Protocols to Strengthen & Pain Proof Your Back
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Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

Today, we are discussing how to build a strong, pain-free back. Having a strong, pain-free back has numerous advantages, not the least of which is you're not in pain, as well as the fact that you can carry out your daily activities, any exercise or sports you might play, interactions with family members, like picking up a kid, leaning down to get things out of a cupboard, or reaching up to get things out of a cabinet without any pain.

And back pain is one of those things that even if minor and certainly if severe, severely impedes our ability to do most everything, even to just sit still or lay still. And one of the things about pain, in particular back and neck pain, is that it also has an effect on our emotional self. It makes us more irritable. It makes any activity, even the most mundane activities, that much more distressing to carry out.

So during today's discussion, we will talk about how to ameliorate pain. However, pain as a general topic was already covered on this podcast with an expert guest, Dr. Sean Mackey, who's a medical doctor at Stanford. He's actually the director of our pain clinic.

And on that episode, which we provide a link to in the show note captions, he talks about the various ways to address pain, everything from pain medication to epidurals to electrical stimulation, and importantly, the biopsychosocial model of pain, whereby our thoughts and our perceptions about pain actually influence the severity and the duration of that pain. So if you're interested in pain and the treatment of pain per se, I highly recommend that episode.

Today, we will certainly talk about ways to deal with back pain, ways to reduce it and perhaps even eliminate it altogether. But we are also going to talk a lot about how to pain-proof your back and how to build a really strong back, not just for pulling things because the back muscles are involved in pulling things,

but also just for generating a really strong stable core, strong spinal erectors, making sure that your pelvis and your spine are interacting correctly, that your shoulders, neck and spine and pelvis, and even your lower limbs and feet are working together in the proper manner to make sure that you have the strongest and most pain-free back possible. So what I'm going to do is first I'm going to describe a bit of

back anatomy and physiology. I'm going to talk about the neuromuscular components as well as the spinal and disc components. I promise, even if you don't have a background in biology, I'm going to make this all very accessible to any and all of you. And then I'm going to go into the 10 or 12 specific things, in particular, six things that take very little time, that require no equipment, no purchase of anything whatsoever, and involve a very minimal time investment that will allow you to build a really strong pain-free body.

back. What's covered are protocols from three of the world's foremost experts in back pain, but also back strengthening and building resilience into the back. So they include a medical doctor expert in back strengthening and rehabilitation.

a PhD researcher who has spent decades researching the spine and ways to strengthen the core and spine, and a world-class PhD physical therapist who is expert not just in the spine, but in fact, in the movement, rehabilitation, and strengthening of the entire body. They are...

the MD, Dr. Sean Miller, the PhD, Dr. Stuart McGill, and also the PhD, Dr. Kelly Starrett. I provide links to them and resources that they provide in the show note captions. And indeed, I plan to host all three of them separately on the Huberman Lab Podcast as expert guests in the not too distant future. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

It is, however, part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast.

Our first sponsor is Aeropress. Aeropress is like a French press, but a French press that always brews the perfect cup of coffee, meaning no bitterness and excellent taste. Aeropress achieves this because it uses a very short contact time between the hot water and the coffee. And that short contact time also means that you can brew an excellent cup of coffee very quickly. The whole thing takes only about three minutes. I started using Aeropress over 10 years ago.

And I learned about it from a guy named Alan Adler, who's a former Stanford engineer, who's also an inventor. He developed things like the Arobi Frisbee. In any event, I'm a big fan of Adler inventions. And when I heard he developed a coffee maker, the Aeropress, I tried it and I found that indeed it makes the best possible tasting cup of coffee. It's also extremely small and portable.

So I started using it in the laboratory when I travel on the road and also at home. And I'm not alone in my love of the Aeropress coffee maker. With over 55,000 five-star reviews, Aeropress is the best reviewed coffee press in the world. If you'd like to try Aeropress, you can go to aeropress.com slash Huberman to get 20% off. Aeropress currently ships in the USA, Canada, and to over 60 other countries around the world. Again, that's aeropress.com slash Huberman. Today's episode is also brought to us by Juve.

Juve makes medical grade red light therapy devices. Now, if there's one thing I've consistently emphasized on this podcast, it's the incredible role that light can have on our biology. And of course, I'm always telling people that they should get sunlight in their eyes as soon as possible after waking on as many days of their life as possible for sake of setting circadian rhythm, daytime mood focus and alertness and improve sleep.

Now, in addition to sunlight, red light and near infrared light has been shown to have positive effects on improving numerous aspects of cellular and organ health.

including faster muscle recovery, improved skin health and wound healing, even improvements in acne, or that is removal of acne, reducing pain and inflammation, improving mitochondrial function, and even improving vision itself. What sets Juva apart and why it's my preferred red light therapy device is that it has clinically proven wavelengths.

meaning it uses specific wavelengths of red light and near infrared light in combination that trigger the optimal cellar adaptations. Personally, I use the JOOV handheld light both at home and when I travel. It's only about the size of a sandwich. It's very convenient to use. I also have a JOOV whole body panel and I use that about three or four times a week. If you would like to try JOOV, you can go to J-O-O-V-V.com/huberman.

Juve is offering an exclusive discount to all Huberman Lab listeners with up to $400 off select Juve products. Again, that's Juve, J-O-O-V-E.com slash Huberman to get $400 off select Juve products. Today's episode is also brought to us by Waking Up.

Waking Up is a meditation app that offers hundreds of guided meditations, mindfulness trainings, yoga nidra sessions, and more. I started meditating over three decades ago, and what I found in the ensuing years is that sometimes it was very easy for me to do my daily meditation practice. I was just really diligent. But then as things would get more stressful, which of course is exactly when I should have been meditating more, my meditation practice would fall off.

With Waking Up, they make it very easy to find and consistently use a given meditation practice. It has very convenient reminders and they come in different durations. So even if you just have one minute or five minutes to meditate, you can still get your meditation in, which research shows is still highly beneficial. In addition to the many different meditations on the Waking Up app,

They also have yoga nidra sessions, which are a form of non-sleep deep rest that I personally find is extremely valuable for restoring mental and physical vigor. I tend to do a yoga nidra lasting anywhere from 10 to 20 minutes at least once a day. And if I ever wake up in the middle of the night and I need to fall back asleep, I also find yoga nidra to be extremely useful. If you'd like to try the waking up app,

you can go to wakingup.com slash Huberman to try a free 30-day trial. Again, that's wakingup.com slash Huberman. Okay, let's talk about the back.

The back for many people simply means the spine, the bony stuff that runs down your middle. Now, of course, your spine doesn't just run down your middle. You've got your cervical spine or your neck. Don't ever forget that. Your neck is the upper part of your spine. You've got the thoracic spine, which essentially through, you know, in insects, we think of the thorax. Remember that from biology class in middle school or high school, but through your spine,

basically down from the neck through the chest. And then you've got your lumbar spine, which is the part right below that. And then you have the sacral spine, which is the area of the spine that is in the pelvic region. And then of course there's the bottom region of that, which is called the coccyx spine, which is the very lowest part of the sacral region of the spine. Now, of course, that's the bony stuff. And if you've ever seen a spine on a skeleton of any kind or a drawing of a skeleton, you know that it's a bunch of segments. It's a bunch of bony segments.

It's important to understand that the back is made up not just of bony stuff, but it's got stuff in between, which are the discs. The discs are the soft tissue that sit between the vertebrae, right? The vertebrae are the bones. And those discs have some durability to them. They're not easily squished, but they can be squished. That is, they can move. They're a soft tissue that allows for mobility of the bony stuff.

So you've got basically bone, disc, bone, disc, bone, disc, bone, disc.

And it's those discs that allow for movement of the spine from side to side. And it actually allows for some compression along the length of the spine as well. What sometimes today I'll refer to as vertical compression, but actually vertical isn't the correct anatomical term. So in anatomical terms, we talk about anterior posterior, we talk about rostral caudal, which is just different language for anterior posterior. I'm going to try and avoid using fancy nomenclature as much as possible. But the point here is that those discs allow for movement of the vertebrae.

But keep in mind that the vertebrae and the discs have a hole down the middle. They look like donuts, basically. They're not perfectly round like donuts, but for the time being, just think of them as donuts, right? Some are bony donuts and others have more pliability to them. But there's a hole down their middle. Why? Well, within that hole is a long snake-like bone.

of the nervous system called the spinal cord, which is the neural stuff, the neurons. Now within the spinal cord, it's not just neurons, nerve cells, okay, neurons means nerve cells. It's also glia, which are another cell type that provides yes, support to the neurons, but also do some really important things on their own, like clearing out of metabolic waste. They actually regulate communication between neurons. If you've ever heard that the glia are just glue, and that's actually the Latin translation of glia, glue,

it implies that they're not doing much actively, that they're just sort of a passive participant keeping things together. The glia are really doing important things as well. But keep in mind that the spinal cord is this long snake-like process of the nervous system that extends down through the vertebrae and down through the discs. Or if you prefer, you can think about the long snake-like

process of the spinal cord, and then around it, all along its length, you have bony vertebrae disc, bony vertebrae disc, bony vertebrae disc, going all the way from the neck region down to that coccyx region within the pelvis. Now, the thing about neural tissue is it's very soft. It's very fragile.

And one of the reasons we have vertebra is to give the spinal cord some rigidity and protection from damage. And that's really important because the spinal cord, this long tube of neural tissue that sits inside of the vertebrae and the discs,

It's central nervous system tissue, CNS tissue. And as CNS tissue, it does not regenerate after injury. Okay, maybe a tiny bit in certain conditions and in very young people, but if the spinal cord is damaged, typically there's a lot of scar tissue that forms, but there is no renewal of the neurons that are damaged. So it's very important that the spinal cord be protected, which is one of the reasons why it is encased by those vertebrae and the discs.

Now, the other thing to understand is that the spinal cord is indeed a snake-like extension out the back of the brain. So the brain and spinal cord make up what we call the central nervous system, the CNS. We just talked about that a moment ago.

But now I want you to think about the brain. Your brain, of course, is encapsulated within the skull, the cranial vault. There are only two pieces of your brain that reside outside of the cranial vault. They are your neural retinas that line the back of your eyes. I know many of you have heard me say this before, but it's so cool that I can't help but share it again and again, which is that you have two pieces of your brain, literally your central nervous system, that were extruded out from the cranial vault during development while you were in utero. This happens

in the first trimester when you were an embryo that line the back of your eyes like a pie crust. And those linings of the back of your eye like a pie crust are made up of three layers of neurons and a bunch of glia. And they are your neural retinas. They are two pieces of brain that literally look out into the world

and are activated by what? By light, by sunlight, by edges and objects, by the photons in the outside world. And that's what gives rise to vision. So starting at the front of your head and working down through the spinal cord, we can do this very quickly to give you a complete picture. You've got your neural retinas that line the back of your eyes. They are central nervous system. They are brain.

They communicate with the rest of your brain through the optic nerves. Then you've got your brain. You've got the brain parts that respond to hearing, the brain parts that allow you to think, imagine, learn, remember, et cetera. And then at the back of the brain, you have the brain stem. And then extending out from the brain stem, you have the spinal cord, this tube-like neural structure that extends down through the vertebrae

down through the discs all the way to your pelvic region. Now, why am I telling you all this neuroscience? If we're talking about strengthening the back, why am I talking about the spinal cord? Why am I talking about neurons in the brain? Well, just as your brain has the cranial vault, your skull to protect it,

your spinal cord has the vertebrae to protect it and the discs to protect it, but the discs allow for some movement of the spinal cord. In fact, quite a bit of movement. If you just lean forward in your chair, you lean back, arch your back, or you twist to the side, your spinal cord is actually twisting in that way. Okay, this would be akin to your brain actually moving within the skull. It can move a little bit, but it doesn't move nearly as much as your spinal cord does.

So your back has of course many functions. It's there to stabilize your body. It's there to provide stiffness in order to be able to move your limbs in very dynamic ways. We're going to talk about back and core stiffness as such a key feature of having a strong back. When you hear the word stiffness, you probably think, well, that can't be good. I don't want a stiff back. Ah, but you actually want to be able to generate rigidity within your core and spine in order to move your limbs, to throw a ball or to do a martial arts punch or to even dance gracefully, or even just move up some stairs without falling.

So basically when we talk about the brain and spinal cord as extending down through the vertebrae and through the discs, we're doing that to set up the other piece of this whole story, which is that the neurons that reside in the spinal cord, in particular what we call the ventral spinal cord, which if we're going to imagine this in kind of more real world terms, they're sitting in the part of the spinal cord that's kind of on your front, okay, that's facing the front of the world.

There are neurons that are called motor neurons. The motor neurons themselves, what we call the cell bodies reside in the spinal cord, in the so-called ventral horn of the spinal cord. You can look this up if you like, although you don't need to know that. And they extend little wires that we call axons out to the muscles. And through the release of neurotransmitters, they allow our muscles to move, our flexors to flex like our bicep, our extensors to extend like our tricep.

