While these three strengthening exercises can help prevent or recover from lower back related issues, they won’t correct the original source of the injury. Making sure to identify and correct the root cause of your injuries is the first and most important step to recovering and preventing re-injury. Working with a medical professional, such as a physiotherapist or chiropractor, can aid in identifying the imbalance or root cause of your pain/injury, develop a recovery plan specific to you, and set you on the path to living a healthy and pain-free life.

A potential root cause of many individuals, especially those in an office, is how your chair and computer are set up. Ensuring an office that is adjusted to you, promoting neutral and proper postures, support, and reducing muscle fatigue can be a great step to reduce your pain. 

Some people pay hundreds of dollars for an ergonomic assessment. However, for many who don’t have medical coverage or who may be self-employed or work for small businesses, this cost can put the help from a professional ergonomist out of reach. 

I have spent over 10 years learning and applying my knowledge of ergonomic principles in the office through my career. I have condensed it all into a single guidebook to help readers set up their office to minimize discomfort, reduce fatigue, and fit the workstation to their unique body.

My self-published book, titled “The Pain-Free Office',' will be released in-print and digitally on August 30, 2021. If you are interested in learning more, click here to be directed to my book page.

In our last blog post, we discussed tips and tricks to protect our back while conducting manual materials handling tasks. Preventing an injury, in the workplace or at home, is key to living a healthier life.

This post will focus on protecting our backs from injury by strengthening and training the muscles around the core/abdomen area. 

Disclaimer: These exercises are for instruction purposes only and do not replace any exercises or limitations prescribed by your medical practitioner. Prior to starting any new exercises, please consult your doctor to ensure you are healthy and fit to safely participate. 

It is important to ensure mobility is present at the hips and thoracic spine as the below exercises rely on these joints. Restrictions in these areas can lead to compensation movements that place unwanted stress in the lower back, which could aggravate existing issues.

The exercises that we will be discussing today are called the “McGill Big 3”. Researched and championed by Dr. Stuart McGill, a world renowned specialist and professor in low back research and rehabilitation. If you are interested in learning more about his research, training programs, or his books, check out his website https://www.backfitpro.com/.

The Curl-up

The first of the three exercises is the curl-up. This exercise focuses on strengthening and building the endurance of the rectus abdominis muscle, commonly referred to as the abs or “six pack”. Much like a traditional sit-up, the curl-up involves activating the abdominals to lift the upper body. The big difference, and the main reason why people should do curl-ups instead of sit-ups, is that it does not involve repetitive flexion of the lower back, reducing the risk of injury.

In a curl-up, you start by lying down on the ground, facing upwards, with one leg bent at 90° and the other leg relaxed. Place both hands behind the back in the lumbar spine area (just above the hips where the back curves “in”).

By lifting one leg, we’re creating a stabilizing effect to the lumbar spine to prevent it from flattening to the floor. When activating the abdominals, you want to focus on movement in the thoracic spine (upper body/shoulder spine) and minimal movement in the cervical or neck (no chin poking or tucking to the chest).

In the beginner version, you want to leave your elbows touching the floor and focus on lifting the head and shoulders a short distance off the floor.

The intermediate version will see the elbows lifting a few centimeters off the ground but the head and shoulders should not be lifted any higher than in the beginner version.

The Side Bridge

Side bridge exercises, the second of the McGill Big 3, target the quadratus lumborum (quads), latissimus dorsi (lats), and the abdominal obliques without placing excessive loads on the spine.

As the name suggests, this exercise is done on the left and right sides but can be done in 3 positions, depending on muscle condition and pain levels.

The first and most basic form of a side bridge involves leaning against a wall. Start with your feet shoulder width apart and standing one to two steps back from the wall. Place both forearms against the wall with the hands together (forming a triangle with the elbows) while leaning forwards. With slow, controlled movements, rotate the upper body and hips by pivoting at the toes, trying not to twist the spine (keep the shoulders and hips in-line).

The second progression is moving to the floor where we start by lying on one side, knees bent and feet tucked in, with the elbow and forearm supporting the upper body. You want to make sure your elbow is directly below the shoulder with the forearm/hand pointing forwards.

While performing this version, make sure the knees, hips, and upper body form a straight line. For those with shoulder related issues, you can lie flat on your side and attempt to lift the legs or, at the least, take the weight off the legs.

The third and more advanced version of the side bridge involves only the feet and the elbow/forearm in contact with the floor. Start with the elbow and forearm below the shoulder, as we had done in the previous version, and have the foot of the top leg in front and the lower foot behind. In order to perform the exercise correctly, imagine a ruler running from the feet to the head and keep the hips from dropping to the floor. It may be beneficial to do this exercise with someone else who can give you tips on your posture.

The Bird Dog

The third and final exercise that Dr. McGill recommends is called the “bird dog”. This exercise focuses on the abdominals and the back extensors to maintain spine posture while lifting an opposing arm and leg.

The starting position is on the hands and knees with the knees directly below the hips and the hands directly below the shoulders (think of mimicking a standing dog).

For beginners, start by just lifting one hand and the opposite knee off the ground, trying to limit movement in the lower back and keeping the hips and shoulders flat or parallel to the floor. Progress through to lifting one leg or one arm at a time by reaching them away from the body (backwards for the leg, and forwards for the arm), while continuing to maintain hip and shoulder position. A cue to prevent lifting the leg or hand too high, leading to over-arching of the back, is to drive the heel backwards or reach the hand forwards in a fist. These cues will help prevent the hip or shoulder from lifting, maintaining back posture during the exercise.

The intermediate version of this exercise sees you lifting one arm and the opposite leg off the floor at the same time. This movement will activate the back muscles and abdominals to brace the core and prevent twisting of the spine. Lifted arm/leg should be held above the floor for 6 to 8 seconds before alternating sides.

Reference:

1. McGill, Stuart. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics, 2007.