Back pain will affect most of us at some point in our lives. Mostly because we have become more sedentary than we seemingly care to admit. For many of us, our daily routine tends to be that we wake up and head to work in the car or public transport — or move to our home office space. Then we at our desk, followed by travelling home and spending the evening sitting or lying down to rest and repeat tomorrow. This is why our back can suffer long-term pains, and it’s why good habits are ever-important.
It’s naturally hard for us to have the motivation to exercise or conceive simple habits that look after our health. But despite those reasons, it doesn’t mean we escape the consequence of back pain, poor movement patterns and injury.
No matter the excuse, we have to look after ourselves, especially our spine and joints. There is never a reason to ignore our health because no one is too busy to put their health first.
Luckily, the best thing about creating healthy habits is it doesn’t need to be time-consuming or overly strenuous. There are various ways to make the small steps that have a monumental difference in how good you feel, move and live daily.
One of the best practitioners I learnt from is Dr Stuart McGill, a professor in low back pain, core training and rehabilitation. I first heard about Dr McGill while at university. I used to deal with chronic low back pain from a young age, and his work helped me figure out how to resolve it.
A problem we face with today's advice is who or where it comes from. It seems as though most people or “reputable sources” believe they have a reliable opinion on how others should treat and look after their body.
Most people think the same solution can work for everyone. Not true. There’s no “one size fits all” to most things, including fixing back pain — nor is there a single exercise that acts as a panacea to our problems with back pain.
Your guiding principle should always be to pick the safest and most effective route for you. But if you do need some direction, here are some of Dr McGill’s suggestions for maintaining a healthy spine during your life.
1. Add variety to your movements
“Perhaps the most important guideline should be this: don’t do too much of any one thing. Both too much and too little loading are detrimental.”
Repetitive stress can wear down your tissues. By varying your movements and posture, you’ll learn to use different muscles and evenly spread the workload, avoiding putting excess stress on your spine.
If you spend a long time sitting at your desk, make sure you frequently change your position and stretch — even if you sit with “Good posture”. When I go out on my bike for two, three, four hours, it means I could spend a long time in one or two positions — which can cause problems for my back even if I am exercising. So, I alternate between positions by standing up and pedalling every few minutes. This helps relieve pressure and rest certain muscle groups from time to time.
2. Don’t sit for too long
This is one of the worst and most common habits. No matter what someone says, you should not be tied to a chair for long periods without stretching.
Prolonged sitting is linear to a heightened risk of disc herniation and problems with your movement patterns.
Dr McGill, therefore, recommends adjusting your position frequently, standing up at least every 50 minutes, extending your spine, and walking for a few minutes.
He shared a case study in one of his books of a worker in a radio centre whose job required them to sit for 12-hour shifts. Despite this, there were no back pain reports; the likely reason was that the employees had to get up every 10 minutes to check certain readings.
But the company later renovated the room and made it easier for employees to monitor things without getting up. After that, back pain became an issue among staff.
Remember to stand up every 10 minutes during work and stretch your arms overhead for 10–20 seconds. It’ll give you enough time to extend and decompress your spine and relax at the same time.
3. Avoid strenuous exercise straight after sitting for long periods of time
During flexion — sitting or bending — your ligaments stretch and ‘loosen’, and the forward bending of the spine pushes the nucleus backwards within your vertebral disc.
And when you hold your spine in one position for a long time, the ligaments and nucleus can change shape and adapt. The result of this can be a lack of support and an increased risk of herniation or disc damage if you then perform vigorous movements.
So, it’s best to avoid strenuous activity if you’ve been sat for a while; your spine needs time to return to its original state. If you’ve spent all day sitting at your desk, and you go to the gym or do exercise after work, leave some time for a break before your after-work workout session. If you can’t wait, then make sure to get in a proper core-focused warm-up before your main session, and be slow and progressive with your lifting. Wait for a little, go for a walk, and do some extensions before you take part in strenuous activity.
4. Don’t lift or bend your spine after rising from bed
We’re shorter in the evening than in the morning by as much as half an inch.
The reason is, throughout the day, gravity compresses the discs of your spine. Then at night, as you lay down, these discs rehydrate and decompress.
Think of it as a bike tyre losing air as you ride it. Every night, your body “refills” for tomorrow. However, like a fully-pumped, rigid bike tyre, your spine is at a higher risk of popping if you thrash it about straight away.
When you wake up, your spinal discs are like a filled tyre vulnerable to damage or injury.
The stress from forward bending on your discs and ligaments are higher just after you get out of bed, which can cause a disc to be injured at lower levels of loading and bending.
Dr McGill recommends avoiding lifting and spinal bending immediately when you wake up; rather, wait an hour for the disc to decompress. If you do some walking, your spine can decompress in as little as 30 minutes. This will keep you from placing excess stress on your spine.
5. Have a good rest break
Your core muscles are necessary for day-to-day movement and exercise. They provide total stability and protection for your spine.
Throughout the day or during an activity, these muscles will fatigue. And as they fatigue, it becomes difficult to provide support. The result is your larger muscles start to over-compensate, your posture weakens, you tire, and the threshold it takes to damage or injure your spine decreases.