You could think quadricep, hamstring, calf, abdominal muscles, all the movement of those muscles is controlled by neurons that reside within the spinal cord. Some of the movements that we generate are unconscious movements, especially movements that are required for breathing, although you can consciously take care of your breathing as well, right? You can breathe unconsciously.

You're always doing that even in sleep, or you can take conscious control of your breathing. You can generate limb movements consciously, or you can generate limb movements unconsciously. Typically, once you know how to walk and you get up and you walk across the room, you're not thinking right foot, left foot, right foot, left foot. All of that's handled by motor neurons and what are called central pattern generators in the spinal cord, and to some extent, the brainstem.

but the commands for specific deliberate movements that you're thinking about, especially when you're trying to learn a movement or you're trying to be very deliberate in a movement, those come from what are called upper motor neurons in the brain. They communicate with lower motor neurons, which then communicate with the muscles. Okay, so that's one neural outflow pathway from spinal cord out to muscles. Some of it's conscious, some of it's unconscious. And then there are the neural pathways from skin, from the tendons and insertions of the muscles,

on to bone within the muscles that register how much stretch are on our muscles.

And those are the so-called sensory inputs that come into the dorsal part of the spinal cord, the part that is facing toward our back. And that sensory information tells our spinal cord, which then informs our brain, whether or not our limbs are extended too far and about to snap, or whether or not a muscle is loaded too heavy and is about to be pulled off the bone. And in that case, the brain and spinal cord have these magnificent mechanisms to shut down the neurons so that, you know, we,

drop the load so that we don't overwhelm the muscle and rip it off the bone, or we don't stretch our limbs too far. Now, keep in mind that the neurons within the spinal cord that communicate with muscles or the neurons that innervate, as we call it, the skin or the tendons or different parts of the body and go into the spinal cord, those little wires, those axons literally leave the spinal cord and they go out into what's called the peripheral nervous system.

Now, a big source of pain in back pain is when those nerve roots, as they're called, they're little bundles, okay? Bundles of nerves are sometimes called fascicles, sometimes called nerve roots. The nomenclature kind of depends on where you are in the nervous system, but I'll call them nerve roots or bundles of nerves. Those bundles of nerves are sometimes impinged on, they're physically pressed on by say, a bulging, what's also called a herniated disc.

The discs can sometimes bulge out from the side of the spine a little bit too much, maybe by compression from the overlying vertebrae, maybe from some inflammation. We'll talk about the various sources today. Oftentimes, the source of back pain or neck pain or even pain in the pelvic region is because of a compression of the nerve roots that are going into and out of the spine.

When we talk today about back pain, and when we talk today about building a strong back, we need to focus on two major themes. One is the extent to which those nerve roots are free and clear of any physical pressure from say herniated discs, from compressed vertebrae, from inflammation in those regions, maybe all three.

And what we're really trying to do when we talk about relieving back pain often is creating space, creating room for those nerve roots to travel in and out of the spine, for those messages to come in from the periphery,

the skin, the tendons, the muscles, et cetera, up into the brain, because the brain needs that information to know where our limbs are, still needs to keep us safe, as well as the nerve pathways traveling out of the spine that control our musculature for deliberate movements, unconscious movements, and so on. And so much of what you'll hear about today when thinking about how to build a really strong pain-free back is about creating the kind of stability around the spine so that we can engage in the different limb movements that we need to,

but to do so in a way that doesn't create compression of those nerve pathways. Now, with all that said, it's really important to also understand that not all of back pain is neural in nature. Now, technically all pain is neural in the sense that it's a perception. Okay, if you listen to the episode with Dr. Sean Mackey, which includes a deep description of the biopsychosocial model of pain,

It will tell you, or I'll just tell you now, that indeed pain involves a lot of different things. It involves psychology, it involves prediction, it involves history, it involves inflammation, it involves a lot of things. And yes, ultimately it's neural. It is the firing of nerves that create the perception of pain and your perception of pain is also the firing of neurons in your brain and spinal cord. However,

What you'll also learn today is that there are many things that you can do, including creating stability of your feet, your toes, believe it or not, the position of your pelvis, your neck, your chin,

All these things, as well as the spinal erector muscles in your lower back, as well as your abdominal region, your so-called core, all of those things combine to create a milieu for the spine and back to function at its best. So if by now you're getting overwhelmed, you're thinking, my goodness, we have to learn about the entire body's physiology and anatomy in order to understand back pain and strengthening. To some extent, that's true, but really all we've said so far and all you need to know or keep in mind that is,

is we have the vertebrae, the bony segments that surround the spinal cord. In between those, we have the discs, the soft tissue that also have a hole through them. The spinal cord travels through that so that the vertebrae can move so that we have some pliability and mobility of our spine forward, flexion, so your chin closer to your belly, extension, your chin back and away from your belly, sort of arching of the lower back. You can twist to side to side to some extent. You have all that stuff.

And through the middle is the spinal cord and the brain. And then you have sensory information going into the spinal cord from the body, from the muscles, from the skin. And then you have motor commands going out the bottom of the spinal cord. So literally traveling out past those vertebrae and discs out to the muscles to control those muscles for involuntary and voluntary movement. If you can understand that and you can envision it just a little bit, even just a little bit,

you're going to be able to think about all of the various protocols that we talk about next in the most functional way. Meaning as you learn about and hopefully incorporate the various protocols for strengthening and pain-proofing your back,

that you'll occasionally think back to, okay, it's my spinal cord that I'm bending in my lower back region. I'm allowing the discs to kind of move forward and they likely are kind of bulging out a little bit. They're not necessarily herniating, let's hope not, but they're bulging a little bit in that direction, then back in the other direction. And if you happen to have herniated, that is bulging discs,

which many people do. In fact, I've had that. I've got a sort of an L3, a kind of lumbar 3-4 bulge that got activated a few years ago. I'll tell you what allowed me to very quickly fix that permanently with no medication, no surgery whatsoever. And it was extremely debilitating. There's some simple movements that one can do if done in the proper direction and in the proper way that can allow you to push that bulge, that herniated disc back into

or I should say closer to the spinal cord, okay, moving it from the kind of bulging out from between the vertebrae to closer again toward the center point of the spine. By doing that, one can take pressure off of the nerve roots that are traveling out to the muscles and in from the skin and other sensory information coming into the spinal cord and allow yourself relief from back pain. And then by building up stability in the abdominal region, the lower back region,

you can create a nice firm core that will allow you to protect all of that with plenty of space so the nerve roots are not impinged. And then of course, by focusing on some of the stabilizers that exist really distal, which means far from all of that, further from all of that, such as the feet, literally how you position your feet, the ability to spread your toes, believe it or not, as a way to provide support for your back, not just when doing exercise, but also at rest.

There are some things you can do about neck positioning, strengthening of the front of the neck, strengthening of various muscles. Again, that involves no equipment whatsoever that allows you to have a pain-free strong back, both at rest and during movements of different kinds, different dynamic sport movements like tennis or golf, et cetera, as well as if you're into it, resistance training, if you're putting yourself under heavy loads, all of that pain-free and moving through life with a tremendous amount of mobility and versatility.

Now, before we get into the specific protocols and exercises for strengthening and pain-proofing your back, it's worth mentioning something that really was first told to me by Dr. Stuart McGill. Again, he's going to be a guest on this podcast. Dr. Stuart McGill is a world expert in spine physiology and anatomy.

And he's worked with a lot of athletes, but his work is not specific to athletes. It's really for the everyday person as well. And in discussions with Stu, he raises some really important points. First of all, if you have back pain, you need a proper assessment and diagnosis. It's really impossible for me in this format to try and diagnose your back pain or for you to try and diagnose your back pain. That would just be irresponsible of both of us. There's just so many things that are specific to each circumstance.

For instance, some people get back pain or neck pain or both because of overuse of certain motor patterns. Maybe they are avid golf players and they're always swinging a certain way with one foot forward. That's typically the way it works. And they built up some strength in certain pathways, both muscular strength and neural strength, but they have a weakness in the opposite side muscles and nerves, and they need to rehabilitate those in order to eliminate the back pain.

Other people have an injury, right? They have a spinal compression injury. They don't just have a herniated disc. They have a ruptured disc. Oftentimes ruptured discs need surgery. I don't want to give the impression that all back pain can be resolved without surgery. There are cases where surgery is necessary. Okay. So it's very important that if you have severe back pain or persistent back pain, and you're not able to alleviate it with non-surgical methods, that you talk to a back expert.

expert, perhaps even a surgeon. There are cases for epidurals, for painkillers, for different types of rehabilitative approaches. But Dr. Stu McGill has also pointed out that there are a number of things that any and all of us can do by just self-assessing that I think are appropriate for today's discussion

that relate to whether or not we are likely to have a thick spine or a thin spine, okay? This isn't a psychological feature, at least not to my knowledge. But if you look at different body types, you know, what in the old days used to be called the ecto, endo, and mesomorphic body types, okay? This nomenclature isn't used quite as much anymore, but just to kind of return to it, the ectomorphic,

Body phenotype is one in which people are typically kind of light boned, meaning thinner wrists, smaller knees, smaller ankles. So not really thick bones and thick wrists. So that's the ectomorphs. These are people that tend to be pretty thin. Sometimes referred to as people that have very low body fat, less muscle mass, although that's not always the case. Just think lighter, thinner skeleton versus mesomorphs, which tend to be people with kind of thicker wrists, thicker knee joints, kind of thicker overall.

And then endomorph, which was at the time used to describe people that are carrying more body weight in the form of body fat. I don't know how often the endomorph phenotype language is used anymore. But what Dr. Stu McGill has pointed out is that people in general tend to be more ectomorphic or mesomorphic. They tend to be more thick through the torso or thin through the torso. They tend to have thinner wrists or smaller wrists as compared to their age-matched, sex-matched counterparts. But in general, so these are generalizations,

People who have thicker wrists generally are going to have thicker spinal segments, okay, in terms of the circumference of the spinal segments and discs.

Whereas people with smaller wrists, smaller joints, smaller ankles are going to have thinner spines. So thinner vertebrae, thinner discs between them and so on. Now, neither is good or bad. They are just different. And they create a situation where people have different needs in order to build a strong pain-free spine. So for instance, people who have thick spinal segments, so these are people who tend to be more barrel chested, thick through the torso, maybe thicker wrists and ankles and knees have thicker spinal segments.

and therefore may not need quite as much buildup of the musculature around their spine in order to handle vertical loads, okay, compression along the spinal length because they have those big, thick spinal segments and discs. It's not to say that they don't need to do any spinal strengthening, they do,

but they are generally going to be very stable along the, I'm calling it the vertical axis, but along the length of the spine. Those people, perhaps not surprisingly, are not going to be as mobile in terms of the twisting and bending of the spine, meaning spine mobility along the different axes

apart from that vertical axis that I was referring to along the length of the spine. But twisting and bending is going to be harder for them. Now at the opposite extreme, you're going to have people with smaller wrists, smaller ankles, smaller knees, and they in general are going to have a thinner spine, meaning vertebrae and discs that are smaller in circumference, and they are not going to have the capacity to sustain as much vertical compression along the length of the spine as somebody with thick spinal segments,

but they are going to be more quote unquote bendy, if you will. Now that doesn't always mean more flexibility. What I'm referring to here is a capacity or a potential for the ability to generate movements in which the spine is twisting from side to side with more ease than would be the power lifter. So imagine at the extremes, the thick torso and spine of the power lifter, of the shot putter, somebody like that versus the spine of say,

the yoga teacher, the dancer. They have these smaller wrists, smaller pelvis, smaller knees, et cetera, but they're going to have more ability to twist themselves, their spine. So imagine just kind of like bending over to the side a little bit while looking up. The spine is going to do that very easily.

as compared to the person with a thicker torso and spine. These two distinctions, and here I'm really making them polarized distinctions, and in reality, there's a whole distribution of thick spine, very thick spine, moderately thick spine, thin spine, ultra thin spine, and so on. But at these two extremes, you can start to imagine that each of those spines, each of those backs probably has different requirements in order to make it strong and pain-proof depending on the activities that those people are engaged in. Now, of course,

a thin spine person can decide to power lift. That can be very good for them. And indeed, one of the things that somebody with a thin spine should do, according to Dr. Stu McGill, and I'll reiterate this several times today, is build up the musculature around the spine so that they can stabilize that otherwise bendy spine along both the vertical and side to side axis so they don't injure it. They want to make it strong.

as well as the person with the thick spine who can tolerate heavy loads around one axis, but maybe needs to generate more mobility of that spine so that they don't go reaching for a glass up in the cupboard and all of a sudden they have compression of a nerve root coming out the spine because they just twisted it to the side by about five to seven degrees.

