.740 | that of course just relates to my experience.

01:10:41.820 | So it certainly doesn't carry over to everybody,

01:10:44.020 | but it's an experience that I've shared

01:10:46.180 | with a number of people who've also experienced

01:10:48.340 | lower back pain to some degree of success.

01:10:51.340 | And the story goes as follows.

01:10:53.100 | A few years ago, when I was in Seattle giving a talk,

01:10:56.020 | I decided to go to the gym that morning

01:10:57.940 | and I did an exercise, which was not a deadlift.

01:11:00.640 | It wasn't anything spinal really.

01:11:02.260 | It was kind of a reverse bench dip

01:11:04.880 | that I do for my triceps.

01:11:05.940 | I've always enjoyed doing these.

01:11:07.180 | I've always been able to do these completely pain-free,

01:11:09.900 | but that morning I got ambitious

01:11:11.340 | and I put a couple plates on my lap in order to do them.

01:11:15.260 | And I don't know exactly when it happened,

01:11:17.980 | but as I was doing these bench dips

01:11:20.220 | with the weight on my lap,

01:11:22.180 | something felt like it "went" in my back.

01:11:25.740 | Something felt off.

01:11:27.100 | I don't know what happened,

01:11:28.120 | but it felt like a little kind of like a little pull

01:11:30.940 | or something of that sort.

01:11:31.780 | And when I stood up, I felt okay.

01:11:33.940 | And then as I started to walk around a little bit more

01:11:35.780 | and went through my workout, I thought,

01:11:36.900 | uh-oh, something happened back there.

01:11:38.780 | This is not good.

01:11:40.380 | And what essentially was happening

01:11:42.460 | is I was experiencing pain on my kind of lower

01:11:46.300 | and mid right side of my back down the hip.

01:11:49.340 | So intense pain at the hip socket and down the leg.

01:11:53.020 | You know what some people might describe as classic sciatica

01:11:55.740 | or something similar to that.

01:11:57.580 | I thought, oh goodness, this is not good.

01:11:59.300 | And as the morning progressed,

01:12:00.980 | I was having a harder and harder time, not walking.

01:12:03.980 | Walking was okay, but if I sat down

01:12:06.620 | and then I need to stand up, it was incredibly painful.

01:12:09.980 | And I thought, oh no, this is it.

01:12:12.100 | I really did something bad to my back.

01:12:14.060 | So much so that I was literally bent over

01:12:17.260 | at about 20 or 30 degrees,

01:12:18.760 | walking back to the Space Needle in Seattle,

01:12:20.860 | 'cause we were giving the talks up in the,

01:12:23.420 | one of the rooms there, I don't know if it was the top room,

01:12:25.220 | but one of the rooms at the Space Needle,

01:12:26.520 | and I could barely walk up to the Space Needle.

01:12:29.860 | I was just, you know, hunched over.

01:12:32.160 | It was miserable.

01:12:33.660 | Now, eventually what happened was I was able to fly home.

01:12:36.860 | I was in a ton of pain.

01:12:38.540 | I started reaching out to colleagues of mine

01:12:40.540 | that work on the back, that understand pain.

01:12:43.240 | They were suggesting painkillers.

01:12:44.580 | I personally like to avoid taking painkillers

01:12:46.460 | unless I have to take them.

01:12:48.060 | And I basically don't take them.

01:12:49.320 | I might take an aspirin every once in a while,

01:12:51.260 | but I really like to avoid taking painkillers.

01:12:53.020 | That's just me.

01:12:53.860 | I don't judge those that need painkillers.

01:12:55.900 | But basically in talking to medical colleagues,

01:12:58.340 | I thought, okay,

01:12:59.180 | maybe I'm going to need a corticosterone shot.

01:13:01.060 | Maybe I'm going to need to just wait it out

01:13:03.500 | and keep in mind that a lot of back pain does relieve itself

01:13:06.420 | if people just wait it out and avoid the movement

01:13:08.700 | or movements that caused or exacerbate that back pain.

01:13:11.220 | This is something really important to know.

01:13:12.580 | A lot of back pain will just relieve over time,

01:13:15.700 | but I wanted to stay active.

01:13:17.940 | So I started reading online, as one does,

01:13:20.500 | and I even started doing

01:13:22.340 | some abdominal strengthening exercises.

01:13:24.340 | At the time, I wasn't aware of the curl-up,

01:13:26.780 | and instead what I was doing was some crunches.

01:13:29.660 | So I was doing sit-ups,

01:13:30.940 | which, you guessed it,

01:13:32.540 | made things way, way worse for the obvious reasons.

01:13:35.420 | It was actually causing more of bulging of the discs

01:13:39.460 | that were impinging on those nerves,

01:13:40.900 | bulging out the, I guess it would be

01:13:42.620 | the backside of the back, the posterior side of the back.

01:13:45.460 | At the time, I didn't really understand disc anatomy

01:13:48.300 | and vertebral anatomy in a way that would tell me

01:13:50.820 | that the sit-ups were going to cause that problem,

01:13:52.460 | but they were making it worse and worse.

01:13:54.300 | Eventually I crossed paths with a PT who said,

01:13:57.260 | "Absolutely stop doing any abdominal crunching.

01:14:00.140 | Just stop, you're making it much, much worse."

01:14:02.460 | He explained to me that the discs were bulging

01:14:04.780 | at about the L3, L4 region.

01:14:07.500 | You can look up where that is.

01:14:08.900 | And then it was impinging on the nerve,

01:14:10.220 | which was causing the pain both in the back,

01:14:12.020 | at the hip socket, down the leg.

01:14:14.100 | What did he suggest I do?

01:14:15.100 | He suggested that I do essentially the opposite of a sit-up,

01:14:18.940 | basically that I lie down on the floor

01:14:20.780 | with toes extended, legs together,

01:14:23.300 | and then do essentially a push-up

01:14:25.460 | while keeping my hips in contact with the floor.

01:14:27.860 | So you might think of this kind of as an up-dog

01:14:29.880 | or a Cobra pose in yoga,

01:14:31.940 | although not so much extending the head,

01:14:34.460 | looking up at the ceiling,

01:14:35.620 | but keeping the head in a neutral position,

01:14:37.340 | and then doing anywhere from eight to 10 repetitions

01:14:39.940 | of those, and then holding the final repetition

01:14:42.640 | for as long as I could until I started to quake a little bit

01:14:45.980 | and then relaxing onto the floor.

01:14:48.220 | What was remarkable is that from the very first set

01:14:51.220 | of those that I did,

01:14:52.300 | I started to experience some degree of pain relief,

01:14:54.780 | not total pain relief, but some degree of pain relief.

01:14:57.700 | And what he suggested I do,

01:14:58.820 | and what of course I did,

01:15:00.300 | was to do those essentially Cobra push-ups,

01:15:03.240 | or I don't know really what to call them.

01:15:05.540 | Again, it's hips in contact with the floor,

01:15:07.340 | toes pointed back, legs straight, pushing back.

01:15:10.940 | Essentially what he was having me do

01:15:12.860 | was to try and work that disc bulge

01:15:14.700 | back into the more vertical alignment of the spinal column.

01:15:18.660 | I realize that's not the exact nomenclature,

01:15:20.480 | so all you PTs and chiros and physios

01:15:22.600 | are probably cringing at this point,

01:15:23.960 | but for the common listener,

01:15:25.300 | what we were trying to do

01:15:26.140 | was get the cream of the Oreo cookie

01:15:28.220 | from stopping to squeeze out from the back of,

01:15:31.020 | from between those cookies

01:15:32.020 | and back under those cookies, so to speak.

01:15:35.060 | And what I found, and this was just remarkable,

01:15:38.340 | was that within two, maybe three days,

01:15:41.520 | the pain was almost completely gone,

01:15:43.740 | almost completely gone,

01:15:44.600 | which was to me just staggering.

01:15:46.300 | No pain medication.

01:15:48.100 | I mean, prior to this, I was thinking,

01:15:49.460 | oh goodness, I'm going to need corticosterone injection.

01:15:51.620 | I'm going to have to take pain meds.

01:15:52.840 | I might even need surgery.

01:15:54.180 | I mean, I was completely debilitated.

01:15:56.800 | Now, of course, we don't have the control experiment

01:15:58.840 | where I didn't do these exercises and I did nothing.

01:16:01.300 | So we don't know how fast it would have relieved itself

01:16:04.280 | had I just done nothing.

01:16:05.400 | So that's an important caveat to all of this.

01:16:07.420 | And again, this is just my experience.

01:16:09.360 | But the reason I'm sharing this experience

01:16:11.440 | is not because I necessarily think

01:16:14.240 | that you should be doing these same exercises

01:16:16.280 | to relieve a disc bulge and the pain that results from it,

01:16:18.860 | but to give you a sense of how the disc bulging

01:16:20.720 | and the impingement on the nerve

01:16:22.320 | is very often the cause of back pain

01:16:24.680 | and you want to absolutely avoid doing anything

01:16:26.940 | that exacerbates that disc bulge.

01:16:28.880 | So in my case, it meant avoiding doing any crunching

01:16:32.000 | because that would send the cream

01:16:33.100 | from between the two Oreo cookies further and further out,

01:16:35.320 | impinging on the nerve more and more and more,

01:16:37.120 | creating more and more pain,

01:16:38.840 | rather to try and push things back

01:16:40.880 | by doing a spinal extension,

01:16:42.560 | by creating an arch in the lower back,

01:16:44.560 | by doing these essentially Cobra pushups from the floor.

01:16:48.200 | And when talking with this PT again and telling him,

01:16:51.200 | gosh, the back pain is essentially removed.

01:16:53.660 | This is amazing.

01:16:54.500 | Back to exercising, walking, running in the very same week.

01:16:58.160 | He said, yes, indeed, some people have so much back pain

01:17:01.080 | that they can't even do the Cobra type pushup.

01:17:03.120 | They need to just go to a wall

01:17:05.560 | and actually just put their hands on the wall,

01:17:07.680 | standing about six inches or so away from the wall,

01:17:10.240 | and then just push their hips towards the wall.

01:17:12.800 | Okay, yeah, I acknowledge it kind of an odd visual there,

01:17:14.920 | but pushing their hips towards the wall

01:17:17.520 | while keeping their arms bent and their torso

01:17:20.640 | anywhere from six to 12 inches from the wall.

01:17:23.400 | And then eventually progressing to being able

01:17:25.180 | to do these Cobra type pushups or up dogs,

01:17:27.900 | whatever you want to call them, on the floor.

01:17:30.200 | I, again, will provide a link in the show note captions

01:17:32.540 | of how these are done.

