As I mentioned in my last post I tweaked my back a little on the left side about a week ago. While I was waiting for it to heal, I read The Back Mechanic by Dr. Stuart McGill. He is a well-regarded spine specialist, probably best known for his book Low Back Disorders: Evidence-Based Prevention and Rehabilitation. That one is more intended for professionals, while The Back Mechanic is more intended to teach us lay people to take care of our own backs. It is an excellent book. I learned good advice on what he calls “spine hygiene” or correct spine-sparing movements in daily life. The most obvious example is hinging at the hip instead of flexing the spine when bending over. I thought I was pretty good at these already but learned of a few things to clean up.
Dr. McGill also myth-busts some stretches and other exercises that can feel good while you do them, but not be good for your spine in the long run. Some of the stretches I was doing in my yoga routine at night were in this category, like arching the back too much in the “cat-cow” or excessively flexing the lumber region by laying on my back and bringing the knees to the chest. Dr. McGill is not a fan of overstretching for anyone with spine issues. Just like athletes like to progress their strength training by adding more weight, stretching practitioners (Yoga, Pilates) may think they are progressing by adding more range of motion to a stretch. Stretching to your current pain-free range is OK to prevent getting stiffer with age, but he frowns on trying to extend that range. So I modified some of my stretches and dropped others. That’s fine because he gave me plenty of other exercises to do.
There is a long session on self-assessment, because we all have different issues. I found that my lumbar stenosis, caused by arthritis, makes me sensitive to excessive extension of the spine, but not flexion. The opposite would be true for someone who also had lumbar stenosis, but stemming from a disk bulge instead of arthritis. Knowing this helps me fine-tune my exercises.
Aside from spine hygiene throughout the day, Dr. McGill wants us to do 3 non-negotiable exercises every day: The McGill curl-up (his replacement for the crunch, which eliminates downsides of the crunch), the bird-dog, and the side plank. I was familiar with the latter two but if you’re not they are well explained and illustrated in the book.
I also modified my routine so what I previously considered my “abs and core” workout is now my “spine and pelvis PT” workout. I added some of Dr. McGill’s suggestions to this, which I do 3 times a week. So far all of this seems to be helping. It’s hard to tell because I was healing from a recent “tweak”, but I’m hopeful that correct movement patterns (“spine hygiene”) as well as corrective exercises will make me more resilient against future tweaks.
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