"Both groups have specific needs, meaning specific protocols that they can emphasize to a greater or lesser degree in order to strengthen and pain-proof their spine." So while we can't do an assessment of spinal pain and your exact needs for your particular body type in this kind of format through the tunnel of the internet,

You can take a look at yourself or just think about yourself and think, oh, do I tend to have thicker wrists, knees, elbows, et cetera? Am I more of a, you know, kind of thick torso person? Or do I tend to be someone who's more lithe, who's more, you know, small wristed? Somebody who can move from side to side with a lot of ease, but probably can't handle as much what I was calling vertical load along the length of the spine. And some people have a kind of mixed phenotype, not purely ecto, not purely mesomorphic.

I can say that about myself. I have fairly long limbs. In fact, I have like almost sort of like gibbon arms. I have this kind of really long reach. So more kind of ectomorphic arms. And at the same time, I have a short torso and I am fairly thick through the circumference of my torso. I've always been like that. Even before I started doing any kind of resistance training, my legs are somewhere in between. Okay. So I don't have small knees or small ankles. They're kind of moderate in that way. My wrists are

And my arms probably a bit more ectomorphic, not strong ectomorphic phenotype. But then my torso is a short torso and it's kind of thick through the circumference. That's just the way that my genetics landed me into the world.

you have genetics that landed you into the world in a particular way, you can take a look at these kind of external phenotypes about joint size and how to do an assessment, just thinking about it. And by doing that, you'll be able to know which protocols, which we're about to talk about, you may want to emphasize or de-emphasize in order to best strengthen and pain-proof your back. So a good analogy that Dr. Stuart McGill offers when thinking about this thin spine versus thick spine thing is if you think about a willow tree, which

which has essentially a thin trunk and thin branches relative to say an oak tree or redwood tree.

The willow tree trunk and branches can bend to quite a considerable degree without breaking. So it's just very bendy from side to side, but they're thin and they can't sustain a lot of vertical pressure, a lot of loads from top to bottom, or else they'll simply collapse. They might not snap to the point of breaking, but they will definitely bend to the point of not being able to bend back.

as opposed to the trunk and branches of a full grown oak tree or redwood tree, which are very thick and very strong and can sustain a lot of loads from top to bottom along this vertical axis. But if they bend even just a tad too far from one side to the next,

they're going to snap and essentially break off. So while that analogy isn't a perfect one to explain the situation with thin spines versus thick spines, I think it gives you a mental image of the general situation for which some people who have the more willow-like spine probably need to

build more musculature around the spine in order to stabilize it, but probably don't have to do quite as much work in order to generate more side-to-side flexibility, as opposed to people who have a thicker spine, who probably don't need to do quite as much work to

develop the musculature of the spinal erectors, of the abdominals. It's not to say they don't need to develop those at all, they do, but that they don't need to do quite as much work to build the musculature around the spine in order to stabilize it for vertical loads, but they perhaps want to do more work

aimed at generating more flexibility in these planes of motion from side to side and at different angles, you know, relative to the vertical axis. And again, most people don't fall at either extreme of willow-like or redwood-like. Most people are going to fall somewhere in the middle. And as I mentioned before, many of us, including myself, have a sort of combination of more thin musculature and thick musculature, depending where in the body you look. Look, I'd like to take a brief break and acknowledge our sponsor, AG1.

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So now let's discuss the protocols that allow you to strengthen your back. The first three of these protocols are the so-called McGill's Big Three, named after Dr. Stuart McGill, who again has done a tremendous amount of work in the research and practical realm.

and has developed a number of different protocols for strengthening and de-painting the spine, but has distilled down three specific protocols that everyone I spoke to in the PT community, in the MD community, for those that specialize on spine, and in the sports community, as well as people who don't play sports, but are simply interested in having a healthy spine for sake of daily mobility, all agree are extremely useful for everybody to carry out.

Now, the one caveat is that Stu McGill himself has told me that he doesn't want the big three to be viewed as the be all end all of back strengthening and pain relief. By no means is it exhaustive to do just the big three. So I'm also going to include a bunch of other protocols that are gleaned from other practitioners and that Dr. McGill often offers himself in his books. And I'll certainly put links in the show note captions to his books. And again, he'll be a guest on this podcast, but for sake of clarity and simplicity, the

The big three are as follows. The first is called the curl up. The curl up is in many ways a replacement for the sit up. Most people are familiar with ab crunches and sit ups where you lie down. Typically people will bend their knees, although not always. They'll often put their hands behind their head or on their chest, and then they'll essentially sit up to contract the abdominals.

It turns out that if you have back pain, and even if you don't, that is probably the least efficient and perhaps even the worst thing that you can do for your back pain. And if you think about the discs that sit between those vertebrae, remember those soft tissue discs that allow for some mobility of the spine? Well, if you happen to have a disc that's bulging even slightly, that is it's herniating, it's getting pushed out from between the vertebrae and it's impinging on a nerve and there's some pain,

If you are crunching, you can imagine that's essentially bringing the vertebrae together in the front of that sandwich that is vertebrae, disc, vertebrae. And what it's going to do is it's going to have that disc bulge out even further. It's going to herniate even further and impinge on those nerves even further. So what's required in a situation where you want to strengthen the back or increase

try and eliminate or reduce pain of the back is a way in which you can strengthen the abdominals because the abdominals and the abdominal wall is very important for stabilizing the spine and you want a stable spine. That's a very important point, but you wanna do it in a way where you're not adding to the herniation of the disc in any way.

So the curl up is an excellent exercise for people who have back pain and who don't have back pain to strengthen the abdominal wall. And it's done as follows. You lie down, you put one knee up, meaning one leg is bent, the other leg is extended. You put your hands, both hands below the lower portion of your back. So in the arch of your back, and you actually want to maintain the arch of your back. That's one of the reasons your hands are there.

The head is in a neutral position, okay? So your chin isn't tucked toward your chest. The chin is in a neutral position. And this is important. Your tongue is on the roof of your mouth. This is something I talked a little bit about in my description of neck exercises in a previous video. We're going to get back to this. But tongue on the roof of the mouth often puts the head into a safe default position. It also allows for breathing, in particular nasal breathing, to be done very easily. So you've got your tongue on the roof of your mouth.

The mouth is typically closed. And then what you do is you raise your elbows off the ground. And then while maintaining that small of the back, you're going to just raise your upper chest. You're going to lead with the upper chest, not with the chin and head. Although, of course, the head will follow. You're going to raise the upper chest, meaning raise the upper torso. So the head's going to move forward. And you're going to exhale and contract the abdominals for anywhere from eight to 10 seconds.

So you get a very strong contraction of the abdominals, but you're not doing a full sit up. You're only coming up maybe about, I don't know, somewhere between five to 10 degrees. So your back is coming up, the head is coming up and the chin is not moving towards the chest. It's staying in a neutral position.

You're going to repeat that. So meaning you're going to go up, contract for eight to 10 seconds. You're going to contract the abdominal walls. If you want to exhale, you can usually get a stronger contraction of the abdominal walls. And then you're going to go back down and relax on the floor, maybe rest 10 to 30 seconds, maybe a minute, and then repeat.

Okay, so that's the basic movement. And then you would switch to the other side, meaning you're then going to extend the leg that was bent. You're going to bend the other leg and you're going to repeat. In terms of sets and repetitions, typically the best way to do this is to do anywhere from three to five sets, starting with 10 second contractions done five times for the first set. So it'd be 10 second hold,

then relax, 10 second hold, then relax, doing that five times, maybe four times, but five would be ideal. That would be one set. And then on the next set, you're going to do four repetitions, meaning four 10 second holds with rest in between. And then on the next one, three,

on the next one, two, and the next one, one 10-second hold or so. These are just rough guidelines. You certainly don't have to do quite as long holds as those. If you can't do those, you don't have to do all of those sets if you find you're fatiguing. One of the advantages, however, of doing these brief 10-second holds and really focusing on the contraction of the abdominals hard or as hard as you can, and then releasing is that

as opposed to doing a long hold, just trying to hold as long as you can and building a lot of endurance in the abdominals. When you repeatedly contract a neuromuscular connection, you build the pathways. You basically allow the pathways that can engage those strong muscular contractions to a greater degree than if you're trying to just statically hold that particular position for a very, very long time, like 30 seconds or 60 seconds or longer.

Okay? Now, there are a bunch of different variations of the curl up. You can do the curl up with the extended leg elevated slightly to make it harder. You can do the curl up with your elbows positioned closer to the ceiling. So you're really lifting your elbows and arms far off the ground as opposed to having them just hovering right above the ground. There are a bunch of different variations of these. We include links to a few short videos in the show note captions so you can see the different variations of the curl up.

has me doing these on the floor in my typical street clothes. So you don't need to get into workout gear to do these. And I should mention that the curl up is something that you can do every day if it occurs to you and if you have the time. It's something that you would certainly benefit from doing every day, but it's also something that even if you do once or twice a week for even just a couple of sets, you're going to see some benefit in terms of strengthening your back and probably relieving some pain of your back as well. The other terrific thing about the curl up is if you have back pain,

and doing the curl up doesn't aggravate it, you are most certainly doing things to strengthen the musculature around the back that's going to help you avoid more back pain as you work through the different rehabilitative practices that hopefully you're doing with a PT or with a excellent MD who specializes in back pain relief.

As the pain dissipates, you're going to be building up the musculature of the abdominals that's going to then further protect your spine, especially if you're one of those people that has a thinner spine that needs more muscular support around the spine in order to support it. Just as a final note about the curl up, two of the most common errors that people make when doing the curl up

is to make it more like a sit-up and generate a chin to chest movement first and let the chest follow. You really want the chest to lead and keep the head in a neutral position, tongue on the roof of your mouth, try and breathe through your nose. And if you find that you can't do the big exhale as you bring it up to the top, don't worry about it. It's perfectly fine to hold your breath as you come up and then just maybe release a little bit of air to enhance the

of that abdominal contraction. The second exercise in the McGill Big Three is the side plank. I confess, and I don't know why, I hate doing side planks. I don't know why I hate doing side planks. I just hate doing side planks, which tells me I should do side planks.

So I've started doing some side planks recently after talking to Dr. McGill. I'm fortunate that right now I don't have back pain. I haven't for a while. I'll talk about how I alleviated my back pain, but I spend a lot of time as a 48 year old thinking about having a strong spine, being able to jump off things and land with confidence, all the sorts of things that set one up for both health span and lifespan as has been taught to us by Dr. Peter Atiyah.

Some of you may know Dr. Peter Attio because he's been a guest on this podcast. He wrote the incredible book "Outlive" and he talks about how having a strong spine, having the ability to break falls by virtue of training your ability to jump down things and step down things with confidence is essential to offset the aging process.

I've decided I'm going to do side planks. I'm going to embrace the spine strengthening exercises that Stu McGill has put forward as the big three, and that includes side planks. So how do you do side planks? Well, most people think that a side plank is just getting on your side, essentially on the floor, then putting one arm down and stacking your feet on the other side and trying to make yourself as stiff as a plank as you possibly can. And while that is certainly one way to do it, most people find that they are going to get the most interlaced

in terms of strengthening their spine and preventing back pain and maybe even alleviating back pain if they build up through a set of incremental steps, making sure that the form on each of the steps is absolutely perfect. So the way to really start doing side planks and

if you think you can already do side planks to assess whether or not you're doing them properly is to start with knees slightly bent. So maybe at about a 30 or 40 degree angle. So you're on your side, your knees are bent, the feet are stacked. You're of course going to push one arm down. Although many people find that putting their hand in a fist as opposed to a flat hand is going to be best.

I don't know if most of you are aware of this, but anytime that we generate a fist in either hand, it sets in motion a number of different neural pathways.

that allow for a firmer contraction of muscles, not just within the fist, but elsewhere in the body. Okay, if you've ever heard the great teachings of Pavel Satsulin, who I hope to have on this podcast as a guest, he's talked about how if you were say to try and squeeze a metal bar, or think about just trying to give your friend the firmest handshake you possibly can, you're having that handshake squeeze competition. If you make a fist with your other hand, you're actually going to be able to generate a harder,

of the shaking hand, okay, of the squeezing hand. And this is because of the way that we have these bilaterally wired nerve to muscle connections and the fact that neural activation on one side is related to neural activation on the other side and so forth. But basically what you're going to do for the side plank in order to generate the strongest and most efficient side plank for strengthening and hopefully de-painting your back is to get on the side, bend those knees, put the hand down in a fist position,

Then you're going to push the hips off the ground so the upper body is indeed in a plank position. Then you're going to raise the hips up and you're going to have to put some considerable effort into pushing the floor away from you. That's really the key here, pushing the floor away from you. Now, if you find that you can do that and you can hold that position for a good eight to 10 seconds with

a strong degree of rigidity, so you're not quaking and you're not feeling as if the hips want to collapse down to the floor, something you really want to avoid, especially if you already have some back pain or even a subtle back injury, you want to make sure that your spine is straight, okay? And that those hips come off the ground and you're really in a plank position, right? No bend. If you find that you can do that and it's fairly straightforward for you, well then,

feel free to then extend your feet out further, put the top foot on top of the other foot and out to the front. Okay, so you're not stacking the feet right on top of one another, we just shoe on top of shoe, but you've got our foot on top of foot if you're doing this barefoot or in socks, but you've got one foot in front of you for some stability. And then you're generating that long side plank pose and holding that for eight to 10 seconds

then pause for 10, maybe 30 seconds if you have to, and then repeat again, all of that part of one set, just as we talked about for the curl up previously.