01:17:34.100 | I found these to be tremendously beneficial,

01:17:36.420 | not just when I have back pain, because yes,

01:17:38.740 | indeed, a couple of years later,

01:17:40.340 | I did something else in the gym.

01:17:41.660 | I wasn't training particularly heavy.

01:17:43.100 | And that same L3, L4 thing started again.

01:17:46.540 | And I started doing these right away

01:17:48.100 | and it resolved it right away.

01:17:49.660 | Okay, so clearly it works for me.

01:17:52.200 | But one of the things that's really been key for me

01:17:53.980 | is to understand that I have a propensity for a disc bulge,

01:17:57.100 | a herniation in that region.

01:17:59.100 | I now know what direction the disc bulge goes,

01:18:02.260 | therefore, which exercises to avoid

01:18:04.700 | because they exacerbate that herniation of the discs,

01:18:07.220 | and which exercises to emphasize

01:18:09.500 | because they help alleviate the herniation of that disc.

01:18:12.420 | And this is why a little bit later,

01:18:14.760 | I'm going to talk about some of the protocols

01:18:16.680 | that you can incorporate into your resistance training,

01:18:18.660 | things like posterior chain work,

01:18:20.820 | like glute ham raises, Nordic curls,

01:18:22.760 | and things of that sort.

01:18:23.660 | That if you're like me,

01:18:24.860 | and you're prone to slight herniation of the discs

01:18:28.260 | in the direction towards the posterior side, right?

01:18:31.140 | That it's very important to build up the musculature

01:18:33.600 | that surrounds those discs

01:18:35.300 | so that one can avoid herniating them further.

01:18:38.860 | So again, this is my experience.

01:18:40.700 | You, if you have back pain, I would hope not,

01:18:43.340 | but if you have back pain,

01:18:44.520 | it might be a herniation

01:18:45.720 | toward the anterior side of your spine, right?

01:18:47.700 | It might be herniation in the direction of spine flexion.

01:18:51.340 | And so therefore you need to do different exercises.

01:18:53.420 | The point is that you need to understand

01:18:54.640 | what the origin of the pain is,

01:18:56.620 | but I also offer this story

01:18:58.340 | because I've known several people,

01:19:00.740 | one of whom is in my family,

01:19:02.580 | who experienced back pain,

01:19:04.340 | thought they need to get corticosterone injections,

01:19:07.220 | actually got those injections,

01:19:09.260 | got some degree of pain relief, which is not surprising,

01:19:11.640 | but then the pain came back.

01:19:13.460 | Okay, it turns out they had a herniated disc

01:19:15.060 | in the same kind of area and general category of posterior,

01:19:19.940 | you know, the cream of the cookie going out the back,

01:19:22.500 | all right, or towards the back as I did,

01:19:25.060 | thought that my anecdote about the herniated disc

01:19:28.760 | and these, you know, pushups and these wall pushups

01:19:30.740 | and pushing one's pelvis towards the wall was kind of goofy

01:19:33.220 | and, you know, wasn't really medical,

01:19:35.560 | but was very interesting,

01:19:36.980 | is when they then traveled to Europe,

01:19:40.040 | to Scandinavia for the summer, living there,

01:19:42.260 | they're Scandinavian, and spoke to a physician there,

01:19:46.060 | the instruction from that MD,

01:19:47.660 | that physician was not to do corticosterone injections

01:19:50.860 | or to get surgery, but you guessed it,

01:19:53.100 | to do exactly the same exercises

01:19:55.200 | that the PT in the United States suggested to me.

01:19:58.520 | Now, why do I raise this?

01:19:59.740 | Well, the last thing I want to do

01:20:01.300 | is get into a debate online

01:20:02.980 | about whether or not one profession like PT or Cairo or MD,

01:20:06.380 | et cetera, is better than the other.

01:20:07.740 | I realized there's a range of talents.

01:20:09.980 | There are mediocre, terrible, bad,

01:20:12.620 | excellent, and superb practitioners

01:20:14.640 | in all these categories, by the way.

01:20:16.820 | That's clear to me and hopefully to everybody else, right?

01:20:19.980 | You can't look at an entire field and say good

01:20:21.780 | or entire field and say bad.

01:20:23.060 | There's going to be a range of quality of practitioners

01:20:25.300 | in any of those fields.

01:20:26.780 | But when it comes to back pain,

01:20:28.140 | we are at an interesting point in history

01:20:30.540 | where depending on where you are in the world,

01:20:32.660 | depending on the traditions of the medical practice

01:20:35.940 | in the area in which you live,

01:20:37.900 | certain forms of relieving back pain

01:20:40.460 | are going to be looked at as more esoteric than others.

01:20:43.300 | So that's the other reason I offer this anecdote.

01:20:45.740 | This family member of mine and a couple of friends

01:20:47.820 | who've experienced back pain of a similar nature

01:20:49.980 | have all now incorporated these Cobra pushups,

01:20:54.020 | up dog type approaches to some degree of success or another.

01:20:57.980 | It is true that one of them had a badly enough

01:21:00.260 | herniated disc that they did need surgery.

01:21:02.460 | So surgery sometimes is needed, of course,

01:21:04.940 | but it's been remarkable to me

01:21:06.340 | to see how much I and others can relieve their back pain

01:21:09.620 | and strengthen the particular areas and aspects of the body

01:21:13.420 | that then can avoid further back pain.

01:21:15.380 | And I'm quite happy to say

01:21:16.460 | that I've had essentially zero back pain

01:21:18.620 | now that I've incorporated

01:21:19.700 | the right rehabilitative exercises,

01:21:21.620 | as well as the right strengthening exercises,

01:21:24.020 | which include the big three that we talked about before

01:21:26.540 | and the ones I'm going to talk about next.

01:21:28.460 | I realized that when a lot of people hear about back pain,

01:21:31.140 | they immediately think of sciatica.

01:21:33.260 | And as somebody who's always carried his wallet

01:21:35.640 | in his back right pocket, I'm often told,

01:21:38.100 | "Hey, you're going to get sciatica

01:21:39.460 | if you carry your wallet in your back right pocket."

01:21:42.860 | Well, I always take my wallet

01:21:44.700 | and put it in my front right pocket when I sit down,

01:21:46.900 | or at least I try to remember to.

01:21:48.740 | So I don't think that's the cause.

01:21:50.420 | I'm certainly somebody who's had quote unquote sciatica.

01:21:53.780 | Now, sciatica is most commonly thought of

01:21:56.060 | as tingling pain or numbness

01:21:58.180 | or some combination of the three

01:22:00.100 | in maybe a little bit in the lower back,

01:22:02.140 | in the glute region, in the hip and down the leg,

01:22:05.140 | especially.

01:22:06.500 | Now, relieving sciatica

01:22:08.580 | involves a number of different approaches,

01:22:10.240 | and I'll probably have to do an entire episode

01:22:11.840 | about sciatica and other nerve pathway pain specifically.

01:22:15.380 | But for the time being,

01:22:16.220 | a lot of sciatica is caused by exactly the sorts of things

01:22:19.460 | that we were talking about thus far,

01:22:20.980 | the herniation of the disc,

01:22:22.100 | the bulging of the disc and the impingement on the nerve.

01:22:24.580 | And when that bulging, aka herniation,

01:22:27.140 | is occurring within the lower lumbar region of the spine,

01:22:31.240 | oftentimes it will impinge on a nerve or nerves

01:22:34.040 | that innervate the various regions I just described.

01:22:36.340 | So the glutes, the hip, down the leg,

01:22:38.340 | and sometimes will activate pain,

01:22:41.180 | tingling or numbness in areas

01:22:42.980 | which are not innervated by that nerve.

01:22:45.600 | There's something called referred pain

01:22:47.100 | where you're experiencing pain in one part of the body

01:22:49.700 | due to an impingement or disruption of a neural pathway

01:22:52.420 | or other pathway or inflammation elsewhere in the body.

01:22:55.500 | So we're not going to do a deep dive on sciatica right now.

01:22:58.460 | Suffice to say that a lot of the symptoms of sciatica

01:23:02.100 | fall under the umbrella of what we're talking about today,

01:23:05.240 | which is back pain and strengthening the back in a way

01:23:08.200 | that can help you avoid back pain

01:23:09.600 | and indeed sciatica as well.

01:23:12.120 | Much of what I just spoke about

01:23:13.520 | in terms of my own experience with lower back pain

01:23:16.080 | could be thought of as sciatica

01:23:17.400 | 'cause there was a lot of pain in the hip.

01:23:19.020 | I almost felt as if the hip socket was in pain.

01:23:21.440 | And there was some pain, not shooting down the leg,

01:23:24.400 | but kind of in the outer uppermost thigh for me.

01:23:26.760 | Some people experience it all the way down to their toes,

01:23:28.640 | even numbness, tingling, or pain within the foot.

01:23:31.360 | So it really depends on the degree

01:23:32.740 | to which those neural pathways are impinged.

01:23:35.340 | But the principles are the same, which are,

01:23:38.060 | if you are experiencing lower back or related pain

01:23:41.500 | in the hip, the leg, the buttocks, et cetera,

01:23:45.060 | you really want to figure out,

01:23:46.660 | is there a bulging, also called a herniated disc?

01:23:49.540 | If so, which direction is the herniation likely occurring?

01:23:53.220 | Is it out toward the back of the spine?

01:23:54.380 | Is it on one side?

01:23:55.740 | You really want to understand where that herniation

01:23:58.380 | and bulging is occurring

01:23:59.640 | so that you can do the proper exercises

01:24:01.180 | to work that bulging,

01:24:02.600 | to push essentially what I'm referring to an analogy

01:24:05.940 | as the pushing back of the cream

01:24:07.680 | between the two Oreo cookies,

01:24:08.940 | back between those two Oreo cookies

01:24:10.620 | so that you can give some relief

01:24:12.560 | from the impingement on those nerve roots

01:24:14.940 | that are no doubt causing the flare up of back pain

01:24:18.260 | or what some people experience and call sciatica.

01:24:20.940 | Okay, so thus far, we've largely been talking

01:24:22.740 | about different structural features of the back,

01:24:25.100 | things like vertebrae, which are bony, the discs, et cetera,

01:24:28.580 | that can impinge on nerves and cause pain.

01:24:30.660 | And while pain is certainly neural,

01:24:33.320 | there are a number of things that exist

01:24:35.260 | from literally toe to head that allow our back

01:24:39.900 | to move through the various planes of motion

01:24:42.380 | in the ways it needs to,

01:24:43.700 | to carry out daily living, to carry out sport,

01:24:45.860 | and that if we strengthen certain things,

01:24:48.140 | even very distal, very far from the spine,

01:24:51.620 | we can allow for more mobility of the spine,

01:24:53.900 | strengthening the spine,

01:24:55.000 | and indeed even pain relief within the spinal pathways.