To delay fatigue and keep your body moving for longer, you need to train your core endurance. It is more important that your core muscles can resist strong forces for a long time than it is for them to resist higher forces for a short time.
If you’re sitting all day, take frequent and dynamic breaks. If you’re engaged in dynamic work, take longer and more restful breaks. And include exercises like light stretching and deep breathing.
6. Keep the workload on your spine low
Like all parts of your body, your spine has a limit to the stress it can take before faltering.
If you exceed that threshold, you will get injured.
Dr McGill notes that as power is the product of force and velocity (speed), high spine power can induce a disc injury. Your spine isn’t meant to bear loads as your glutes and lats and thigh muscles can — nor are your core muscles designed to initiate fast movements or act as prime movers.
Be wary of moving too much weight or moving too rapidly, and be especially careful of combining the two.
- If the spine force is high, perform your movement or exercise slowly and focus on control.
- If you’re moving quickly, keep the force low.
The spine is made to stabilise, providing support, and transfer force to more capable muscle groups. If you want to create power, focus on driving through your hips.
7. Learn to brace
As I mentioned previously, your core muscles are for stabilisation and support purposes.
Dr McGill recommends lightly pre-stressing and stabilising your spine even during a light task — through warm-ups or light activity.
When lifting heavy objects, it is crucial to brace and create tension before you move to protect your spine.
When lifting smaller objects, your core should naturally feel braced and engaged. This process should be automatic and reflexive.
If you have weak core endurance or poor engagement, you may need to brace consciously while learning how to reflexively engage your core until it becomes second nature.
8. Drive through your hips and maintain a neutral spine
When you bend or do forward movements, push through your hips. The muscles around the hips are big and powerful mechanisms that help you shift great amounts of power without burdening your spine.
When you squat, bend at your hips. When you lean forward, push your hips back. When you walk, drive through your hips.
The spine can handle loads and forces when it is straight. But when the spine is bent under load, it can’t manage much force.
When under load, maintain a stiff, neutral spine, and use your hips and legs to generate locomotion and force. Rounding your back and using that to exert force is simply asking for injury.
Granted, it’s not always possible to exhibit this posture in the real world — like when lifting awkwardly shaped objects. In that case, brace your core and lock it in position before you bend.
9. Minimise joint stress
Rotation can be broken into two categories: creating rotation and resisting rotation.
When moving or producing force through exercise, you should generate most of your power through your hips and limbs while relaxing your spinal muscles.
Every joint is built for either mobility or stability. For instance, your low back centres around stability while your thoracic spine is meant for mobility. Therefore, the mobility in your postural movements should come from your upper back than your low back.
The role of the spinal musculature is to resist motion. If the spine moves when it shouldn’t, injury is likely to occur. This is why your core muscles are made to resist motion, not create it.
To minimise the force your back is put under, here are Dr McGill’s suggestions:
- Keep the load close to your body. It’s easier to hold, control and move a weight when it’s closer to you than further in front.
- Hold heavier weights with both arms. If you’re carrying something heavy, use both arms to do so. Imagine the difference when you hold a heavy object, like a full shopping bag, at your side compared to in both arms.
- When pushing or pulling, make sure the lever is close to you. Imagine shovelling snow or sweeping the floor. If the handle is close to your centre of gravity, it’ll help you avoid overworking your low back.
10. Develop your fitness
This goes without saying. Undertaking regular exercise is a straightforward approach to preserving your health and keeping your body feeling well.
Most people know this, yet they still don’t do it enough.
There is a difference between fitness and health. You could be the fittest person in the world and still suffer every day from pain and injuries. I’ve known professional cyclists to ride tens of thousands of miles a year yet pull out of races because of core weaknesses or poor movement patterns. It’s also for this reason Dr McGill makes says it’s better to be undertrained than over-trained.
We often vie for the idea that “more is better”. More weight. More reps. More stress. But that only puts unnecessary stress on our bodies without allowing ourselves to recover.
Exercises such as sit-ups or weighted ab machines are likely to do more harm to your spine than good. And more is certainly not better. While they may define your six-pack, they can also come at a cost to your long-term spinal health. I had this very problem from my early teens right until the last five or six years. Something I wrote more about in my book on core training.
That said, maintaining a sensible exercise regime, one which emphasises proper technique and spine-saving exercises can do a lot of good for your back and keep you strong and pain-free for decades.
Here is a summary of the above:
- Move well, move often.
- Brace your spine and use your hips.
- Train your core muscles often.
- Continuous movement is continuous improvement.
Health starts with how you think and move. If you want to live well, looking after your well-being should be above everything else.
If you suffer from back pain, these suggestions can go a long way in helping you resolve it. If you’ve never had back pain, that’s fantastic. And I want to do what I can do help you keep it that way.
Back pain can be a debilitating affliction. Most of our lives now involve things that promote further pain. But if we can take just a short amount of time every day to nurture our back and train our core, the benefits will last longer than any shortcut anyone else can recommend you.
I’ve written a 51-page eBook on Core Training with 30+ exercises to help you prevent injury or discomfort forever. Check it out here.