So you're working through the progression from bent legs to straightening your legs. If the top foot is placed in front of the other foot with legs straight, and that's something that you can do for say anywhere three to five repetitions of those eight to 10 second holds, which make up one set, well then you have the option to make the whole thing more difficult by doing a sort of roll forward where you actually take the part of your shoulders, which is on the side of your free arm. So the hand that is not,

pressing into the floor and you rotate forward so that your chest is now aiming toward the floor, maybe not to a full pushup position, but maybe close. And then back again to the side plank. What you're doing there is you're activating some of the musculature that is for rotation of the spine. Okay. And as you do that, you're getting closer and closer to a front plank.

And of course, front planks are also an excellent way to generate spine stability. Most people can do a front plank by resting on their forearms. Why start with the side plank? Well, there are a lot of different reasons for that. But what you'll realize is that when you're doing a side plank, you're actually only really loading half of the spine maximally. The other half of the spine is not being loaded maximally 'cause it's the side of the spine that's up.

And of course, that's a reason why you want to do these on both sides of your body, right? So what's the sets and repetition scheme that's going to work here? Well, if you're like me and you loathe doing side planks and you find that they do take a lot more effort than perhaps you would like either psychologically or physically, then for me, what I've been doing is

One set consists of three 10 second holds. I've been doing these with knees bent, although I've now progressed to the point where I can do one foot over the other and resting that top foot across the bottom foot. So legs straight, doing that for three 10 second holds to make up one set and doing that for two or three sets on one side of my body, two or three sets on the other side of my body.

So slightly different than as I described for the curl up where it was descending repetitions, where you know, the first set you're doing five, 10 second holds next one, four, 10 second holds next one, three, two, one for the side planks. I don't like them enough that I just prefer to do two or three sets of three, 10 second holds on each side. Although I'm starting to enjoy them just enough that I might progress to the kind of what's called reverse pyramid where you go five, five, four, three, two, one, this sort of thing, increasing the number of sets.

And again, I have a link in the show note captions that shows you how the side planks are done in these different variations. I should mention that the most common mistake with side planks is letting the hips sag. So if you don't push the floor away from you enough, if you're not stable enough through the foot contact with the floor or the leg contact with the floor, if you're doing these with knees bent,

even if you go to like straight and you consider yourself very, very strong in the side plank, if the hips start to sag, you can imagine based on what you now know about back anatomy, right? The spinal cord being this kind of snake-like extension out the back of the brain with the vertebrae as segments and the discs in between them, if that's sagging, well,

especially if you have an issue with a disc bulge and some impingement on one of those nerve roots, either coming into or out of the spinal cord, you're going to get into some trouble, meaning it's going to cause some pain or at least some aggravation. So the goal is to get that spine really straight as you're doing the side planks, regardless of whether or not you're doing that with knees bent or you're doing it

with legs straight. In fact, that's the reason I went through all of that anatomy earlier. So that as you're doing these exercises, whether or not it's the big three or the other protocols I'll talk about, you can really envision the major components of the spine that are getting engaged. It's not just about the abdominals and the obliques and the lower back. Of course, it's about all of that. That's what you're exercising, but you're also getting the neural engagement within the spine. You should think about the vertebral segments,

the discs, the fact that those nerve roots need to run in and out of the spinal cord, out past the bony and disc material, and to do that without impingement. So as you do these movements, it can be very beneficial to think about the different anatomical features of the back, including spinal cord, vertebrae, discs, nerves, et cetera, but mainly those,

And as you're doing that, you'll not just be strengthening your back, you'll also be strengthening your learning of neuroanatomy. So the last of Stu McGill's big three, again, Stu kind of cringes every time people say, okay, it's just McGill's big three and that's back.

strengthening and pain relief. And he always just kind of, oh, I can tell it pains him, no pun intended, because he knows, and it's true that there's a lot more involved in strengthening and pain proofing the back, but always good to have a great place to start, a simple place to start and something that's really tractable without equipment or any cost. And so we're very grateful that Stu was willing to kind of resist his temptation to be beyond nuanced and thorough, which he always is and offer us

the curl up, the side plank, which we've covered. And now the third, which is the bird dog. The bird dog, as some of you may know, is where you get into all fours on the ground. You extend one arm forward and you extend the opposite one leg backward. Okay? So if you're down on all fours and you extend your right hand in front of you,

you're going to extend your left leg behind you. Now, there are a couple of key things about this. One is again, have the extended hand in a fist. Why? Because you want to generate a strong neural contraction so that you don't forget and in fact facilitate keeping your upper body parallel to the floor. So no tilting from side to side as best you can.

And you also want the neural activation to allow you to then engage the lift of the leg in a way that's also very strong and stable. Okay, so nothing floppy, no leaks as they say. A key point is to make sure you don't raise the leg too high. You're not trying to arch your lower back. In fact, what you want to do is raise the hand in front of you, generate that fist. It can even just be out in front of your eyes at first, maybe a little bit higher. And then the leg that's extending toward the back,

feel free to either point the toe toward the ground, or if you want to extend a toe a little bit, like you're doing a little bit of calf raise in the air, pointing your toe that is, that's fine too. But don't get that heel up too high or even the upper thigh up too high that you're getting a really big arch in the back. The idea is to envision one long line between the extended arm and fist,

all the way back across the midline because it's to the opposite leg and to the foot behind you. Again, it's about creating a strong, stable,

a strong, stable lift of the foot, but not too high. And this is very important with the hand that remains planted and the knee that remains planted, pushing the ground away from you. Okay, that's as important as is the lifting of the arm, the clasping of the fist and the raising of the leg. In all of these movements, the pushing of the ground away from you, the resistance to gravity is as important as whatever movement you happen to be doing.

Again, this is a terrific movement for strengthening the spine that most people can do because you're only working one half of the musculature on either side of the spine. Okay, there's of course activation of the musculature on the other side to some degree in order to balance things out.

but by emphasizing only one half of the musculature, A, you can really focus on the contractions. Again, you can really put a lot of mind into the pushing of the floor away. You can put your mind into where the fist is and your foot is. And of course you can generate the kind of hard contractions that are really going to strengthen those lower back muscles, as well as the upper back muscles

and shoulder muscles that are required for generating stability of the spine. Again, that's really what this is all about. Again, it's going to be maybe three to five repetitions of eight to 10 second holds for one set done for repeated sets, maybe for descending number of repetitions where you're going five holds, four holds, three holds, two holds, one hold.

all of that being done repeatedly and with the greatest amount of intensity and focus so that those nerve pathways can be engaged over and over again very easily, generating a lot of strength of contraction that then of course carries over into your exercise activities and even just your passive activities throughout the day and even

stability of the spine while at rest, which is something that we're going to talk about more as we get into some of the other protocols. Now, of course, with the bird dog exercise, you also need to train the opposite side of your body. So after doing say two to five sets of those two to five sets of the bird dog,

of eight to 10 second holds on one side, you're going to want to switch to the other side and do the same thing. Or you could alternate. You could do right hand extended, left leg extended, do one set, then switch to the other side, left hand extended, or I should say left fist extended, right leg extended.

do those repetitions, call that one set, and then shift back to the other side and so on and so forth. Really depends on how much time you have, how frequently you're doing this throughout the week. Again, right now I'm striving to do all of Stu McGill's big three at least once a week, maybe twice a week. I know many of you will say, oh, that's pretty...

"You know, you should be doing this every single day or five times a week." Well, I have a busy schedule just as many of you do. And it's something that I'm trying to incorporate more and more typically at the end of a workout. Although some people decide to do this at the beginning of a workout right now, fortunately, I'm not dealing with any back pain, knock on wood.

But it's something that for many people who have back pain, they find that if they do this at the beginning of a workout, it allows them to then move into the workout warmed up and to avoid a lot of the back pain they would otherwise experience. With that said, I want to be very clear that if any of these movements exacerbate your back pain,

then you should definitely avoid doing them. And of course, if you have back pain, you should be working with a licensed professional to figure out how to treat that back pain. You may very well need pain meds and or surgery. I don't know because I don't know your specific circumstance, but for most people who are just trying to strengthen their back, who perhaps are dealing with a little bit

of nagging back pain, the big three are often very, very accessible, meaning they don't exacerbate back pain. And in many cases, they alleviate it, sometimes partially, sometimes completely. There are a lot of wonderful anecdotes out there of people who have benefited from doing the big three in all of those categories. Now, again, we have a link in the show note captions showing how the bird dog exercise is done. There are a couple of variations that you can do to make it harder. One is to draw boxes with the extended fist and the extended foot.

That's actually a coordination issue too for some people. So some people choose to do a box with their hand, maybe they do it clockwise, then they do it counterclockwise. Some people choose to do the hand and foot moving in a box together, meaning simultaneously. Sometimes they'll alternate foot then hand, this sort of thing. Any kind of movement that you're doing with the extended fist and or foot is going to add some degree of difficulty to this.

but you want to make sure that if you're going to add those movements, those progressions, that you're keeping the pushing away of the floor constant throughout and that you're keeping your torso parallel to the floor as you go. Now, when I say parallel, I realize that as you do an extension of one fist or the other fist, as you kick out that back leg,

it's going to be near impossible for most people to stay perfectly parallel to the floor. What you're trying to do, however, is to make sure that you're not rolling from one side to the next. You're trying to make sure that you don't get tilted onto the stabilizing shoulder hand side. Okay, so that's what's really important. You can also, if you really want to make it difficult, you can start to take the extended hand, fist that is, and reach back and then touch the knee that was a few...

seconds ago extended. So you can do that in kind of a kind of reaching back, touching the knee, then re-extending the leg. You can do that for one side, both sides, et cetera. Again, there are a number of different progressions that I do in the video. I must say these are challenging for me, especially doing more than three sets. After you've contracted your muscles really hard in the way that you're supposed to for these exercises in the big three, you're not going to have the sort of fatigue that you experience after sprinting or after doing heavy deadlifts or something of that sort.

but it's a certain kind of fatigue that prevents you from performing the movements properly. And so the whole point here is to perform the movements properly, to build a pattern, what's sometimes called an engram, but basically it's an activation pattern of nerve to muscle and the resulting limb movements that allow you to do the movements perfectly. So don't be in a big rush to do tons of this stuff right out the gate. Be in a rush to do as much of it as you can perform

properly and consider it a progression and something that you're going to keep up, not just for a week, not just for a year, but it's something that you're going to do for the rest of your life. Even if that means doing it just once a week or once in a while, learn the movements properly. That's the most important thing. And of course, I'd be remiss if I didn't mention the common mistakes that people make when they do the bird dog. One is people often raise that front fist way too high. Okay, as they're reaching for the sky or they're kicking way too high.

They're generating a sort of bow shape from extended fist to extended back foot. That's not good. You really want to raise these things up as stiff, straight levers while also maintaining as much as you can parallel to the floor stance and pushing the floor away. This is about generating strength of contraction. And I know the word sounds bad, but rigidity. It's about generating stiffness

in the spinal muscles and in the abdominal muscles and in the upper back muscles and the other muscles that are required for this. And when I say stiffness, I don't mean a lack of ability for the muscles to move once you're in sport or once you're about your daily activities. What I'm talking about is an ability to generate a really firm muscular contraction so that those nerve pathways are strong so that you can stabilize the spine in any number of different

dimensions and planes and orientations as you embark on your daily activities, sports activities, et cetera. That's what all of this big three stuff is about. It's about strengthening the musculature of the abdominals, of the lower back, of the shoulders and everything that connects it neurally. Again, these are pathways. It's something that I should have said earlier and didn't, which is we often experience pain in a given location, like lower back pain or pain in the lower back and down the hip into the leg. But pain is always the consequence of a pathway

pathway being irritated or a pathway being activated. And in order to strengthen the components around the back, to strengthen the components of the back, to avoid pain, you want to work pathways. And so the big three that Stu McGill has developed is really about generating the kind of muscular strength and stability, the neuromuscular activation patterns,

and doing it in a way that is generally safe for most people to perform to get the strongest and most pain-free back possible. And what I just described might sound like a lot of exercise. It's actually something that if you decide to just include one or two sets of each of those curl-up sets,

side plank bird dog, you could complete in anywhere from five to 10 minutes. Again, if done once a week or twice a week, whereas a warmup before weightlifting or at the end of say a cardiovascular training session, maybe even while watching TV or listening to a podcast or something of that sort, it actually doesn't take that much time at all. And of course it doesn't require any equipment and it can be done essentially work or street clothes. I'd like to take a quick break and acknowledge one of our sponsors, Plunge.