01:24:58.900 | Now, the protocols we're about to discuss

01:25:00.440 | were shared with me with Dr. Shawn Wheeler.

01:25:03.080 | Shawn Wheeler is a medical doctor

01:25:05.340 | who has an incredible knowledge of back pain,

01:25:08.860 | back relief, and back strengthening.

01:25:10.820 | By no means can I exhaustively cover

01:25:14.000 | all of the knowledge that he shared with the world.

01:25:16.400 | I'll provide links to some of his work

01:25:18.520 | in the show note captions.

01:25:19.460 | I intend to bring him onto the podcast as a guest,

01:25:22.160 | but the hallmark of the protocols

01:25:23.540 | I'm about to share with you is the following.

01:25:26.140 | We have muscles that are constantly actively engaged

01:25:31.140 | in order to stabilize our spine,

01:25:33.260 | which again, is a good thing.

01:25:34.380 | You want a stable spine.

01:25:35.980 | And we have muscles that are not actively engaged,

01:25:38.880 | but for which we can engage them either voluntarily,

01:25:41.760 | or we can train them to be more engaged

01:25:44.260 | when we're not thinking about it.

01:25:45.620 | So involuntary engagement.

01:25:47.900 | But we have an entire set of musculature

01:25:50.180 | that is constantly actively engaged

01:25:52.660 | in order to stabilize our spine,

01:25:54.660 | which again, is a good thing.

01:25:56.500 | And we have musculature

01:25:57.460 | that can potentially stabilize our spine

01:25:59.460 | if we focus on it, if we consciously decide to.

01:26:02.620 | So what I'm about to describe are some simple protocols.

01:26:05.100 | In fact, very simple protocols that you can do

01:26:07.600 | in order to create more spine stability.

01:26:09.900 | And in fact, you can do these anywhere.

01:26:11.820 | The first involves strengthening the muscles

01:26:13.620 | in the front of the neck.

01:26:15.200 | Now, this is something that I do believe

01:26:16.780 | most everybody should be doing anyway.

01:26:19.060 | Why?

01:26:19.900 | Well, most people nowadays are starting to take on

01:26:22.380 | a C shape, not just rounding of the lower spine,

01:26:25.300 | but the chin is starting to move toward the chest.

01:26:28.320 | And of course, this is because most everybody is texting

01:26:31.140 | or on a laptop much of the time.

01:26:33.380 | Okay, this is not an exaggeration.

01:26:35.420 | If you look at people walking around now,

01:26:37.300 | they are tilted forward at the chin.

01:26:40.100 | They are essentially taking an inch or two off their height.

01:26:43.060 | They are potentially creating pain elsewhere in the body,

01:26:46.260 | maybe even in the neck itself.

01:26:48.020 | And what I'm about to describe is a way in which

01:26:50.060 | you can very easily strengthen the muscles

01:26:52.180 | in the front of the neck without adding size to the neck,

01:26:55.080 | because I know a lot of people don't wanna add size

01:26:57.440 | to their neck.

01:26:58.280 | I've talked elsewhere about strengthening the muscles

01:27:00.260 | on the side of the neck and in the back of the neck.

01:27:02.360 | This is something that I do believe is important,

01:27:04.060 | especially for people that are doing a lot

01:27:05.540 | of heavy weightlifting, who are broadening their shoulders

01:27:08.140 | or who already have broad shoulders.

01:27:10.340 | Also just from a sheer aesthetic perspective,

01:27:12.980 | nothing looks weirder than a little head and neck

01:27:14.900 | placed on broad shoulders, okay?

01:27:16.860 | But more importantly than any aesthetic matters

01:27:18.900 | is that if the musculature of the neck is weak,

01:27:21.800 | you have a weak upper spine,

01:27:23.580 | which is not a good thing from the perspective

01:27:26.100 | of avoiding pain and not a good thing

01:27:28.240 | from the perspective of safety,

01:27:30.340 | let alone posture, breathing, et cetera.

01:27:32.060 | I've talked about that elsewhere.

01:27:33.140 | I'll provide a link in the show note captions

01:27:34.700 | to some of the simpler exercises for strengthening the neck

01:27:37.780 | that you can do without equipment.

01:27:39.240 | In the meantime, for sake of strengthening

01:27:42.140 | and pain-proofing the back,

01:27:44.460 | it's very clear that strengthening the muscles

01:27:46.520 | of the front of the neck can be very beneficial.

01:27:48.700 | This is something that not just Dr. Wheeler,

01:27:50.380 | but also Stuart McGill have been proponents of.

01:27:53.740 | And the simplest way to do this without any equipment

01:27:56.020 | is to simply put your fists underneath your,

01:27:59.260 | not your chin, but on the two sides of your jaw.

01:28:01.460 | So on either side of your chin, if you're just listening,

01:28:03.320 | that's why my voice is going like this.

01:28:04.820 | And then with your tongue on the roof of your mouth

01:28:08.100 | and breathing through your nose,

01:28:09.460 | you're just going to do a 10 second static contraction

01:28:12.300 | where you're going to try and move your chin down

01:28:14.260 | against the resistance of your fists

01:28:16.580 | underneath your jaw, okay?

01:28:18.540 | So you're going to go push down there.

01:28:21.760 | Again, tongue on the roof of your mouth.

01:28:23.460 | Feel free to exhale as you do this.

01:28:25.220 | You might want to do this for three or four repetitions

01:28:27.820 | of 10 second static contractions, and then just relax.

01:28:32.300 | You could do that for anywhere from two to five sets.

01:28:35.020 | Very easy to do.

01:28:36.300 | What you're doing is you're generating strength

01:28:38.000 | in the muscles of the front of the neck

01:28:39.900 | and some nearby musculature.

01:28:42.220 | It has the tendency to then put you into a default position

01:28:46.100 | at a distance from your chest, okay?

01:28:48.140 | So this is different than strengthening the muscles

01:28:50.900 | on the back of your neck,

01:28:51.780 | which will of course help to keep your chin out

01:28:54.420 | and away from your chest.

01:28:56.080 | But when one does this,

01:28:57.460 | there are a number of different benefits,

01:28:59.140 | improved airway passage.

01:29:01.640 | So as many of you know,

01:29:03.040 | I'm a big proponent of nasal breathing,

01:29:04.540 | unless you need to breathe through your mouth,

01:29:06.380 | both during sleep and sometimes during exercise,

01:29:09.200 | but certainly at rest.

01:29:10.420 | So strengthening the muscles of the front of the neck.

01:29:12.620 | Again, I'll provide a link to this in the show note caption.

01:29:14.620 | It's very easy to do.

01:29:15.500 | It takes barely any time.

01:29:16.660 | You can do it anywhere.

01:29:18.180 | And it has a number of different benefits

01:29:19.820 | for strengthening and pain proofing the spine.

01:29:23.140 | Next is to focus on strength of your feet and your toes.

01:29:28.060 | Yes, you heard me correctly.

01:29:29.380 | Why are we talking about feet and toes

01:29:31.060 | when we're talking about back strengthening

01:29:33.700 | and alleviating back pain?

01:29:34.940 | Well, your feet are the foundation of your entire body.

01:29:37.980 | They're carrying you around all day long.

01:29:40.360 | And it's very clear that the stronger your feet are,

01:29:44.100 | the healthier the rest of your body is going to be.

01:29:46.100 | It's not to say that the rest of your body will be healthy

01:29:48.020 | if you just focus on foot strength.

01:29:49.540 | That's certainly not the case,

01:29:50.600 | but strengthening your feet has many, many benefits.

01:29:54.160 | It's something that I've been focusing a lot on

01:29:55.940 | in the last couple of years.

01:29:57.140 | And it's made a huge difference

01:29:58.840 | in terms of eliminating shin splints when I run.

01:30:02.060 | It's made a huge difference in terms of alleviating

01:30:04.580 | a certain amount of lower back pain.

01:30:06.180 | Although you heard the anecdote about how I largely did that

01:30:09.120 | through other mechanisms earlier.

01:30:11.980 | Basically strengthening your feet

01:30:13.620 | is an all around terrific thing to do.

01:30:15.640 | How do you do this?

01:30:16.480 | Well, some people opt to get very wide toe box shoes.

01:30:19.780 | Some people will even run in those shoes

01:30:21.980 | where the individual toes look like they're in a glove.

01:30:25.340 | I don't own those shoes.

01:30:26.300 | I do have a slightly wider toe box shoe for running

01:30:28.500 | and I've really benefited from that.

01:30:30.140 | But basically what anyone can do

01:30:32.980 | and you don't need to purchase any shoes

01:30:34.500 | or anything like that is to try and see

01:30:37.620 | if you can spread your toes out from one another

01:30:40.500 | so that none of them are touching on both feet.

01:30:42.740 | Many people find that they are able to do that.

01:30:45.420 | Some people, including myself, found that they could do that

01:30:47.320 | on one foot, not the other.

01:30:48.640 | And it just took a couple of weeks of working at it

01:30:52.280 | and strengthening those neural pathways,

01:30:54.580 | learning how to activate those neural pathways

01:30:56.360 | through concentration to be able to spread my toes

01:30:59.280 | on both feet.

01:31:00.440 | This might sound a little silly to some of you,

01:31:01.900 | but being able to spread your toes on both feet

01:31:04.220 | actually says a lot about your ability

01:31:06.320 | to activate distal neural pathways,

01:31:08.520 | or I should say neural pathways

01:31:09.880 | to distal parts of your body.

01:31:11.760 | There's a bunch of interesting data

01:31:13.000 | about how that correlates with some metrics of aging

01:31:16.840 | or lack of aging.

01:31:17.680 | I'm going to cover that in a future podcast.

01:31:20.040 | But some people find that they can't spread their toes out

01:31:23.800 | and they need a little bit of help from toe spreaders.

01:31:25.600 | Yes, there are commercially available toe spreaders

01:31:29.200 | that take the form of these kind of stocks

01:31:31.920 | that you can put between your toes.

01:31:34.680 | These are rubber stocks that then spread the toes.

01:31:36.760 | It can be a little bit uncomfortable at first,

01:31:38.660 | but then you get better at it,

01:31:40.200 | help you learn to spread your toes.

01:31:42.640 | You certainly don't need those things.

01:31:43.800 | You could even just take some paper towel or tissue paper

01:31:47.200 | or something that's firm and put it between your toes,

01:31:49.840 | and that will help you learn to spread your toes.

01:31:52.940 | I'm not suggesting you walk around all day

01:31:54.560 | with toe spreaders,

01:31:55.380 | although some people actually do that.

01:31:57.000 | But basically what you're doing

01:31:57.820 | is you're creating the ability

01:31:59.320 | to activate the neural pathways

01:32:00.640 | that allow you, excuse me, to spread your toes.

01:32:03.520 | I know this might sound silly,

01:32:04.800 | but if you do this,

01:32:05.640 | you're going to find that you're walking,

01:32:07.520 | your stance when you're stationary,

01:32:09.880 | and certainly if you do any kind of running or cycling,

01:32:12.560 | you're going to find that all of those things

01:32:14.140 | are going to benefit.

01:32:15.380 | In addition, there is benefit to strengthening your toes.

01:32:18.160 | This is something that I'm only now starting to explore.

01:32:21.640 | One way you can do this is by sitting in a chair barefoot,

01:32:24.740 | spreading your toes as much as possible,

01:32:27.480 | and then seeing whether or not

01:32:28.320 | you can lift each toe independently.

01:32:30.720 | I'm not at the point where I can do that yet.

01:32:32.260 | I'm still trying to learn how to lift my big toes

01:32:35.060 | independent of my other toes.

01:32:36.400 | Again, all of this is learning

01:32:37.640 | how to activate neural pathways

01:32:39.420 | to distal parts of your body

01:32:41.320 | that serve as stabilizers for the arch of the foot,

01:32:45.960 | for the foot itself, for the ankle, for the shin,

01:32:48.960 | that carry over to spine stability and a strong spine.

01:32:53.360 | I know it seems kind of wild

01:32:55.160 | that we're talking about the feet and toe spreading

01:32:56.960 | to benefit your back,

01:32:58.240 | but all of these things relate to one another up and down,

01:33:00.880 | the chain of activation involved in walking, in running,

01:33:03.820 | and certainly if you're involved in any other sports,

01:33:05.580 | but also just standing around.

01:33:07.300 | So don't underestimate the power

01:33:09.320 | of learning to spread your toes

01:33:10.520 | and learning to move your toes independently.

01:33:12.160 | And then of course,

01:33:13.000 | there's a whole set of exercises that you can find online

01:33:15.040 | of how to actually strengthen the individual toes

01:33:17.040 | with bands and things of that sort, pretty advanced stuff.

01:33:19.720 | Most people aren't going to do that,

01:33:21.680 | but if you're willing to explore that stuff,

01:33:23.720 | it's clear that there are a lot of benefits.

01:33:25.360 | And again, there's some exciting literature

01:33:27.160 | starting to emerge about the benefits of toe strengthening

01:33:30.980 | and toe spreading and all that stuff

01:33:33.600 | as it relates to, believe it or not,

01:33:35.320 | neurocognitive longevity.

01:33:37.740 | I know it sounds wild,

01:33:38.640 | but this is actually a literature

01:33:39.960 | that's starting to pick up some weight.

01:33:41.660 | So it's one that I'm paying attention to

01:33:43.800 | and that I'm certainly going to cover in a future podcast.

01:33:46.640 | Okay, so we've got strengthening the neck.

01:33:48.480 | We've got toe spreading at a minimum,

01:33:50.800 | making sure that you can spread all your toes,

01:33:52.460 | move them independently.

01:33:53.700 | That would be great.

01:33:54.920 | What's that going to do?

01:33:55.760 | That means that when you're standing at rest,

01:33:58.240 | that you're creating a stable base for yourself

01:34:00.320 | when you're walking, when you're running,

01:34:01.840 | and certainly when you're lifting

01:34:02.920 | or you're playing any sports,

01:34:04.440 | you're creating the most stable base for yourself possible.

01:34:07.840 | When I say stable base,

01:34:08.860 | I don't just mean because the toes are spread.

01:34:10.440 | I mean, because if you can activate the musculature

01:34:12.860 | to spread those toes,

01:34:14.720 | or if they're passively in that spread toe position,

01:34:17.520 | not touching one another,

01:34:18.840 | you're going to be activating some of the musculature

01:34:21.240 | that's, I guess, for the typical person

01:34:23.640 | we would think of this as in the arch of the foot,

01:34:26.040 | in the top of the foot,

01:34:27.360 | and running up to the front of the shin,

01:34:29.160 | that's going to create the most stability

01:34:30.960 | for your lower limbs, your upper limbs,

01:34:33.120 | your pelvis, and your spine, okay?

01:34:35.680 | Now, in discussions with Dr. Wheeler

01:34:37.440 | and discussions with Dr. Starrett

01:34:39.180 | and discussions with Dr. Stu McGill,

01:34:41.480 | all of them really emphasize

01:34:43.120 | that when doing resistance training,

01:34:44.960 | that bracing the body

01:34:47.960 | by essentially not doing a big belly breath,

01:34:50.460 | but filling the body with air

01:34:52.120 | so that you essentially create a firmness

01:34:54.120 | within the abdominal walls

01:34:55.280 | and the spinal erectors and the obliques,

01:34:57.120 | so this would be essential in a squat-type movement

01:35:00.200 | or other types of movements,

01:35:01.640 | that's beneficial during resistance exercise

01:35:03.780 | to create the most stable canister of you,

01:35:06.160 | the most stable activation of the musculature

01:35:08.880 | around the spine to avoid injury

01:35:10.880 | and also to lift the greatest amount of weight.

01:35:12.680 | There's a number of different mechanical advantages

01:35:15.120 | and safety advantages that are afforded when we do that.

01:35:17.400 | This was also something that I discussed

01:35:19.520 | with Dr. Andy Galpin when he did his series

01:35:21.880 | on exercise physiology with us.

01:35:24.160 | Again, we find a link to that in the show note captions.

01:35:26.520 | Now, that bracing, that filling of the body with air

01:35:29.160 | and that bracing of the abdominals and the musculature,

01:35:31.480 | essentially that runs like a belt around the midsection

01:35:33.960 | to make yourself strong and stable during those movements,

01:35:36.400 | that's all fine and good,

01:35:38.040 | but it turns out that when we're at rest,

01:35:41.400 | when we're just standing around,

01:35:42.760 | we actually want to do the opposite.

01:35:44.240 | We actually want to relax that musculature

01:35:46.880 | and belly breathe.

01:35:48.480 | Now, I've done an entire episode about breathing

01:35:50.500 | and the difference between belly breathing

01:35:52.040 | versus breathing where the chest lifts

01:35:54.280 | or a combination of both,

01:35:55.560 | but we can keep this very simple.

01:35:57.800 | You can do yourself a great favor

01:35:59.560 | by trying to remember that when you're at rest,

01:36:01.920 | you're just standing around,

01:36:02.980 | maybe you're seated or standing and working

01:36:05.180 | or you're talking or something of that sort

01:36:07.000 | that you're ideally nasal breathing

01:36:08.720 | unless you're speaking or eating or something of that sort

01:36:11.200 | and you are belly breathing, okay?

01:36:13.880 | So you're actually relaxing the abdominals as you inhale

01:36:18.120 | and the belly is moving out

01:36:19.480 | and then as you exhale, the belly moves in.

01:36:21.780 | So that's the ideal pattern when at rest,

01:36:23.920 | the exact opposite of the pattern that you want

01:36:26.040 | when you're actively engaging all that musculature

01:36:28.280 | for sake of exercise and stability,

01:36:30.040 | especially when you're engaging

01:36:31.560 | in weight training under loads.

01:36:33.460 | So that places us at strength in the front of the neck,

01:36:35.980 | toe spreading and strengthening of the feet,

01:36:37.900 | belly breathing at rest.

01:36:40.020 | And then there's a kind of fun one

01:36:42.040 | that's something that I've been incorporating a lot

01:36:44.280 | because frankly, I'm not a big fan of doing abdominal work.

01:36:47.140 | It's just not something that I really enjoy doing

01:36:49.180 | in the gym or elsewhere,

01:36:50.280 | but I know that it's important

01:36:51.700 | to have a strong abdominal wall.

01:36:53.340 | It's important to have strong abdominals generally.

01:36:56.940 | And yes, occasionally I'll grab onto a bar

01:36:59.460 | and I'll do a set of pikes.

01:37:00.860 | I actually enjoy pikes, you know,

01:37:02.060 | bring my ankles up to my hands and doing that,

01:37:04.380 | trying to stop there, doing L-sits, things like that.

01:37:06.340 | I'll do those every once in a while,

01:37:08.100 | but what I found to be very beneficial

01:37:10.300 | and that is more kind of real world related

01:37:14.100 | in the sense that it activates the musculature

01:37:16.220 | of the abdominals.

01:37:17.280 | You can train your abdominals while doing things

01:37:19.460 | that more closely mimic what you do in real life

01:37:22.900 | is to actually stagger one's stance

01:37:25.400 | while doing certain forms of resistance training.

01:37:27.660 | Okay, so not during deadlifts,

01:37:29.620 | not during squats or anything of that sort,

01:37:32.020 | but let's say during dumbbell curls for the biceps,

01:37:36.180 | rather than stand with feet parallel,

01:37:38.620 | standing with one foot in front of the other,

01:37:40.780 | making sure that they are wide enough apart

01:37:42.860 | in the lateral plane, as we'll call it.

01:37:45.100 | Okay, so far enough away on either side

01:37:46.680 | of your belly button so that you're stable,

01:37:48.140 | little bend in the knees.

01:37:49.340 | And then making sure that your belly button

01:37:51.580 | is still facing directly forward.

01:37:54.300 | This is really key, not twisting the torso,

01:37:56.180 | but making sure that your belly button

01:37:57.340 | is facing directly forward and doing curls,

01:38:00.820 | one arm, then the other arm, one arm, then the other arm,

01:38:03.020 | then switching to a stance in which the other foot

01:38:06.500 | goes forward and the other foot goes back.

01:38:08.060 | Again, make sure that you're not

01:38:09.780 | in a cross-country skier position

01:38:11.500 | with the feet very close to your midline,

01:38:14.580 | because if they are, you're not going to be stable.

01:38:16.260 | So make sure that they're far enough away

01:38:17.860 | from your belly button on either side,

01:38:19.420 | that there's a bend in your knees so that you're stable,

01:38:21.340 | and then doing curls that way.

01:38:23.340 | Could also do this for any kind of triceps exercise,

01:38:25.860 | like an overhead triceps extension.

01:38:27.920 | Those are mainly the exercises

01:38:29.580 | in which one could apply this,

01:38:31.100 | although there are a few others,

01:38:32.460 | maybe for back work, maybe for shoulder work,

01:38:34.640 | although I think parallel stance is probably best for that,

01:38:37.300 | and certainly for leg work.

01:38:38.940 | So what are you doing if you do curls

01:38:40.420 | or overhead triceps extension in this way

01:38:42.700 | with one foot forward, then the other foot forward?

01:38:45.080 | What are you doing?