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are big increases in adrenaline, also called epinephrine, and dopamine. So while some people do cold water plunging in pursuit of increasing metabolism or reducing inflammation, it's really those big increases in adrenaline and dopamine that lead to those long-lasting increases in alertness and feelings of well-being, not just in the seconds or minutes after the cold plunge, but indeed for several hours afterwards.

I've been using a plunge for several years now, typically first thing in the morning or after cardiovascular training. I do agree that doing cold water plunging after a workout designed to generate hypertrophy or strength gains is not a good idea, but doing cold plunging at the other times of day can be tremendously beneficial. I use the version of plunge called the All-In Ice Bath, and Plunge Now also makes saunas that get up to 230 degrees Fahrenheit.

I love how the Plunge ice bath and sauna can both be controlled from an app on my phone so that if I'm headed home, I can turn on the sauna and it'll be hot when I arrive. So if you would like to try a Plunge ice bath or sauna, you can go to plunge.com/huberman to get $150 off either product. Again, that's plunge.com/huberman. Okay, so before I get into some of the other protocols for strengthening the back,

which largely center around building strength into the stabilizing muscles and parts of the body that allow the spine to move through different planes of motion safely.

I want to talk about two protocols that one can use to alleviate back pain that many people find beneficial. Now, all of this goes back to this thing about vertebrae, disc vertebrae, right? That's the alternating sequence along the length of the spine. And again, the vertebrae are bony tissue, so it's hard stuff. The discs are a softer, right? It's got some durability to it, but it's a softer tissue.

but it allows for pliability of the spine because it's a soft tissue. So imagine an Oreo cookie, something that I'm not a fan of eating. I don't like the way they taste and I'm told they're probably not good for us. But in any case, if you like Oreos or you don't, it's a good analogy here where you've got the two cookies and the cream center. So the two cookies are analogous to the vertebrae here and the cream center is analogous

to the disc. If you squeeze the cookies evenly from top to bottom, the cream center is going to move out towards all sides along the full circumference, right? So all the white stuff is going to move towards the edges more or less equally. If you squeeze just on one side, right? The cream filling is going to move out toward one side. If you squeeze on the other side, cream filling will move out

toward the other side. And of course, if you were to crush the cookies from top and bottom, or even just the top cookie or the bottom cookie, the cream filling is going to go up and through. That will be equivalent to the rupturing of the disc along that dimension. Okay, why am I mentioning this? Well, as I said before, a lot, not all, but a lot of back pain has to do with compression or impingement of nerves at some point along a pathway, sometimes multiple points along a pathway.

And one of the most common sources of back pain is when those discs are bulging, they're herniating and they're impinging on a fascicle of nerves, a bundle of nerves. So two of the things that many people find beneficial when they're experiencing back pain are first,

If you can find a bar or something that you can hang from, but don't worry, you're not going to have to actually hang in a full dead hang position. If you don't have the strength for that, or even if you do, the idea here is to get your arms overhead onto a bar, you're holding onto the bar and your legs are going to drape down and your toes are going to be in contact with the floor. So we're not talking about a dead hang here, okay? Which actually requires that you engage some muscles that can actually aggravate back pain.

What you're doing here is you're going to hold onto the bar. You're in more or less a hang, except that your toes are supporting you or your feet, or sometimes your heels are supporting you. What you're trying to do is get lengthening of the spine. Basically what you're doing is the opposite of pressing down on those spinal discs. And you're going to do that for anywhere from 10 to 30 seconds.

You're not going to twist, okay? You could imagine how twisting of the spine could be bad depending on where the bulge is and which nerves are being impinged. What you're trying to do is just create length along the spine to relieve some of that disc bulging, which is impinging on the nerves. Again, without knowing the source of your back pain, it's impossible to know whether or not this will help or it won't, but many people get some degree of pain relief by doing this.

you need to be cautious in how you do it. You don't want to hang for a long time if you don't have the strength to do that while trying to find the distance to the floor with your toes, you're going to want to progress toward this very carefully. But this is something that many people find beneficial. It's also the kind of logic behind, you know, inversion tables and,

these kind of look more like kind of chair apparatus where people have designed chairs that then can invert so that people can relieve some of the pressure on their spine. I've personally never tried those inversion chairs. I did used to have an inversion table that I had out on my deck in the morning. And I like to, you know,

lock my ankles in and invert on that thing. It was kind of fun. Keep in mind, if you're going to do any kind of inversion, you are going to generate intracranial pressure. If you're somebody, and I feel obligated to say this because I'm a vision scientist and I worked on glaucoma for a number of years, which is intraocular pressure. If you have glaucoma or you're predisposed to glaucoma, you're going to increase ocular pressure if you're inverted in that way or any way. So keep that in mind. You would want to avoid that in those cases.

But for many people just generating some degree of lengthening of the spine by hanging from a bar or from some other physical object that's sturdy while keeping your toes or your feet or your heels in contact with the floor. So you're just kind of lightly touching there so that you can keep that going for anywhere from 10 to 30 seconds and then just kind of relax, let go.

and you walk around a little bit and then repeat doing that two or three times. Many people experience some degree of pain relief from doing that for all the reasons that now should be logical and obvious to you based on your understanding of spine anatomy and physiology that we talked about earlier, and the general theme of just trying to relieve compression that is herniation of the discs. Now, what about reversing herniation of the discs? Okay, so this is something I'm very familiar with. And I have an anecdote here that of course just relates to my experience. So it certainly doesn't carry over to everybody.

but it's an experience that I've shared with a number of people who've also experienced lower back pain to some degree of success. And the story goes as follows. A few years ago, when I was in Seattle giving a talk, I decided to go to the gym that morning and I did an exercise, which was not a deadlift. It wasn't anything spinal really. It was kind of a reverse bench dip that I do for my triceps. I've always enjoyed doing these. I've always been able to do these completely pain-free, but that morning I got ambitious and I put a couple

plates on my lap in order to do them. And I don't know exactly when it happened, but as I was doing these bench dips with the weight on my lap, something felt like it quote unquote went in my back. Something felt off. I don't know what happened, but it felt like a little kind of like a little pull or something of that sort. And when I stood up, I felt okay. And then as I started to walk around a little bit more and went through my workout, I thought, oh, something happened back there. This is not good.

And what essentially was happening is I was experiencing pain on my kind of lower and mid right side of my back, down the hip. So intense pain at the hip socket and down the leg. You know what some people might describe as classic sciatica or something similar to that.

I thought, oh goodness, this is not good. As the morning progressed, I was having a harder and harder time, not walking, walking was okay, but if I sat down and then I need to stand up, it was incredibly painful. And I thought, oh no.

This is it, I really did something bad to my back. So much so that I was literally bent over at about 20 or 30 degrees walking back to the Space Needle in Seattle 'cause we were giving the talks up in one of the rooms there. I don't know if it was the top room, but one of the rooms at the Space Needle and I could barely walk up to the Space Needle.

I was just hunched over. It was miserable. Now, eventually what happened was I was able to fly home. I was in a ton of pain. I started reaching out to colleagues of mine that work on the back, that understand pain. They were suggesting painkillers. I personally like to avoid taking painkillers unless I have to take them. And I basically don't take them. I might take an aspirin every once in a while, but I really like to avoid taking painkillers. That's just me. I don't judge those that need painkillers.

But basically in talking to medical colleagues, I thought, okay, maybe I'm going to need a corticosterone shot. Maybe I'm going to need to just wait it out and keep in mind that a lot of back pain does relieve itself. If people just wait it out and avoid the movement or movements that caused or exacerbate that back pain, this is something really important to know. A lot of back pain will just relieve over time, but I wanted to stay active.

So I started reading online as one does, and I even started doing some abdominal strengthening exercises. At the time I wasn't aware of the curl up and instead what I was doing was some crunches. So I was doing sit-ups, which you guessed it, made things way, way worse for the obvious reasons. It was actually causing more of bulging of the discs that were impinging on those nerves, bulging out the, I guess it would be the backside of the back, the posterior side of the back.

At the time, I didn't really understand disc anatomy and vertebral anatomy in a way that would tell me that the sit-ups were going to cause that problem, but they were making it worse and worse. Eventually I crossed paths with a PT who said, "Absolutely stop doing any abdominal crunching. Just stop. You're making it much, much worse." He explained to me that the discs were bulging at about the L3, L4 region. You can look up where that is. And then it was impinging on the nerve, which was causing the pain both in the back, at the hip socket, down the leg.

What did he suggest I do? He suggested that I do essentially the opposite of a sit-up.

basically that I lie down on the floor with toes extended, legs together, and then do essentially a pushup while keeping my hips in contact with the floor. So you might think of this kind of as an up dog or a cobra pose in yoga, although not so much extending the head, looking up at the ceiling, but keeping the head in a neutral position and then doing anywhere from eight to 10 repetitions of those, and then holding the final repetition for as long as I could until I started to quake a little bit and then relaxing onto the floor.

What was remarkable is that from the very first set of those that I did, I started to experience some degree of pain relief, not total pain relief, but some degree of pain relief. And what he suggested I do and what of course I did was to do those essentially Cobra pushups or I don't know really what to call them. Again, it's hips in contact with the floor, toes pointed back, legs straight, pushing back.

Essentially what he was having me do was to try and work that disc bulge back into the more vertical alignment of the spinal column. I realize that's not the exact nomenclature, so all you PTs and chiros and physios are probably cringing at this point, but for the common listener, what we were trying to do was get the cream of the Oreo cookie from stopping to squeeze out from the back of, from between those cookies and back under those cookies, so to speak.

And what I found, and this was just remarkable, was that within two, maybe three days, the pain was almost completely gone, almost completely gone, which was to me just staggering. No pain medication. I mean, prior to this, I was thinking, oh goodness, I'm going to need corticosterone injection. I'm going to have to take pain meds. I might even need surgery. I mean, I was completely debilitated. Now, of course, we don't have the control experiment where I didn't do these exercises and I did nothing. So we don't know how fast it would have relieved itself

had I just done nothing. So that's an important caveat to all of this. And again, this is just my experience. But the reason I'm sharing this experience is not because I necessarily think that you should be doing these same exercises to relieve a disc bulge and the pain that results from it, but to give you a sense of how the disc bulging and the impingement on the nerve is very often the cause of back pain. And you want to absolutely avoid doing anything that exacerbates that disc bulge.

So in my case, it meant avoiding doing any crunching because that would send the cream from between the two Oreo cookies further and further out, impinging on the nerve more and more and more, creating more and more pain.

rather to try and push things back by doing a spinal extension, by creating an arch in the lower back, by doing these essentially Cobra pushups from the floor. And when talking with this PT again and telling him, gosh, the back pain is essentially removed. This is amazing. I'm back to exercising, walking, running in the very same week. He said, yes, indeed, some people have so much back pain that they can't even do the Cobra type pushup. They need to

just go to a wall and actually just put their hands on the wall, standing about six inches or so away from the wall, and then just push their hips towards the wall. Okay, yeah, I acknowledge a kind of an odd visual there, but pushing their hips towards the wall while keeping their arms bent and their torso anywhere from six to 12 inches from the wall, and then eventually progressing to being able to do these cobra type pushups or up dogs, whatever you want to call them,

I again will provide a link in the show note captions of how these are done. I found these to be tremendously beneficial, not just when I have back pain, because yes, indeed, a couple of years later, I did something else in the gym. I wasn't training particularly heavy and that same L3, L4 thing,

started again and I started doing these right away and it resolved it right away. Okay, so clearly it works for me. But one of the things that's really been key for me is to understand that I have a propensity for a disc bulge, a herniation in that region. I now know what direction the disc bulge goes. Therefore, which exercises to avoid because they exacerbate that herniation of the discs and which exercises to emphasize because they help alleviate the herniation of that disc.

And this is why a little bit later, I'm going to talk about some of the protocols that you can incorporate into your resistance training, things like posterior chain work, like glute hem raises, Nordic curls, and things of that sort, that if you're like me and you're prone to slight herniation of the discs in the direction towards the posterior side, right? That it's very important to build up the musculature that surrounds those discs

"so that one can avoid herniating them further." So again, this is my experience. You, if you have back pain, I would hope not, but if you have back pain, it might be a herniation toward the anterior side of your spine, right? It might be herniation in the direction of spine flexion, and so therefore you need to do different exercises. The point is that you need to understand what the origin of the pain is

But I also offer this story because I've known several people, one of whom is in my family who experienced back pain, thought they needed to get corticosteroids injections, actually got those injections, got some degree of pain relief, which is not surprising, but then the pain came back.