01:38:45.920 | Well, if you deliberately insist,

01:38:48.560 | meaning force yourself to keep your belly button

01:38:50.340 | facing exactly forward, and for that reason,

01:38:53.100 | sometimes it's helpful to do these in front of a mirror,

01:38:55.340 | what you're doing is you're generating

01:38:57.180 | anti-rotational forces.

01:38:59.220 | You're requiring that your upper body not twist

01:39:01.260 | while you're lifting these loads.

01:39:02.420 | And what that does is it trains the obliques,

01:39:05.620 | it trains components of your abdominals,

01:39:08.140 | and to some extent, it's training components

01:39:10.300 | of your lower back, although not so much,

01:39:12.860 | as it is the obliques to the abdominals,

01:39:14.820 | that are anti-rotation, that are preventing your body

01:39:17.700 | from twisting while you're carrying out these movements.

01:39:20.900 | And in doing so, you're also mimicking the way

01:39:23.380 | that a lot of movements are carried out in daily life.

01:39:25.900 | Because if you think about it, it's pretty uncommon

01:39:28.500 | that you're going to be lifting things with one arm

01:39:30.900 | with feet parallel.

01:39:31.980 | I mean, it happens, okay?

01:39:33.220 | There are times when feet are parallel

01:39:34.700 | and we're lifting something up with both hands.

01:39:37.260 | There are times in which you do something similar

01:39:39.100 | to kind of the stance that you would be in

01:39:41.340 | for a dumbbell curl, you know, with feet parallel in the gym

01:39:44.380 | or a tricep extensions with feet parallel.

01:39:46.700 | But more often than not, as we move through life,

01:39:48.900 | one or the other feet is positioned in front of the other.

01:39:52.100 | And, you know, we're reaching for something

01:39:53.780 | or lifting something, or we're pulling something.

01:39:56.180 | Those are the patterns that exist more typically

01:39:58.940 | in daily life.

01:40:00.140 | And those are the patterns of movement

01:40:02.020 | that typically people hurt themselves while doing.

01:40:04.940 | You know, they reach down to get something

01:40:07.060 | out of a cabinet, they'll reach into the back

01:40:08.620 | and they'll twist a bit to grab something in the back

01:40:10.420 | and that's when their back will go.

01:40:11.620 | Or they're reaching overhead to grab something

01:40:13.580 | and they're twisting as they reach with one arm.

01:40:16.220 | So I've certainly found, and this was supported by, again,

01:40:19.180 | all of the experts that I spoke to,

01:40:21.780 | that staggering one stance

01:40:23.580 | while performing resistance training,

01:40:25.340 | typically curls or overhead tricep extensions.

01:40:27.700 | And there aren't many other things

01:40:28.620 | that lend themselves well to this.

01:40:29.860 | So those are the two that I'm really focusing on.

01:40:33.060 | Doing that while insisting, that is forcing yourself

01:40:35.700 | to keep your belly buttons facing completely forward.

01:40:38.860 | Okay, not tilting to the side either way.

01:40:41.620 | That can really help strengthen the abdominals

01:40:43.780 | through the use of what's called anti-rotation.

01:40:46.300 | This is also what you're going to experience

01:40:47.940 | if you ever take a yoga class and you do a pose

01:40:49.980 | where it's arms overhead, like a warrior two pose

01:40:52.700 | or a warrior one pose, and they'll say,

01:40:54.260 | make sure that your belly button

01:40:55.380 | is facing completely forward,

01:40:57.100 | that you're not twisting to the side too much.

01:40:59.240 | This is also what the instructor will tell you

01:41:01.120 | in a Pilates or a yoga class very often in certain movements

01:41:04.400 | where there's a tendency to kind of relax

01:41:07.660 | or sag into a twisted upper torso.

01:41:09.900 | Of course, there's some yoga and Pilates movements

01:41:11.780 | that require that you twist your upper torso,

01:41:13.360 | but that's not what we're talking about here.

01:41:14.980 | This is when they tell you,

01:41:16.140 | keep your belly button facing forward.

01:41:18.300 | You're generating anti-rotation forces,

01:41:20.800 | not just of the abdominals,

01:41:22.220 | but as the abdominals connect to the pelvis.

01:41:24.700 | And of course, all of that is providing stability

01:41:26.940 | for the spine.

01:41:27.940 | And then if you run down the legs in your mind,

01:41:30.140 | that is, and you think about your feet

01:41:31.820 | with those nice spread toes and the activated musculature

01:41:35.480 | on the base and the top of your feet

01:41:37.500 | and running up the front of your shin and your calves,

01:41:39.660 | well, you can really imagine how you're creating

01:41:41.700 | the most stable positioning on the floor,

01:41:44.260 | stable positioning of the spine.

01:41:45.740 | No wonder that the spine is not only going to experience

01:41:49.260 | less shearing stress, less pain,

01:41:52.220 | but you're also in a position to create a nice strong chain

01:41:55.980 | of activation from the nerves and muscles

01:41:58.140 | from the base of the floor all the way up to your neck,

01:42:00.420 | because you're already strengthening your neck.

01:42:03.020 | Okay, so in terms of protocols,

01:42:04.580 | thus far we've covered Stumagil's big three.

01:42:07.780 | Then we talked a little bit about things you can do

01:42:10.420 | to relieve pain.

01:42:11.460 | So this was the hanging from a bar

01:42:13.380 | with the toes touching the ground, right?

01:42:15.340 | As well as the kind of up dog or Cobra exercises.

01:42:18.540 | And then we talked about five or six things

01:42:20.220 | that one can do, including strengthening the neck,

01:42:22.780 | spreading the toes, strengthening the feet, et cetera,

01:42:25.220 | in order to generate strength and stability

01:42:27.380 | distal to the back and thereby to strengthen

01:42:30.500 | and pain-proof the back.

01:42:31.860 | Now we're going to cover four final protocols

01:42:34.680 | to strengthen your back, pain-proof your back,

01:42:37.540 | and allow you the greatest degree of mobility,

01:42:40.100 | both for sake of mobility during exercise

01:42:42.140 | and in daily living.

01:42:43.380 | The first of those four protocols

01:42:45.420 | is going to be to activate and strengthen,

01:42:48.820 | and in some cases, de-spasm the medial glute,

01:42:52.640 | which is a muscle that most people don't think about.

01:42:54.800 | The medial glute is involved in stabilizing the hips

01:42:57.420 | as you walk, as you run, okay?

01:42:59.980 | So it's going to prevent the pelvis

01:43:01.780 | from moving from side to side.

01:43:03.880 | It's one that when it weakens,

01:43:06.080 | or when you have trouble activating it,

01:43:08.100 | can lead to some forms of what is perceived

01:43:10.940 | as lower back pain.

01:43:12.360 | So if you reach to your lower back

01:43:14.500 | and you feel these kind of like two,

01:43:16.300 | kind of like, almost like nodules

01:43:17.760 | at the top of your pelvis,

01:43:18.900 | a lot of people will experience pain

01:43:20.420 | in and around that region,

01:43:22.100 | or maybe even as a kind of a,

01:43:23.760 | like a belt of pain around that area, more or less.

01:43:28.700 | And in some, not all cases, but in some cases,

01:43:31.140 | that's due to lack of medial glute activation,

01:43:33.500 | or in some cases, it's due to spasming

01:43:35.460 | of musculature in that region.

01:43:36.860 | It's really hard to tell,

01:43:37.780 | unless you're being assessed by an expert,

01:43:39.380 | which one it is.

01:43:40.220 | Again, that's not what we're here to do.

01:43:41.920 | What I am here to do is to provide you a protocol

01:43:44.420 | that I've found to be tremendously beneficial

01:43:46.820 | for relieving the sort of lower low back pain,

01:43:49.780 | and the kind of pain that even extends

01:43:52.300 | into the top of the glutes that many people experience,

01:43:54.820 | especially if you've been sitting a lot,

01:43:56.620 | if you've been driving a lot, flying a lot,

01:43:59.020 | if you find yourself doing a lot of hip hinging exercise,

01:44:03.220 | like squats, and then you travel.

01:44:06.020 | So you're sitting on a plane for a while,

01:44:07.500 | and you don't pay mind to really stay in a flat back,

01:44:11.460 | or arched back position.

01:44:13.120 | By the way, if you're somebody who has disc bulging

01:44:15.640 | in that direction that we talked about before,

01:44:17.440 | and can benefit from doing those Cobra poses,

01:44:19.620 | or kind of up dog pushups.

01:44:22.760 | If you travel, or drive, or you're seated a lot for work,

01:44:26.980 | I, and many others, find it really beneficial

01:44:28.880 | to just take a towel, and just roll it up, and put it,

01:44:31.040 | so that you maintain the arch in your lower back,

01:44:33.040 | so you're not rounding in your seat.

01:44:35.600 | That can be really useful,

01:44:36.880 | and it makes perfect sense if you think about it,

01:44:39.040 | given what we were talking about before,

01:44:40.440 | with the squeezing out of the cream of the Oreo cookie

01:44:42.440 | in that direction.

01:44:43.280 | You want to make sure that you're not rounding

01:44:44.600 | your lower back too much.

01:44:45.620 | Keeping it straight, or a little bit arched,

01:44:47.120 | is going to be beneficial.

01:44:48.520 | Not overly arched, but straight, or a little bit arched,

01:44:51.760 | in a rolled up towel, or something of that sort,

01:44:55.360 | that you can put in your lower back,

01:44:56.400 | can really be helpful for that.

01:44:59.080 | Now, the protocol here is to essentially activate,

01:45:02.680 | and de-spasm the medial glute.

01:45:04.440 | This is actually a protocol that I learned

01:45:06.080 | from Jeff Cavalier, long before I ever met him,

01:45:08.520 | or he was on the podcast, which he's been on the podcast.

01:45:11.360 | Jeff Cavalier has a YouTube channel called ATHLEANX,

01:45:14.200 | which has tons of zero-cost protocols

01:45:16.480 | for resistance training, for cardiovascular training.

01:45:19.320 | He just provides so much useful information.

01:45:22.040 | Again, zero cost.

01:45:23.000 | I've actually paid for his programs.

01:45:24.440 | No, he didn't ask me to say that.

01:45:26.080 | He doesn't pay me to say that.

01:45:27.160 | Over the years, I've paid to use various programs

01:45:29.440 | from ATHLEANX, and they've benefited me tremendously.

01:45:32.200 | I've customized them a bit for myself,

01:45:34.320 | but in any case, love the work he does.

01:45:37.560 | Grateful to call him a friend.

01:45:39.720 | Extremely grateful that he was a guest on this podcast.

01:45:41.880 | We'll provide a link to the episode that he did

01:45:44.560 | talking about exercise, and exercise physiology,

01:45:47.040 | and nutrition in the show note captions.

01:45:49.880 | In any event, the protocol here is to activate,

01:45:52.680 | and in some cases, de-spasm the medial glutes,

01:45:55.400 | which can be done in a very straightforward way,

01:45:57.880 | where you lie on your side,

01:45:59.240 | essentially like you were going to do a side plank.

01:46:01.840 | So you've got your elbow and your forearm on the ground,

01:46:04.600 | making that fist.

01:46:06.120 | You would imagine you'd go into a side plank, except no.

01:46:09.480 | You're going to keep the lower leg,

01:46:11.760 | the leg that's in contact with the floor,

01:46:13.720 | against the floor.

01:46:14.720 | You're going to take the leg that's on top.

01:46:17.280 | You're going to point the toe down, okay?

01:46:19.840 | So you're not bridging up into a side plank.

01:46:22.000 | You're just resting on the floor on your side.

01:46:24.380 | You take that top leg, point the toe down.

01:46:27.120 | You bring that toe out in front of you,

01:46:29.520 | touch it to the floor,

01:46:31.000 | and then you're going to bring your heel back.

01:46:33.880 | You're going to extend it, not overextend it,

01:46:35.520 | but extend it as far as you can,

01:46:37.800 | with your heel pointed toward the back wall

01:46:40.400 | and up towards the ceiling.

01:46:41.760 | So you're trying to maintain

01:46:42.960 | that downward pointed toe effort, okay?

01:46:47.700 | Then you're going to lower it again, touch,

01:46:49.720 | bring it all the way back up.

01:46:51.320 | You're going to do that for maybe five to 10 repetitions.

01:46:53.820 | And then on the final repetition,

01:46:55.140 | you're going to hold it there in that raised position,

01:46:59.260 | not as long as you can,

01:47:00.440 | but probably anywhere from 10 to 20 seconds,

01:47:03.560 | depending on how much strength you have

01:47:06.440 | in your medial glutes to be able to do that.

01:47:08.520 | And if you like, you can also take your hand on the side

01:47:12.620 | of the foot that you're raising, okay?

01:47:14.680 | So if you're lying on your left side,

01:47:16.420 | you're going to take your right hand

01:47:17.840 | and you're going to take your thumb

01:47:19.880 | and put it right at the top of your glutes.

01:47:21.720 | And you'll feel when the leg is fully extended back

01:47:24.840 | with the heel towards the back wall and ceiling,

01:47:26.840 | you'll feel the muscle activate there

01:47:28.740 | and you can kind of push against it.

01:47:30.080 | What are you doing when you do this?

01:47:31.420 | You're activating the medial glute.

01:47:33.560 | You're, in some cases, despasming the medial glute

01:47:35.960 | and some of the musculature around there.

01:47:37.480 | And many people find that they get considerable pain relief

01:47:40.880 | of that low, low back region when they do this exercise.

01:47:45.000 | You, of course, would want to switch to the other side,

01:47:47.440 | even if you're not experiencing pain on the other side,

01:47:49.760 | and do the same thing for the opposite side.

01:47:52.080 | So lying on your right-hand side,

01:47:54.600 | taking then your left leg, pointing the toe down,

01:47:57.280 | putting it in front of you, bringing it back,

01:47:59.240 | doing multiple repetitions of that.

01:48:01.360 | And then holding it in a static hold

01:48:03.380 | while feeling that medial glute get activated,

01:48:06.240 | and then taking some rest.

01:48:08.140 | This is the sort of thing that you can do

01:48:09.860 | if you're experiencing low, low back pain

01:48:11.700 | to see if it provides some relief.

01:48:13.320 | Many people find it does provide that relief.

01:48:15.380 | If, of course, it exacerbates your pain,

01:48:17.420 | please stop doing it.

01:48:18.480 | You never want to exacerbate pain in any kind of way.

01:48:21.460 | But many people find that it relieves the pain

01:48:24.180 | in that low, low back region.

01:48:26.380 | And it does so not just during the exercise,

01:48:28.380 | but in the minutes and hours following.

01:48:30.260 | You may need to repeat this a couple of times per day.

01:48:33.040 | You may need to adjust your other activities,

01:48:35.080 | including exercise.

01:48:35.980 | It really depends on the severity

01:48:37.220 | of your back pain and injury, the nature of it, et cetera.

01:48:40.060 | However, it's something that many people, including I,

01:48:43.560 | also include in our regular routines.

01:48:45.540 | I'll sometimes do this as part of a warmup on leg day.

01:48:47.760 | I'll sometimes do this just while, you know,

01:48:49.460 | watching TV or something, which I don't do terribly often.

01:48:52.540 | But I'll just take a couple of minutes,

01:48:54.220 | literally just two minutes or three minutes,

01:48:56.620 | and I'll do a couple sets of these on either side

01:48:58.740 | just to maintain that neuromuscular activation

01:49:01.300 | of the medial glute.

01:49:02.340 | Some people, I would say most people,

01:49:04.460 | are not very good at activating that medial glute region.

01:49:07.400 | If you're somebody who is being conscientious

01:49:10.540 | and doing a lot of posterior chain work,

01:49:12.540 | such as kettlebell swings on a regular basis,

01:49:15.220 | you're doing glute ham raises, which I'm a huge fan of.

01:49:18.460 | I'll do an entire video about posterior chain

01:49:20.400 | and why I'm such a big fan of glute ham raises.

01:49:22.740 | Unfortunately, you need a specialized piece

01:49:24.180 | of equipment to do them.

01:49:25.700 | Or Nordic curls, such a big fan of Nordic curls,

01:49:28.220 | glute ham raises, et cetera, for all sorts of reasons,

01:49:30.620 | strengthening the back, strengthening the posterior chain,

01:49:33.140 | making sure you can still generate power

01:49:34.940 | in the pelvic region, lower back region,

01:49:36.980 | while maintaining posture, especially as you age,

01:49:38.880 | all of that.

01:49:39.960 | I'll talk more about those in a future episode

01:49:41.700 | of the Huberman Lab Podcast.

01:49:43.040 | But the point is this,

01:49:44.460 | many people just fail to get activation of the glutes

01:49:47.480 | in a way that supports their lower back

01:49:49.620 | and allows them to strengthen their back

01:49:52.300 | to the extent that they would otherwise.

01:49:54.540 | And much of the time, it's not just a failure

01:49:56.260 | to activate the glutes, because of course,

01:49:58.580 | there are many ways to activate the glutes.

01:50:00.180 | There are all sorts of exercises you can read about online,

01:50:02.900 | but a failure to activate the medial glute muscles

01:50:05.140 | in particular that people need to overcome

01:50:08.140 | by strengthening those nerve to muscle pathways.

01:50:10.940 | And of course, I'm talking about activation

01:50:12.580 | of the medial glutes and de-spasming of the medial glute,

01:50:15.180 | which is really what happens when you hold

01:50:16.700 | that medial glute contraction for some period of time,

01:50:19.100 | then afterwards, you allow some relaxation

01:50:21.260 | in those neural pathways.

01:50:22.900 | That is often, again, not always,

01:50:25.060 | but often the cause of that low, low back pain.

01:50:28.240 | So if you have low, low back pain,

01:50:30.100 | and it's safe for you to perform this exercise,

01:50:32.540 | I encourage you to give it a try.

01:50:33.860 | Again, it requires no equipment.

01:50:35.740 | It's very easy, takes almost no time.

01:50:37.940 | And at least for me and many others that I've spoken to,

01:50:40.700 | it has been tremendously helpful

01:50:42.300 | in relieving that lower back pain

01:50:43.820 | by de-spasming the medial glute.

01:50:45.940 | And at the same time,

01:50:47.860 | allowing for nerve to muscle activation of the medial glute

01:50:51.020 | such that the medial glutes can be active when they need to

01:50:53.780 | in order to stabilize the pelvis

01:50:56.300 | and allow for the strongest possible pelvic spine interface.

01:50:59.740 | Okay, so the next protocol

01:51:00.940 | is one that you can do essentially anywhere.

01:51:02.980 | It takes almost no time, and it's a wonderful one

01:51:06.500 | because it allows for stretching of the psoas muscle, right?

01:51:11.460 | The muscle that is easy to say and hard to spell, psoas.

01:51:15.660 | It's P-S-O-A-S, right?

01:51:17.680 | I think the P is generally silent.

01:51:19.220 | You'd say psoas muscle.

01:51:21.140 | The psoas muscle is involved in connecting the spine

01:51:24.520 | to the pelvis, okay?

01:51:25.620 | It also has an interaction with the diaphragm

01:51:28.460 | that's really important,

01:51:29.380 | this muscle that's important for breathing.

01:51:31.620 | And many people have tightening the psoas,

01:51:34.420 | tightening of the hip flexors,

01:51:36.100 | but being able to stretch the psoas muscle

01:51:38.980 | is something that provides a ton of relief to the tightness

01:51:43.500 | that one can experience from sitting too much,

01:51:45.440 | from being in a hip hinge position too much,

01:51:48.720 | especially if you're doing heavy hip hinge work

01:51:50.420 | and then you're sitting or driving a lot.

01:51:52.780 | And many people also just carry a lot of stress

01:51:56.340 | in their midsection and relieving or stretching the psoas

01:51:59.460 | can be very beneficial.

01:52:00.940 | Okay, there's a lot about this that could be said.

01:52:02.880 | In fact, I'll probably do an entire episode

01:52:04.660 | about psoas and fascia.

01:52:07.100 | Okay, I know there's a lot of requests

01:52:08.260 | to talk about fascia,

01:52:09.100 | but it's far too much to get into now.

01:52:10.820 | Here's the protocol that I do believe

01:52:13.020 | everyone can benefit from.

01:52:14.740 | I don't care how bendy you are, how rigid you are,

01:52:16.940 | how big you are, how live you are, how slim you are.

01:52:20.860 | This is a wonderful exercise.

01:52:22.300 | It just feels so good.

01:52:24.020 | And it allows you to afterwards be in a long spine posture

01:52:27.900 | to really feel opened up at the hips, if you will.

01:52:30.180 | Now I'm using yoga type language,

01:52:31.940 | but I think you understand what I mean.

01:52:33.680 | And it is a great stress reliever as well,

01:52:36.200 | which is essentially to do

01:52:38.040 | what looks like a warrior two position in yoga.

01:52:40.620 | So you're essentially doing a lunge, okay,

01:52:42.820 | where you're going to lunge with one leg back

01:52:46.360 | and the other leg forward, of course, that's a lunge.

01:52:49.380 | And then you're going to take the hand on the same side

01:52:53.020 | as the leg that's extended behind you,

01:52:55.880 | reach that toward the ceiling, okay?

01:52:58.600 | And then you're going to rotate pinky clockwise, okay?