It turns out they had a herniated disc in the same kind of area and general category of posterior, you know, cream of the cookie going out the back, or towards the back as I did, thought that my anecdote about the herniated disc and these pushups and these wall pushups and pushing one's pelvis towards the wall was kind of goofy and wasn't really medical, but was very interesting is when they then traveled

to Europe, to Scandinavia for the summer, living there, they're Scandinavian, and spoke to a physician there

The instruction from that MD, that physician was not to do corticosterone injections or to get surgery, but you guessed it, to do exactly the same exercises that the PT in the United States suggested to me. Now, why do I raise this? Well, the last thing I want to do is get into a debate online about whether or not one profession like PT or Cairo or MD, et cetera, is better than the other. I realize there's a range of talents. There are mediocre, terrible, bad,

excellent and superb practitioners in all these categories, by the way. That's clear to me and hopefully to everybody else, right? You can't look at an entire field and say good or entire field and say bad. There's going to be a range of quality of practitioners in any of those fields. But when it comes to back pain, we are at an interesting point in history where depending on where you are in the world, depending on the traditions of the medical practice in the area in which you live,

"Certain forms of relieving back pain "are going to be looked at as more esoteric than others." So that's the other reason I offer this anecdote. This family member of mine and a couple friends who've experienced back pain of a similar nature have all now incorporated these Cobra pushups

up dog type approaches to some degree of success or another. It is true that one of them had a badly enough herniated disc that they did need surgery. So surgery sometimes is needed, of course, but it's been remarkable to me to see how much I and others can relieve their back pain and strengthen the particular areas and aspects

of the body that then can avoid further back pain. And I'm quite happy to say that I've had essentially zero back pain now that I've incorporated the right rehabilitative exercises, as well as the right strengthening exercises, which include the big three that we talked about before and the ones I'm going to talk about next.

next. I realized that when a lot of people hear about back pain, they immediately think of sciatica and as somebody who's always carried his wallet in his back right pocket, I'm often told, Hey, you're going to get sciatica if you carry your wallet in your back right pocket. Well, I always take my wallet and put it in my front right pocket when I sit down, or at least I try to remember to. So I don't think that's the cause. I'm certainly somebody who's had quote unquote sciatica.

Now, sciatica is most commonly thought of as tingling, pain, or numbness, or some combination of the three, and maybe a little bit in the lower back, in the glute region, in the hip, and down the leg especially. Now, relieving sciatica,

involves a number of different approaches. And I'll probably have to do an entire episode about sciatica and other nerve pathway pain specifically. But for the time being, a lot of sciatica is caused by exactly the sorts of things that we're talking about thus far, the herniation of the disc, the bulging of the disc and the impingement

on the nerve, and when that bulging, aka herniation, is occurring within the lower lumbar region of the spine, oftentimes it will impinge on a nerve or nerves that innervate the various regions I just described. So the glutes, the hip, down the leg, and sometimes will activate pain, tingling, or numbness in areas.

are not innervated by that nerve. There's something called referred pain where you're experiencing pain in one part of the body due to an impingement or disruption of a neural pathway or other pathway or inflammation elsewhere in the body. So we're not going to do a deep dive on sciatica right now. Suffice to say that a lot of the symptoms of sciatica fall under the umbrella of what we're talking about today, which is back pain and strengthening the back in a way that can help you avoid back pain and indeed sciatica as well.

Much of what I just spoke about in terms of my own experience with lower back pain could be thought of as sciatica because there was a lot of pain in the hip. I almost felt as if the hip socket was in pain and there was some pain, not shooting down the leg, but kind of in the outer uppermost thigh for me. Some people experience it all the way down to their toes, even numbness, tingling, or pain within the foot. So it really depends on the degree to which those neural pathways are impinged. But the principles are the same, which are,

if you are experiencing lower back or related pain in the hip, the leg, the buttocks, et cetera, you really want to figure out, is there a bulging also called a herniated disc? If so, which direction is the herniation likely occurring? Is it out toward the back of the spine? Is it on one side? You really want to understand where that herniation and bulging is occurring so that you can do the proper exercises to work that bulging, to push essentially what I'm referring to in analogy

as the pushing back of the cream between the two Oreo cookies back between those two Oreo cookies so that you can give some relief from the impingement on those nerve roots that are no doubt causing the flare up of back pain or what some people experience and call sciatica. Okay, so thus far, we've largely been talking about different structural features of the back, things like vertebrae, which are bony, the discs, et cetera, that can impinge on nerves and cause pain. And while pain is certainly neural,

There are a number of things that exist from literally toe to head that allow our back to move through the various planes of motion in the ways it needs to, to carry out daily living, to carry out sport. And that if we strengthen certain things, even very distal, very far from the spine,

we can allow for more mobility of the spine, strengthening the spine and indeed even pain relief within the spinal pathways. Now the protocols we're about to discuss were shared with me with Dr. Sean Wheeler. Sean Wheeler is a medical doctor who has an incredible knowledge of back pain, back relief and back strengthening.

By no means can I exhaustively cover all of the knowledge that he shared with the world. I'll provide links to some of his work in the show note captions. I intend to bring him onto the podcast as a guest, but the hallmark of the protocols I'm about to share with you is the following. We have muscles that are constantly actively engaged

in order to stabilize our spine, which again is a good thing. You want a stable spine. And we have muscles that are not actively engaged, but for which we can engage them either voluntarily or we can train them to be more engaged when we're not thinking about it. So involuntary engagement.

But we have an entire set of musculature that is constantly actively engaged in order to stabilize our spine, which again is a good thing. And we have musculature that can potentially stabilize our spine if we focus on it, if we consciously decide to. So what I'm about to describe are some simple protocols. In fact, very simple protocols that you can do in order to create more spine stability. And in fact, you can do these anywhere. The first involves strengthening the muscles in the front of the neck.

Now, this is something that I do believe most everybody should be doing anyway. Why? Well, most people nowadays are starting to take on a C shape, not just rounding of the lower spine, but the chin is starting to move toward the chest. And of course, this is because most everybody is texting or on a laptop much of the time. Okay, this is not an exaggeration. If you look at people walking around now, they are tilted forward at the chin.

They are essentially taking an inch or two off their height. They are potentially creating pain elsewhere in the body, maybe even in the neck itself.

And what I'm about to describe is a way in which you can very easily strengthen the muscles in the front of the neck without adding size to the neck, because I know a lot of people don't want to add size to their neck. I've talked elsewhere about strengthening the muscles on the side of the neck and in the back of the neck. This is something that I do believe is important, especially for people that are doing a lot of heavy weightlifting who are broadening their shoulders or who already have broad shoulders. Also just from a sheer aesthetic perspective, nothing looks weirder than a little head and neck placed on broad shoulders, okay?

But more importantly than any aesthetic matters is that if the musculature of the neck is weak, you have a weak upper spine, which is not a good thing from the perspective of avoiding pain and not a good thing from the perspective of safety, let alone posture, breathing, et cetera. I've talked about that elsewhere. I'll provide a link in the show note captions to some of the simpler exercises for strengthening the neck that you can do without equipment. In the meantime, for sake of strengthening and pain-proofing the back,

It's very clear that strengthening the muscles of the front of the neck can be very beneficial. This is something that not just Dr. Wheeler, but also Stuart McGill have been proponents of. And the simplest way to do this without any equipment is to simply put your fists underneath your, not your chin, but on the two sides of your jaw. So on either side of your chin, if you're just listening, that's where my voice is going like this. And then with your tongue on the roof of your mouth,

and breathing through your nose, you're just going to do a 10 second static contraction where you're going to try and move your chin down against the resistance of your fists underneath your jaw, okay? So you're going to go push down there. Again, tongue on the roof of your mouth. Feel free to exhale as you do this. You might want to do this for three or four repetitions of 10 second static contractions, and then just relax.

You could do that for anywhere from two to five sets. Very easy to do. What you're doing is you're generating strength in the muscles of the front of the neck and some nearby musculature. It has the tendency to then put you into a default position at a distance from your chest, okay? So this is different than strengthening the muscles on the back of your neck, which will of course help to keep your chin out and away from your chest. But when one does this, there are a number of different benefits, improved airway passage,

So as many of you know, I'm a big proponent of nasal breathing, unless you need to breathe through your mouth, both during sleep and sometimes during exercise, but certainly at rest. So strengthening the muscles of the front of the neck. Again, I'll provide a link to this in the show note captions. Very easy to do. It takes barely any time. You can do it anywhere. And it has a number of different benefits for strengthening and pain-proofing the spine.

Next is to focus on strength of your feet and your toes. Yes, you heard me correctly. Why are we talking about feet and toes when we're talking about back strengthening and alleviating back pain? Well, your feet are the foundation of your entire body. They're carrying you around all day long. And it's very clear that the stronger your feet are,

the healthier the rest of your body is going to be. It's not to say that the rest of your body will be healthy if you just focus on foot strength, that's certainly not the case, but strengthening your feet has many, many benefits. It's something that I've been focusing a lot on in the last couple of years, and it's made a huge difference in terms of eliminating shin splints when I run. It's made a huge difference in terms of alleviating a certain amount of lower back pain, although you heard the anecdote about how I largely did that through other mechanisms earlier.

Basically, strengthening your feet is an all-around terrific thing to do. How do you do this? Well, some people opt to get very wide toe box shoes. Some people will even run in those shoes where the individual toes look like they're in a glove. I don't own those shoes. I do have a slightly wider toe box shoe for running and I've really benefited from that.

Basically what anyone can do, and you don't need to purchase any shoes or anything like that, is to try and see if you can spread your toes out from one another so that none of them are touching on both feet. Many people find that they are able to do that. Some people, including myself, found that they could do that on one foot, not the other. And it just took a couple of weeks of working at it

and strengthening those neural pathways, learning how to activate those neural pathways through concentration to be able to spread my toes on both feet. This might sound a little silly to some of you, but being able to spread your toes on both feet actually says a lot about your ability to activate distal neural pathways, or I should say neural pathways to distal parts of your body. There's a bunch of interesting data about how that correlates with some

of aging or lack of aging. I'm going to cover that in a future podcast, but some people find that they can't spread their toes out and they need a little bit of help from toe spreaders. Yes, there are commercially available toe spreaders that take the form of these kind of stocks that you can put between your toes. These are rubber stocks that then spread the toes. It can be a little bit uncomfortable at first, but then you get better at it, help you learn to spread your toes.

You certainly don't need those things. You could even just take some paper towel or tissue paper or something of that that's firm and put it between your toes. And that will help you learn to spread your toes. I'm not suggesting you walk around all day with toe spreaders, although some people actually do that. But basically what you're doing is you're creating the ability to activate the neural pathways that allow you, excuse me, to spread your toes. I know this might sound silly, but if you do this, you're going to find that you're walking, you're

when you're stationary. And certainly if you do any kind of running or cycling, you're going to find that all of those things are going to benefit. In addition, there is benefit to strengthening your toes. This is something that I'm only now starting to explore. One way you can do this is by sitting in a chair barefoot

spreading your toes as much as possible, and then seeing whether or not you can lift each toe independently. I'm not at the point where I can do that yet. I'm still trying to learn how to lift my big toes independent of my other toes. Again, all of this is learning how to activate neural pathways to distal parts of your body that serve as stabilizers for

the arch of the foot, for the foot itself, for the ankle, for the shin that carry over to spine stability and a strong spine. I know it seems kind of wild that we're talking about the feet and toe spreading to benefit your back, but all of these things relate to one another up and down the chain of activation involved in walking, in running, and certainly if you're involved in any other sports, but also just standing around.

Don't underestimate the power of learning to spread your toes and learning to move your toes independently. And then of course, there's a whole set of exercises that you can find online of how to actually strengthen the individual toes with bands and things of that sort, pretty advanced stuff. Most people aren't going to do that, but if you're willing to explore that stuff, it's clear that there are a lot of benefits. And again, there's some exciting literature starting to emerge about the benefits of

of toe strengthening and toe spreading and all that stuff as it relates to, believe it or not, neurocognitive longevity. I know it sounds wild, but this is actually a literature that's starting to pick up some weight. So it's one that I'm paying attention to.

and that I'm certainly going to cover in a future podcast. Okay, so we've got strengthening the neck, we've got toe spreading at a minimum, making sure that you can spread all your toes, move them independently, that would be great. What's that going to do? That means that when you're standing at rest, that you're creating a stable base for yourself when you're walking, when you're running, and certainly when you're lifting or you're playing any sports,

you're creating the most stable base for yourself possible. When I say stable base, I don't just mean because the toes are spread. I mean, because if you can activate the musculature to spread those toes, or if they're passively in that spread toe position, not touching one another, you're going to be activating some of the musculature that's

I guess for the typical person, we would think of this as in the arch of the foot and the top of the foot and running up to the front of the shin, that's going to create the most stability for your lower limbs, your upper limbs, your pelvis, and your spine. Okay? Now in discussions with Dr. Wheeler and discussions with Dr. Starrett and discussions with Dr. Stu McGill, all of them really emphasize that when doing resistance training,

that bracing the body by essentially not doing a big belly breath, but filling the body with air so that you essentially create a firmness within the abdominal walls and the spinal erectors and the obliques. So this would be essential in a squat type movement or other types of movements. That's beneficial during resistance exercise to create the most stable canister of you, the most stable movement

of the musculature around the spine to avoid injury and also to lift the greatest amount of weight. There's a number of different mechanical advantages and safety advantages that are afforded when we do that. This was also something that I discussed with Dr. Andy Galpin when he did his series on exercise physiology with us. Again, you'll find a link to that in the show note captions.