01:53:03.600 | The other way to think about this

01:53:06.160 | is to put the palm of your hand parallel to the ceiling.

01:53:10.160 | If you're doing it outside, parallel to the sky, okay?

01:53:13.440 | So you're going to get into the longest lunge

01:53:15.240 | that you safely can for you, okay?

01:53:17.080 | That's going to differ for everybody.

01:53:18.720 | And then you're going to raise the arm on the same side

01:53:21.340 | as the leg that's extended backward.

01:53:23.320 | And you're going to go parallel palm to the sky

01:53:27.080 | or to the ceiling.

01:53:28.000 | This will provide a stretch all the way,

01:53:31.760 | or you should feel a stretch all the way

01:53:33.920 | from your wrist down past your hip

01:53:36.840 | and possibly even into the foot that's behind you.

01:53:39.680 | Now, Dr. Stuart McGill showed me this.

01:53:42.880 | I've certainly done warrior two pose in yoga classes.

01:53:45.840 | And when I've done yoga at home from time to time,

01:53:48.200 | I wasn't new to raising an arm overhead

01:53:50.600 | while stretching in a lunge position.

01:53:52.720 | But Dr. Sue McGill was the one who really emphasized

01:53:55.720 | that by putting the palm parallel to the sky,

01:53:58.680 | to the ceiling and twisting a bit

01:54:00.920 | so that you're turning that pinky toward,

01:54:03.860 | I would say the best way to describe this

01:54:05.960 | is to turn that pinky toward your head, okay?

01:54:08.840 | Not away from your head, but toward your head

01:54:10.920 | while still maintaining a flat palm

01:54:12.680 | and reaching as much as you can

01:54:14.160 | and extending all the way from the heel of that back foot

01:54:18.000 | all the way up to your palm

01:54:19.520 | that you're getting stretching, not just of the psoas,

01:54:22.140 | but that you're also getting activation

01:54:24.040 | of some of the neurofascial aspects

01:54:27.300 | going from palm all the way to heel

01:54:29.980 | that provide some relief,

01:54:32.700 | that is some relaxation of the musculature

01:54:34.980 | that otherwise is providing tension

01:54:36.820 | of the spine pelvic interface.

01:54:38.900 | And that can allow for better posture, longer spine,

01:54:43.060 | and at the same time, strong spine positioning

01:54:46.300 | after you do the exercise.

01:54:47.580 | And of course you want to do this on both sides.

01:54:49.980 | Now, I realize that many of you are just listening to this.

01:54:52.340 | You're not watching this,

01:54:53.220 | but even for those of you that are watching on YouTube,

01:54:55.440 | it's very difficult since I'm seated behind a desk

01:54:57.940 | to show you the proper form of this exercise,

01:54:59.940 | which is why we've provided a link

01:55:02.600 | to a visual of this exercise in the show note captions

01:55:05.780 | that you can go look at otherwise.

01:55:07.040 | But hopefully it's clear to you.

01:55:08.600 | It's basically a lunge, front leg slightly bent at the knee,

01:55:13.240 | back leg, perhaps slightly bent, but extended behind you.

01:55:16.700 | So you're in a lunge position,

01:55:18.740 | arm on the same side as the extended leg raised overhead,

01:55:22.200 | palm parallel to the ceiling, okay, with arm extended

01:55:25.380 | and turning your wrist a bit

01:55:28.960 | so that your pinky is more or less

01:55:32.040 | trying to point towards your head.

01:55:33.500 | Although most people, including myself,

01:55:35.140 | probably don't have the flexibility to do that all the way

01:55:38.200 | so that your pinky is pointed towards your head.

01:55:40.100 | I encourage you to experiment with this a little bit

01:55:41.860 | until you feel that stretch all the way

01:55:43.740 | from hand down to heel.

01:55:45.560 | It feels really good to do.

01:55:47.020 | You can hold it for anywhere from five to 10 seconds.

01:55:49.640 | You can exhale or inhale.

01:55:51.380 | It doesn't really matter.

01:55:52.220 | You can just breathe normally.

01:55:53.600 | The point here is that you're getting a terrific stretch

01:55:55.600 | of the psoas.

01:55:56.860 | You then switch to the other side,

01:55:58.020 | get a terrific stretch of the other side psoas.

01:56:01.300 | And after you move out of this pose,

01:56:03.940 | you will definitely feel as if you sort of have

01:56:05.860 | "lengthened the spine."

01:56:07.560 | You know, the extent to which you have lengthened the spine

01:56:09.320 | isn't clear.

01:56:10.160 | What more likely has happened

01:56:11.400 | is that you have some relaxation

01:56:13.280 | and perhaps even some lengthening

01:56:14.920 | between the spine and pelvic connection.

01:56:17.720 | So then you can sit upright, nice straight spine,

01:56:19.920 | and you're not being pulled forward by that tightened psoas

01:56:23.200 | that connects the spine to the pelvis.

01:56:25.280 | Okay, so that's sort of the simplest way

01:56:27.320 | that I can describe all that.

01:56:28.520 | It's a wonderful exercise to do.

01:56:30.000 | You can do it in an airport.

01:56:31.200 | You can do it when you get home.

01:56:32.160 | You can do it when you get out of the car.

01:56:33.880 | It's one of those things that provides a ton of relief

01:56:37.260 | in terms of kind of stress and compression

01:56:39.140 | and C-shaping of the spine from sitting

01:56:41.140 | that most all of us are doing too much of these days.

01:56:44.260 | And as Dr. Stu McGill will explain

01:56:46.780 | when he comes on the podcast,

01:56:48.100 | it also provides some both activation and relaxation

01:56:52.900 | of the nerve to fascial to muscle interface

01:56:55.820 | that's so critical for having a strong and pain-free spine.

01:56:59.960 | Okay, so the final protocol I want to share with you today,

01:57:02.940 | believe it or not, is purely mental.

01:57:05.020 | It's purely cognitive.

01:57:06.500 | It doesn't involve any movement.

01:57:07.980 | What it does involve is developing an awareness

01:57:11.500 | of your movement patterns

01:57:12.700 | as you move through your daily life,

01:57:14.220 | including exercise, but not limited to exercise.

01:57:17.140 | What do I mean by this?

01:57:18.140 | Well, based on what I told you

01:57:20.060 | at the beginning of today's episode

01:57:21.420 | and throughout today's episode,

01:57:22.580 | you are now armed with knowledge

01:57:24.980 | about the different components of back anatomy,

01:57:28.220 | the vertebrae, the discs, the nerves, the muscles,

01:57:31.240 | and how those relate to one another

01:57:32.620 | and how bulging, that is herniating of the discs,

01:57:35.340 | or I would hope not, but even rupturing of the discs

01:57:38.860 | or inflammation in a particular spinal segment

01:57:41.860 | or maybe tonic static contraction at the level of the neck

01:57:45.700 | or lack of strength in the feet,

01:57:47.300 | how that could create back pain,

01:57:50.220 | how that could limit back mobility,

01:57:52.340 | how that could limit overall mobility.

01:57:54.780 | So the final protocol of today's episode

01:57:56.780 | is for you to really pay attention

01:57:58.940 | to any pain you might happen to have in your back region

01:58:02.940 | and any kind of limitation you have

01:58:05.540 | in terms of its ability to manage loads

01:58:08.200 | or to generate the kinds of movement

01:58:09.800 | that you need for your life.

01:58:11.220 | What do I mean by this?

01:58:12.140 | Well, if you're somebody

01:58:13.260 | who has a lot of lower back stiffness, lower back pain,

01:58:17.100 | you might ask yourself, okay, when I drive, when I sit,

01:58:20.300 | even if I use a standing desk,

01:58:22.060 | what is the position of my feet?

01:58:24.360 | Are they directly underneath my pelvis?

01:58:26.580 | Am I rounding my back?

01:58:27.900 | If you're somebody who has a lot of pain

01:58:29.620 | in your low to mid back,

01:58:31.660 | and you find just by way of observation

01:58:34.500 | that you're rounding your back a lot of the time,

01:58:36.880 | either because you're texting or typing,

01:58:38.860 | maybe you need to take a towel and roll it up

01:58:41.340 | and put it in your lower back region.

01:58:42.800 | Maybe you need to just spend a little bit more time

01:58:44.940 | each day, not all day, but a little bit of time

01:58:47.340 | being consciously aware of maintaining

01:58:49.780 | a little bit of lower back arch

01:58:51.200 | or maybe even a straight back

01:58:53.040 | if you can't arch your back in that way.

01:58:55.100 | If you're somebody who's standing at your standing desk

01:58:57.500 | or even just talking to friends or family members,

01:59:00.900 | do you always lean to one side?

01:59:02.380 | Do you always relax to one hip?

01:59:03.660 | Is that because you're not activating the medial glute

01:59:06.260 | on one side more than the other or either?

01:59:08.900 | Or is it because you tend to stand with one foot

01:59:12.340 | in front of the other

01:59:13.160 | or you're not maintaining enough toe spread

01:59:14.980 | or you don't have the strength in your feet

01:59:16.260 | to kind of stabilize yourself?

01:59:17.940 | Are you relaxed with your breathing

01:59:20.620 | and letting your belly go out when you're not exercising?

01:59:23.460 | These are the sorts of things that once you start to observe

01:59:26.100 | and by the way, you don't have to become

01:59:27.180 | neurotically self-observant all the time

01:59:29.180 | about your back and your breathing and your foot position.

01:59:31.180 | That's not what we want, okay?

01:59:32.820 | That is absolutely not the goal here.

01:59:35.240 | But if you're experiencing back tightness

01:59:37.680 | or shoulder tightness, you should ask yourself,

01:59:39.700 | are you constantly like thumbs pointed in,

01:59:42.820 | shoulders rolled forward?

01:59:44.160 | Are you doing enough pulling exercises

01:59:46.060 | to balance out all the pushing exercises

01:59:47.860 | you might be doing like pushups and shoulder presses

01:59:50.000 | and bench presses?

01:59:50.840 | Make sure you're balancing the back musculature

01:59:53.340 | and the shoulder and chest musculature.

01:59:55.920 | These kinds of things are extremely valuable

01:59:58.300 | to pay attention to because oftentimes

02:00:00.860 | the origin of your back pain or the origin of your sciatica

02:00:05.860 | or the origin of your neck pain and tension

02:00:09.600 | is something that can be fairly simply remedied.

02:00:12.680 | It doesn't necessarily mean you have an injury.

02:00:14.520 | Maybe you have a small degree of disc bulging.

02:00:16.860 | And if so, what direction is that bulging?

02:00:19.280 | Is it toward the front of your spine, the side?

02:00:21.680 | Is it toward the back?

02:00:22.540 | And if so, what are you going to do to adjust it?