Now that bracing, that filling of the body with air and that bracing of the abdominals and the musculature, essentially that runs like a belt around the midsection to make yourself strong and stable during those movements, that's all fine and good. But it turns out that when we're at rest, when we're just standing around, we actually want to do the opposite. We actually want to relax that musculature and belly breathe.

Now I've done an entire episode about breathing and the difference between belly breathing versus breathing where the chest lifts or a combination of both, but we can keep this very simple. You can do yourself a great favor by trying to remember that when you're at rest, you're just standing around, maybe you're seated or standing and working or you're talking or something of that sort that you're ideally nasal breathing, unless you're speaking or eating or something of that sort, and you are belly breathing. Okay? So you're actually relaxing the abdominals as you inhale.

and the belly is moving out. And then as you exhale, the belly moves in. So that's the ideal pattern when at rest, the exact opposite of the pattern that you want when you're actively engaging all that musculature for sake of exercise and stability, especially when you're engaging in weight training under loads. So that places us at strength in the front of the neck, toe spreading and strengthening of the feet, belly breathing at rest,

And then there's a kind of fun one that's something that I've been incorporating a lot because frankly, I'm not a big fan of doing abdominal work. It's just not something that I really enjoy doing in the gym or elsewhere, but I know that it's important to have a strong abdominal wall. It's important to have

strong abdominals generally. And yes, occasionally I'll grab onto a bar and I'll do a set of pikes. I actually enjoy pikes, you know, bring my ankles up to my hands and doing that, trying to stop there, doing L-sits, things like that. I'll do those every once in a while, but what I've found to be very beneficial and that is more kind of real world related in the sense that it activates the musculature of the abdominals. You can train your abdominals while doing things that more closely mimic what you do in real life.

is to actually stagger one's stance while doing certain forms of resistance training. Okay, so not during deadlifts, not during squats or anything of that sort, but let's say during dumbbell curls for the biceps, rather than stand with feet parallel,

standing with one foot in front of the other, making sure that they are wide enough apart in the lateral plane, as we'll call it. Okay. So far enough away on either side of your belly button so that you're stable, little bend in the knees, and then making sure that your belly button is still facing directly forward. This is really key, not twisting the torso, but making sure that your belly button is facing directly forward and doing curls, one arm, then the other arm, one arm, then the other arm, then switching

to a stance in which the other foot goes forward and the other foot goes back. Again, make sure that you're not in a cross-country skier position with the feet very close to your midline.

because if they are, you're not going to be stable. So make sure that they're far enough away from your belly button on either side, that there's a bend in your knees so that you're stable and then doing curls that way. You could also do this for any kind of triceps exercise, like an overhead triceps extension. Those are mainly the exercises in which one could apply this, although there are a few others, maybe for back work, maybe for shoulder work, although I think parallel stance is probably best for that and certainly for leg work.

So what are you doing if you do curls or overhead triceps extension in this way with one foot forward than the other foot forward? What are you doing?

deliberately insist, meaning force yourself to keep your belly button facing exactly forward. And for that reason, sometimes it's helpful to do these in front of a mirror. What you're doing is you're generating anti-rotational forces. You're requiring that your upper body not twist while you're lifting these loads. And what that does is it trains the obliques, it trains components of your abdominals, and to some extent it's training components of your lower back, although not so much.

as it is the obliques to the abdominals that are anti-rotation, that are preventing your body from twisting while you're carrying out these movements. And in doing so, you're also mimicking the way that a lot of movements are carried out in daily life. Because if you think about it,

it's pretty uncommon that you're going to be lifting things with one arm with feet parallel. I mean, it happens, okay? There are times when feet are parallel and we're lifting something up with both hands. There are times in which you do something similar to kind of the stance that you would be in for a dumbbell curl, you know, with feet parallel in the gym or a tricep extensions with feet parallel. But more often than not, as we move through life, one or the other feet is positioned in front of the other. And, you know, we're reaching for something or lifting something, or we're pulling something.

Those are the patterns that exist more typically in daily life. And those are the patterns of movement that typically

hurt themselves while doing. You know, they reach down to get something out of a cabinet, they'll reach into the back and they'll twist a bit to grab something in the back and that's when their back will go. Or they're reaching overhead to grab something and they're twisting as they reach with one arm. So I've certainly found, and this was supported by, again, all of the experts that I spoke to, that staggering one stance while performing resistance training, typically curls or overhead tricep extensions, and there aren't many other things that lend themselves well to this. So those are the two that I'm really focusing on.

Doing that while insisting, that is forcing yourself to keep your belly buttons facing completely forward. Okay, not tilting to the side either way.

that can really help strengthen the abdominals through the use of what's called anti-rotation. This is also what you're going to experience if you ever take a yoga class and you do a pose where it's arms overhead, like a warrior two pose or a warrior one pose, and they'll say, make sure that your belly button is facing completely forward, that you're not twisting to the side too much. This is also what the instructor will tell you in a Pilates or a yoga class very often in certain movements where there's a tendency to kind of

relax or sag into a twisted upper torso. Of course, there's some yoga and Pilates movements that require that you twist your upper torso, but that's not what we're talking about here. This is when they tell you, keep your belly button facing forward. You're generating anti-rotation forces, not just of the abdominals, but

as the abdominals connect to the pelvis. And of course, all of that is providing stability for the spine. And then if you run down the legs in your mind, that is, and you think about your feet with those nice spread toes and the activated musculature on the base and the top of your feet and running up the front of your shin and your calves, you can really imagine how you're creating the most stable positioning on the floor, stable positioning of the spine. No wonder that the spine is not only going to experience less tension,

shearing stress, less pain, but you're also in a position to create a nice strong chain of activation from the nerves and muscles from the base of the floor all the way up to your neck because you're already strengthening your neck. Okay, so in terms of protocols, thus far we've covered Stu McGill's big three,

Then we talked a little bit about things you can do to relieve pain. So this was the hanging from a bar with the toes touching the ground, right? As well as the kind of up dog or cobra exercises. And then we talked about five or six things that one can do, including strengthening the neck, spreading the toes, strengthening the feet, et cetera, in order to generate strength and stability distal to the back and thereby to strengthen and pain-proof the back. Now we're going to cover four final protocols

to strengthen your back, pain-proof your back, and allow you the greatest degree of mobility, both for sake of mobility during exercise and in daily living. The first of those four protocols is going to be to activate and strengthen, and in some cases, de-spasm the medial glute, which is a muscle that most people don't think about. The medial glute is involved in stabilizing the hips as you walk, as you run, okay? So it's going to prevent the pelvis from moving from side to side.

It's one that when it weakens or when you have trouble activating it can lead to some forms of what is perceived as lower back pain. So if you reach to your lower back and you feel these kind of like two kind of like almost like nodules at the top of your pelvis, a lot of people will experience pain in and around that region, or maybe even as a kind of a, like a belt of pain around that area more or less.

And in some, not all cases, but in some cases that's due to lack of medial glute activation, or in some cases it's due to spasming of musculature in that region. It's really hard to tell unless you're being assessed by an expert, which one it is. Again, that's not what we're here to do. What I am here to do is to provide you a protocol that I've found to be tremendously beneficial for relieving the sort of lower low back pain and the

kind of pain that even extends into the top of the glutes that many people experience, especially if you've been sitting a lot, if you've been driving a lot, flying a lot, if you find yourself doing a lot of hip hinging exercise like squats,

and then you travel. So you're sitting on a plane for a while and you don't pay mind to really stay in a flat back or arched back position. By the way, if you're somebody who has disc bulging in that direction that we talked about before and can benefit from doing those Cobra poses or kind of up dog pushups, if you travel or drive or you're seated a lot for work,

I and many others find it really beneficial to just take a towel and just roll it up and put it so you maintain the arch in your lower back so you're not rounding in your seat. That can be really useful and it makes perfect sense if you think about it, given what we were talking about before with the squeezing out of the cream of the Oreo cookie in that direction, you want to make sure that you're not rounding your lower back too much, keeping it straight or a little bit arched is going to be beneficial. Not overly arched, but straight or a little bit arched in a, you know, a

rolled up towel or something of that sort that you can put in your lower back can really be helpful for that. Now, the protocol here is to essentially activate and de-spasm the medial glute. This is actually a protocol that I learned from Jeff Cavaliere long before I ever met him or he was on the podcast, which he's been on the podcast. Jeff Cavaliere has a YouTube channel called AthleanX, which has tons of zero cost protocols.

for resistance training, for cardiovascular training. He just provides so much useful information. Again, zero cost. I've actually paid for his programs. No, he didn't ask me to say that. He doesn't pay me to say that. Over the years, I've paid to use various programs from AthleanX and they've benefited me tremendously. I've customized them a bit for myself. But in any case,

Love the work he does. Grateful to call him a friend. Extremely grateful that he was a guest on this podcast. We'll provide a link to the episode that he did talking about exercise and exercise physiology and nutrition.

in the show note captions. In any event, the protocol here is to activate and in some cases, de-spasm the medial glutes, which can be done in a very straightforward way where you lie on your side, essentially like you were going to do a side plank. So you've got your elbow and your forearm on the ground, making that fist.

Imagine you'd go into a side plank, except no, you're going to keep the lower leg, the leg that's in contact with the floor against the floor. You're going to take the leg that's on top. You're going to point the toe down. Okay, so you're not bridging up into a side plank. You're just resting on the floor on your side. You take that top leg, point the toe down. You bring that toe out in front of you, touch it to the floor, and then you're going to bring your heel back

You're going to extend it, not overextend it, but extend it as far as you can with your heel pointed toward the back wall and up towards the ceiling. So you're trying to maintain that downward pointed toe position.

Okay, then you're going to lower it again, touch, bring it all the way back up. You're going to do that for maybe five to 10 repetitions. And then on the final repetition, you're going to hold it there in that raised position, not as long as you can, but probably anywhere from 10 to 20 seconds, depending on how much strength you have in your medial glutes to be able to do that. And if you like, you can also take your,

on the side of the foot that you're raising. Okay, so if you're lying on your left side, you're going to take your right hand and you're going to take your thumb and put it right at the top of your glutes. And you'll feel when the leg is fully extended back with the heel towards the back wall and ceiling, you'll feel the muscle activate there and you can kind of push against it. What are you doing when you do this? You're activating the medial glute

you're in some cases de-spasming the medial glute and some of the musculature around there. And many people find that they get considerable pain relief of that low, low back region when they do this exercise. You of course would want to switch to the other side, even if you're not experiencing pain on the other side and do the same thing for the opposite side. So lying on your right hand side,

taking then your left leg, pointing the toe down, putting in front of you, bringing it back, doing multiple repetitions of that, and then holding it in a static hold while feeling that medial glute get activated and then taking some rest.

This is the sort of thing that you can do if you're experiencing low, low back pain to see if it provides some relief. Many people find it does provide that relief. If of course it exacerbates your pain, please stop doing it. You never want to exacerbate pain in any kind of way. But many people find that it relieves the pain in that low, low back region.

And it does so not just during the exercise, but in the minutes and hours following. You may need to repeat this a couple times per day. You may need to adjust your other activities, including exercise. It really depends on the severity of your back pain and injury, the nature of it, et cetera. However,

It's something that many people, including I, also include in our regular routines. I'll sometimes do this as part of a warmup on leg day. I'll sometimes do this just while watching TV or something, which I don't do terribly often, but I'll just take a couple of minutes, literally just two minutes or three minutes, and I'll do a couple sets of these on either side just to maintain that neuromuscular activation of the medial glute. Some people, I would say most people, are not very good at activating that medial glute region. If you're somebody who is being,

and doing a lot of posterior chain work, such as kettlebell swings on a regular basis. You're doing glute ham raises, which I'm a huge fan of. I'll do an entire video about posterior chain and why I'm such a big fan of glute ham raises. Unfortunately, you need a specialized piece of equipment to do them.

or nordic curls such a big fan of nordic curls glute ham raises etc for all sorts of reasons strengthening the back strengthening the posterior chain making sure you can still generate power in the pelvic region lower back region while maintaining posture especially as you age all of that i'll talk more about those in a future episode of the huberman lab podcast but the point is this many people just fail to get activation of the glutes in a way that supports their lower back and

allows them to strengthen their back to the extent that they would otherwise. And much of the time, it's not just a failure to activate the glutes because of course there are many ways to activate the glutes. There are all sorts of exercises you can read about online, but a failure to activate the medial glute muscles in particular that people need to overcome by strengthening those nerve to muscle pathways.

And of course, I'm talking about activation of the medial glutes and de-spasming of the medial glute, which is really what happens when you hold that medial glute contraction for some period of time, then afterwards, you allow some relaxation in those neural pathways.

that is often, again, not always, but often the cause of that low, low back pain. So if you have low, low back pain and it's safe for you to perform this exercise, I encourage you to give it a try. Again, it requires no equipment. It's very easy, takes almost no time. And at least for me and many others that I've spoken to, it has been tremendously helpful in relieving that lower back pain by de-spasming the medial glute. And at the same time,

allowing for nerve to muscle activation of the medial glutes such that the medial glutes can be active when they need to in order to stabilize the pelvis and allow for the strongest possible pelvic spine interface. Okay, so the next protocol is one that you can do essentially anywhere. It takes almost no time and it's a wonderful one because it allows for stretching of the psoas muscle, right? The muscle that is...

easy to say and hard to spell, psoas. It's P-S-O-A-S, right? I think the P is generally silent. You'd say psoas muscle. The psoas muscle is involved in connecting the spine to the pelvis, okay? It also has an interaction with the diaphragm that's really important, this muscle that's important for breathing. And many people have tightening of the psoas, tightening of the hip flexors, but being able to stretch the psoas muscle

is something that provides a ton of relief to the tightness that one can experience from sitting too much, from being in a hip hinge position too much, especially if you're doing heavy hip hinge work and then you're sitting or driving a lot.

And many people also just carry a lot of stress in their midsection and relieving or stretching the psoas can be very beneficial. Okay, there's a lot about this that could be said. In fact, I'll probably do an entire episode about psoas and fascia. Okay, I know there's a lot of requests to talk about fascia, but it's far too much to get into now. Here's the protocol that I do believe everyone can benefit from. I don't care how bendy you are, how rigid you are, how big you are, how live you are, how slim you are.

This is a wonderful exercise. It just feels so good. And it allows you to afterwards be in a long spine posture to really feel opened up at the hips, if you will. Now I'm using yoga type language, but I think you understand what I mean. And it is a great stress reliever as well, which is essentially to do what looks like a warrior two position in yoga. So you're essentially doing a lunge, okay, where you're going to lunge with one leg back,

and the other leg forward, of course, that's a lunge. And then you're going to take the hand on the same side as the leg that's extended behind you, reach that toward the ceiling, okay? And then you're going to rotate pinky

The other way to think about this is to put the palm of your hand parallel to the ceiling. If you're doing it outside, parallel to the sky. So you're going to get into the longest lunge that you safely can for you. That's going to differ for everybody. And then you're going to raise the arm on the same side as the leg that's extended backward. And you're going to go parallel palm to the sky or to the ceiling.

This will provide a stretch all the way, or you should feel a stretch all the way from your wrist down past your hip and possibly even into the foot that's behind you. Now, Dr. Stuart McGill showed me this. I've certainly done Warrior II pose in yoga classes and when I've done yoga at home from time to time. I wasn't new to raising an arm overhead while stretching in a lunge position, but this,

Dr. Sue McGill was the one who really emphasized that by putting the palm parallel to the sky, to the ceiling, and twisting a bit so that you're turning that pinky toward, I would say, the best way to describe this is to turn that pinky toward your head, okay, not away from your head, but toward your head, while still maintaining a flat palm and reaching as much as you can and extending all the way from,

the heel of that back foot all the way up to your palm, that you're getting stretching not just of the psoas, but that you're also getting activation of some of the neural fascial aspects going from palm all the way to heel that provide some relief, that is some relaxation of the musculature that otherwise is providing tension of the spine pelvic interface.

and that can allow for better posture, longer spine, and at the same time, strong spine positioning

after you do the exercise. And of course you want to do this on both sides. Now I realize that many of you are just listening to this. You're not watching this, but even for those of you that are watching on YouTube, it's very difficult since I'm seated behind a desk to show you the proper form of this exercise, which is why we've provided a link to a visual of this exercise in the show note captions that you can go look at otherwise. But hopefully it's clear to you. It's basically a lunge, front leg slightly bent at the knee, back leg,

perhaps slightly bent, but extended behind you. So you're in a lunge position, arm on the same side as the extended leg raised overhead, palm parallel to the ceiling, okay, with arm extended and turning your wrist a bit so that your pinky is more or less trying to point towards your head. Although most people, including myself, probably don't have the flexibility to do that.

all the way so that your pinky is pointed towards your head. I encourage you to experiment with this a little bit until you feel that stretch all the way from hand down to heel. It feels really good to do. You can hold it for anywhere from five to 10 seconds. You can exhale or inhale. It doesn't really matter. You can just breathe normally. The point here is that you're getting a terrific stretch of the psoas. You then switch to the other side, get a terrific stretch of the other side psoas.

And after you move out of this pose, you will definitely feel as if you sort of have quote unquote lengthen the spine. You know, the extent to which you have lengthened the spine isn't clear. What more likely has happened is that you have some relaxation and perhaps even some lengthening between the spine and pelvic

so then you can sit upright, nice straight spine, and you're not being pulled forward by that tightened psoas that connects the spine to the pelvis. Okay, so that's sort of the simplest way that I can describe all that. It's a wonderful exercise to do. You can do it in an airport. You can do it when you get home. You can do it when you get out of the car. It's one of those things that provides a ton of relief in terms of kind of stress and compression and C-shaping of the spine from sitting that most all of us are doing too much of these days.

And as Dr. Stu McGill will explain when he comes on the podcast, it also provides some both activation and relaxation of the nerve to fascial to muscle interface that's so critical for having a strong and pain-free spine. Okay, so the final protocol I want to share with you today

believe it or not, is purely mental. It's purely cognitive. It doesn't involve any movement. What it does involve is developing an awareness of your movement patterns as you move through your daily life, including exercise, but not limited to exercise. What do I mean by this?

Based on what I told you at the beginning of today's episode and throughout today's episode, you are now armed with knowledge about the different components of back anatomy, the vertebrae, the discs, the nerves, the muscles, and how those relate to one another and how bulging that is herniating of the discs, or I would hope not, but even rupturing of the discs or inflammation in a particular spinal segment

or maybe tonic static contraction at the level of the neck or lack of strength in the feet, how that could create back pain, how that could limit back mobility, how that could limit overall mobility. So the final protocol of today's episode is for you to really pay attention to any pain you might happen to have in your back region and any kind of

limitation you have in terms of its ability to manage loads or to generate the kinds of movement that you need for your life. What do I mean by this? Well, if you're somebody who has a lot of lower back stiffness, lower back pain, you might ask yourself, okay, when I drive, when I sit, even if I use a standing desk, what is the position of my feet? Are they directly underneath my pelvis? Am I rounding my back? If you're somebody who has a lot of pain in your low to mid back,

and you find just by way of observation that you're rounding your back a lot of the time, either because you're texting or typing, maybe you need to take a towel and roll it up and put it in your lower back region. Maybe you need to just spend a little bit more time each day, not all day, but a little bit of time being consciously aware of maintaining a little bit of lower back arch, or maybe even a straight back if you can't arch your back in that way.

If you're somebody who's standing at your standing desk or even just talking to friends or family members, do you always lean to one side? Do you always relax to one hip? Is that because you're not activating the medial glute on one side more than the other or either? Or is it because you tend to stand with one foot in front of the other or you're not maintaining enough toe spread or you don't have the strength in your feet to kind of stabilize yourself?

with your breathing and letting your belly go out when you're not exercising. These are the sorts of things that once you start to observe, and by the way, you don't have to become neurotically self-observant all the time about your back and your breathing and your foot position. That's not what we want. Okay, that is absolutely not the goal here. But if you're experiencing back tightness or shoulder tightness,

You should ask yourself, are you constantly like thumbs pointed in, shoulders rolled forward? Are you doing enough pulling exercises to balance out all the pushing exercises you might be doing like pushups and shoulder presses and bench presses? Make sure you're balancing the back musculature and the shoulder and chest musculature. These kinds of things are extremely valuable to pay attention to because oftentimes the origin of your back pain or the origin of your

sciatica or the origin of your neck pain and tension is something that can be fairly simply remedied. It doesn't necessarily mean you have an injury. Maybe you have a small degree of disc bulging. And if so, what direction is that bulging? Is it toward the front of your spine, the side? Is it toward the back? And if so, what are you going to do to adjust it? Are you going to do, you know, one or two sets of those Cobra pushups each day? Are you going to put that, you know, towel rolled up behind your back?

in order to make sure that that bulge doesn't increase further? Are you going to avoid doing a lot of crunching in the gym? Many of you are going to need to avoid doing crunching and finding other ab exercises like the roll-up to do in order to still strengthen your abdominals, which is so important for stabilizing the spine and having a strong pain-free back, but you don't want to generate more forward rolling and bulging of the discs out the back of the spine for all the reasons that are now obvious to you. So this final protocol is one that I could go on

for hours about, but really it's for you to think about for just a couple of minutes for a couple of days. And just pay attention to your movement patterns, how you stand at rest, how you breathe at rest,

whether or not you're using best possible posture or whether or not you're using postures and patterns of overuse in your daily life and in sport, these things can really build up some strong imbalances in neuromuscular activation patterns that over time can translate into pain. And even if they don't translate into pain, can translate into a weakened back system or put more appropriately, a weakened body system.

where you're always sagging one shoulder or you're not breathing properly because your chin is always towards your chest, these kinds of things. Now, today's episode is certainly not geared towards fixing every aspect of your posture, your movement patterns, strengthening your back and removing your back pain. However, I will say that thanks to the information that's out there from the peer-reviewed literature and from these fabulous practitioners, again, MDs, PTs,

Folks, even in the chiropractic community, I say even because oftentimes they take a lot of heat from people in the other communities. But again, there's a range of quality of practitioners in all these different domains. They've really started to explore these different aspects of back strengthening and removing pain from the back.

in ways that, sure, they come to the table through different lenses of training, right? Some are going to talk about laser therapy. And by the way, we didn't cover that on purpose. There's a little bit of evidence, but it's not super strong for laser therapy for the back. Okay, there, I just upset all the people who are into laser therapy. We'll get into that in a future episode. Sure, there's evidence that Pilates, that yoga, walking has been shown to be tremendously beneficial for back pain. There's wonderful evidence for any and all of those different practices, right?

What I've tried to focus on today were protocols that practitioners who spend most, if not all of their careers thinking about strengthening the back and pain-proofing the back generally agree on. Okay, I realize there isn't going to be universal consensus, but they generally agree that Stu McGill's big three, the curl up, the side plank, the bird dog,

They generally agree that strengthening the stabilization muscles and pathways from feet up to hips and all the way to shoulders and top of the head, including the neck, including breathing in a particular way while relaxed, while not exercising. Again, those would be belly breaths, ideally through the nose, unless you're talking or you're eating.

making sure that your abdominals are strong, not just from crunching, but that you're activating the obliques, that the muscles between your ribs are strong, something that can really benefit from anti-rotation work so that you can generate a stiff, stable spine, which is great provided you can do that when you want to voluntarily, and then you can relax and you can move about your days still in great posture, still in a strong position, but without having to brace all the time, which is obviously something you don't want to have to do as you move through your life.

and having a number of different stretches that allow for lengthening of the spine. We talked earlier about hanging from a bar with feet touching the ground so that you can create some space to alleviate hopefully some of the disc bulge to nerve impingement that might be causing pain. That you might want to do those cobra type pushups or those up dog type movements that can provide some

kind of pushing back of the cream between the two Oreo cookies that I use as an analogy for the discs and the spinal segments. These are the sorts of things that most all of the data and most all of the experts in the field generally agree on.

And so I've offered them to you today in the form of this list of protocols. There are about a dozen of them, I realize. Again, we have links to examples of them in video form in the show note captions. I certainly don't expect that everybody's going to do all of these every day. That's by no means the expectation. Think of these more or less as a buffet of things

that you could explore and experiment with depending on whether or not you have back pain, in which case please proceed towards them with a lot of caution. Please remember also that I am not saying that epidurals, painkillers, surgery, and other methods for treating back pain are not useful. I am certainly not saying that. Those certainly have their place. And yet I would say many people, if not many or even all adults could certainly benefit from thinking about

how their back interfaces with their pelvis, their legs, their feet, their neck, and vice versa, and thinking about how to strengthen that entire system by creating a strong core, a strong lower back, generating the proper movement patterns, and doing so through protocols like the ones I described today that don't take a lot of time, require zero equipment, they're essentially zero cost except for the minimal time investment required, and that have been shown time and time again to lead to a stronger pain-free back.

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