02:00:24.740 | Are you going to do, you know,

02:00:25.960 | one or two sets of those Cobra pushups each day?

02:00:28.560 | Are you going to put that, you know,

02:00:30.360 | towel rolled up behind your back

02:00:32.560 | in order to make sure that that bulge

02:00:34.800 | doesn't increase further?

02:00:36.960 | Are you going to avoid doing a lot of crunching in the gym?

02:00:39.200 | Many of you are going to need to avoid doing crunching

02:00:41.220 | and finding other ab exercises like the roll-up

02:00:44.040 | to do in order to still strengthen your abdominals,

02:00:46.480 | which is so important for stabilizing the spine

02:00:48.760 | and having a strong pain-free back.

02:00:50.880 | But you don't want to generate more forward rolling

02:00:54.080 | and bulging of the discs out the back of the spine

02:00:56.260 | for all the reasons that are now obvious to you.

02:00:58.480 | So this final protocol is one that I could go on

02:01:01.560 | for hours about, but really it's for you to think about

02:01:05.160 | for just a couple of minutes, for a couple of days.

02:01:08.040 | And just pay attention to your movement patterns,

02:01:10.160 | how you stand at rest, how you breathe at rest,

02:01:12.960 | whether or not you're using best possible posture

02:01:15.560 | or whether or not you're using postures

02:01:17.200 | and patterns of overuse in your daily life and in sport.

02:01:20.520 | These things can really build up some strong imbalances

02:01:22.920 | and neuromuscular activation patterns

02:01:24.760 | that over time can translate into pain.

02:01:27.600 | And even if they don't translate into pain,

02:01:29.560 | can translate into a weakened back system

02:01:32.720 | or put more appropriately, a weakened body system

02:01:36.160 | where you're always sagging one shoulder

02:01:39.440 | or you're not breathing properly

02:01:41.500 | because your chin is always towards your chest,

02:01:43.880 | these kinds of things.

02:01:44.760 | Now, today's episode is certainly not geared

02:01:46.560 | towards fixing every aspect of your posture,

02:01:49.680 | your movement patterns, strengthening your back

02:01:52.080 | and removing your back pain.

02:01:53.240 | However, I will say that thanks to the information

02:01:57.220 | that's out there from the peer reviewed literature

02:01:59.120 | and from these fabulous practitioners,

02:02:01.760 | again, MDs, PTs, folks even in the chiropractic community,

02:02:06.320 | I say even because oftentimes they take a lot of heat

02:02:09.440 | from people in the other communities.

02:02:10.800 | But again, there's a range of quality of practitioners

02:02:13.080 | in all these different domains.

02:02:14.880 | They've really started to explore these different aspects

02:02:17.660 | of back strengthening and removing pain from the back

02:02:21.480 | in ways that sure, they come to the table

02:02:23.840 | through different lenses of training, right?

02:02:26.160 | Some are going to talk about laser therapy.

02:02:28.140 | And by the way, we didn't cover that on purpose.

02:02:30.200 | There's a little bit of evidence,

02:02:31.680 | but it's not super strong for laser therapy for the back.

02:02:34.280 | Okay, there, I just upset all the people

02:02:36.000 | who are into laser therapy.

02:02:37.220 | We'll get into that in a future episode.

02:02:39.860 | Sure, there's evidence that Pilates, that yoga,

02:02:42.800 | walking has been shown to be tremendously beneficial

02:02:45.360 | for back pain.

02:02:46.200 | There's wonderful evidence for any

02:02:47.760 | and all of those different practices.

02:02:50.040 | What I've tried to focus on today

02:02:51.360 | were protocols that practitioners who spend most,

02:02:55.160 | if not all of their careers,

02:02:56.400 | thinking about strengthening the back

02:02:58.920 | and pain proofing the back generally agree on.

02:03:01.880 | Okay, I realize there isn't going to be universal consensus,

02:03:04.320 | but they generally agree that Stu McGill's big three,

02:03:08.300 | the curl up, the side plank, the bird dog.

02:03:11.880 | They generally agree that strengthening

02:03:13.800 | the stabilization muscles and pathways from feet up to hips

02:03:18.800 | and all the way to shoulders and top of the head,

02:03:20.720 | including the neck,

02:03:22.000 | including breathing in a particular way while relaxed,

02:03:25.560 | while not exercising.

02:03:26.600 | Again, those would be belly breaths,

02:03:28.360 | ideally through the nose,

02:03:29.360 | unless you're talking or you're eating.

02:03:31.320 | Making sure that your abdominals are strong,

02:03:34.240 | not just from crunching,

02:03:35.520 | but that you're activating the obliques,

02:03:37.380 | that the muscles between your ribs are strong,

02:03:39.840 | something that can really benefit from anti-rotation work

02:03:42.720 | so that you can generate a stiff, stable spine,

02:03:45.100 | which is great provided you can do that

02:03:47.200 | when you want to voluntarily,

02:03:48.520 | and then you can relax

02:03:49.680 | and you can move about your days still in great posture,

02:03:52.120 | still in a strong position,

02:03:53.760 | but without having to brace all the time,

02:03:55.280 | which is obviously something you don't want to have to do

02:03:57.380 | as you move through your life.

02:03:58.960 | And having a number of different stretches

02:04:00.960 | that allow for lengthening of the spine.

02:04:03.080 | We talked earlier about hanging from a bar

02:04:05.300 | with feet touching the ground

02:04:06.540 | so that you can create some space to alleviate,

02:04:09.100 | hopefully, some of the disc bulge to nerve impingement

02:04:12.800 | that might be causing pain,

02:04:14.560 | that you might want to do those Cobra type pushups

02:04:17.520 | or those up dog type movements

02:04:19.080 | that can provide some kind of pushing back

02:04:22.140 | of the cream between the two Oreo cookies

02:04:23.980 | that I use this in an analogy

02:04:25.800 | for the discs and the spinal segments.

02:04:29.320 | These are the sorts of things that most all of the data

02:04:31.680 | and most all of the experts in the field generally agree on.

02:04:35.040 | And so I've offered them to you today

02:04:37.080 | in the form of this list of protocols.

02:04:39.040 | There are about a dozen of them, I realize.

02:04:41.020 | Again, we have links to examples of them

02:04:43.560 | in video form in the show note captions.

02:04:45.880 | I certainly don't expect that everybody's going to do

02:04:48.640 | all of these every day.

02:04:50.080 | That's by no means the expectation.

02:04:52.120 | Think of these more or less as a buffet of things

02:04:55.200 | that you could explore and experiment with

02:04:57.760 | depending on whether or not you have back pain,

02:04:59.840 | in which case, please proceed towards them

02:05:01.900 | with a lot of caution.

02:05:03.320 | Please remember also that I am not saying

02:05:06.240 | that epidurals, painkillers, surgery,

02:05:08.400 | and other methods for treating back pain are not useful.

02:05:11.120 | I am certainly not saying that.

02:05:12.760 | Those certainly have their place.

02:05:14.840 | And yet I would say many people,

02:05:16.480 | if not many or even all adults,

02:05:19.820 | could certainly benefit from thinking about

02:05:22.420 | how their back interfaces with their pelvis,

02:05:25.100 | their legs, their feet, their neck, and vice versa,

02:05:27.560 | and thinking about how to strengthen that entire system

02:05:30.200 | by creating a strong core, a strong lower back,

02:05:33.320 | generating the proper movement patterns,

02:05:35.560 | and doing so through protocols

02:05:37.520 | like the ones I described today

02:05:38.920 | that don't take a lot of time, require zero equipment.

02:05:41.840 | They're essentially zero cost

02:05:43.080 | except for the minimal time investment required,

02:05:45.240 | and that have been shown time and time again

02:05:47.180 | to lead to a stronger pain-free back.

02:05:50.120 | If you're learning from and/or enjoying this podcast,

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02:06:11.520 | If you have questions for me or comments about the podcast

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02:06:21.740 | Not so much during today's episode,

02:06:23.680 | but on many previous episodes of the "Huberman Lab" podcast,

02:06:26.200 | we discussed supplements.

02:06:27.600 | While supplements aren't necessary for everybody,

02:06:29.760 | many people derive tremendous benefit from them

02:06:31.840 | for things like improving sleep,

02:06:33.360 | for hormone support, and for focus.

02:06:35.320 | To learn more about the supplements

02:06:36.640 | discussed on the "Huberman Lab" podcast,

02:06:38.280 | please go to Live Momentous, spelled O-U-S,

02:06:41.040 | so livemomentous.com/huberman.

02:06:44.060 | If you're not already following me on social media,

02:06:46.180 | I am @hubermanlab on all social media channels.

02:06:48.960 | So that's Instagram, X, Threads, LinkedIn, and Facebook.

02:06:52.960 | And on all of those platforms,

02:06:54.360 | I discuss science and science-related tools,

02:06:56.600 | some of which overlaps with the content

02:06:58.200 | of the "Huberman Lab" podcast,

02:06:59.640 | but much of which is distinct from the content

02:07:01.480 | on the "Huberman Lab" podcast.

02:07:02.960 | Again, that's @hubermanlab on all social media channels.

02:07:06.000 | If you haven't already subscribed

02:07:07.280 | to our Neural Network newsletter,

02:07:09.160 | our Neural Network newsletter

02:07:10.480 | is a zero-cost monthly newsletter

02:07:12.400 | that includes podcast summaries, as well as protocols,

02:07:15.140 | in the form of brief one- to three-page PDFs,

02:07:18.000 | where I explain, for instance,

02:07:19.320 | protocols for learning and neuroplasticity,

02:07:22.160 | or for deliberate cold exposure.

02:07:23.600 | We have a foundational fitness protocol,

02:07:25.800 | which explains the fitness program

02:07:27.160 | that I personally have followed,

02:07:28.800 | more or less, for the last 30 years or so.

02:07:31.000 | It includes a resistance training, cardiovascular training,

02:07:33.480 | and we have protocols that relate to things

02:07:35.080 | like optimizing dopamine, sleep, and on and on.

02:07:37.780 | Again, all available, completely zero cost.

02:07:40.040 | You simply go to hubermanlab.com, go to the menu tab,

02:07:43.200 | scroll down to newsletter, and put in your email.

02:07:46.000 | And I should point out that we do not share your email

02:07:48.120 | with anybody.

02:07:49.000 | I'd like to thank you once again

02:07:50.080 | for joining me for today's discussion,

02:07:51.600 | all about how to strengthen and pain-proof your back.

02:07:54.640 | And last, but certainly not least,

02:07:56.940 | thank you for your interest in science.

02:07:58.800 | [upbeat music]

02:08:01.380 | (upbeat music)

Protocols to Strengthen & Pain Proof Your Back

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