Why are lower back injuries and pain so common? | Peter Attia and Stuart McGill

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This clip is from episode 287 - Lower back pain: causes, treatment, and prevention of lower back injuries and pain with Stuart McGill, Ph.D. Stuart McGill is a distinguished professor emeritus at the University of Waterloo and the chief scientific officer at Backfitpro Inc. (www.backfitpro.com/about-us/) where he specializes in evaluating complex cases of lower back pain from across the globe.
In this clip, Peter and Stuart discuss:
- Why the majority of back injuries happen around the L4, L5, and S1 joints
- What are the facet joints
- How the spine responds to forces like bending and loading, and how it adapts do different athletic activities
- And more
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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[@MrJones-cp1sx]

The only thing that’s ever helped with my chronic lower back pain issues, mainly from working manual labor jobs for most of my career, is simply SQUEEZING the hell out of my glutes (the strongest and most stable muscles on the body) whenever I’m forced to bend over to lift anything - light or heavy. A simple but most effective technique that has relieved any and all of my lower back aches and pains …period. 👊🏾

[@zomfgeclipse]

Squeezing glutes helps tilt the pelvis more posterior. I'm always doing this trying to fix my anterior tilt. Will have to remember when lifting too

[@Concojone5]

True. I think because it preserves the arch in your lower back. Try focusing on that one as well for even better results.

[@dareeltoro6681]

Injured my back deadlifting at 27. Back at it lifting heavier than ever. I bend my knees to reach something low, no longer bend my back, very important for my recovery. Also did and do a lot of compound movements exercises with farmers carriers, my back is as healthy as it ever was. I’m 35

[@magosia235]

Thank you so much, dr Attia. You have revolutionized my approach to training and life, since exercising is my greatest passion. And the fact that you're wearing a T-shirt with the name of my beloved athlete makes me appreciate you even more. Thank you once again for everything you're doing!

[@bobwojcik6196]

Stuart is amazing!!

[@DoctorPrepperMD]

A lot to f low back pain is muscular and stems from reflexive spasm after other muscle groups are stressed (like hamstrings, external rotators, gluts).

[@Dynamicdiscdesigns]

Wonderful discussion about biomaterials. Tension and Compression. Force and Deformation.

[@miiitchhh225]

I just love how this man says gymNAST

[@zbLoodlust087]

Well I'll be damned, I did not expect this collaboration.

[@TerriPlunkett]

Stewart McGill is AWESOME!

[@BallietBran]

Thank you Peter. You're saving lives my friend. Much love from Downtown Seattle.

[@Notsorandomwalk]

So if a hypothetical yoga person gets a minor disc bulge backwards, would powerlifting be helpful to correct it? Likewise if a power lifter gets a disc bulge forward, would doing yoga backbends be helpful in correcting that?

[@HkFinn83]

Absolutely not. You’d just be more liable to suffer a traumatic injury by forcing the spine into an extension modality it wasn’t made for.

[@ingoquendlerprivat]

Where do I find the youtube videos showing the big three workout routines?

[@pb7762]

squatuniversity

[@Brurarum]

have you tried on youtube?

[@NickDavidSmith]

Bird dog, curl up, rolling plank

[@nayl3476]

Thank you for this video ! As bjj practitioners im now confuse because im working on strength and mobility….i have to find the best combo…

[@mattstanbridge]

I know, it wasn't a very helpful video, just informative.

[@HkFinn83]

@@mattstanbridgethe helpful part is the knowledge, what you choose to do up to

[@HkFinn83]

This basic truism btw is why you cannot compete in sports at any serious level and not pay a price in the long term. The body in general and spine in particular were simply not made to tolerate these stressors in significant doses. I was always told if you use good technique you can do anything risk free. It always sounded like bs but I’m glad the professor is laying out why it’s so

[@farstrider79]

I think there's an unfortunate truth that BJJ isn't good for your back. I'd love to train it, but my back can't take it. I think you should train it if you enjoy it and your body tolerates it, but have your eyes open to reality.

[@farstrider79]

​@@HkFinn83Yeah, but no matter how good your form is, getting slammed onto a mat and having a 200 lb dude lay on you while your back is torqued then trying to twist out of it.........back is going to get injured. It's a matter more of are you more suspectable due to body type as to when. Conditioning and form are delay tactics.

[@quantumfx2677]

My biggest mistake many years ago was doing yrs of martial arts and then powerlifting doing deadlifts. We know the best fighters are martial artist that powerlift. A powerlifter is the fastest off the line then any runner or sprinter between 5 yards and that's about the distance a match is in martial arts. Think of a power lifter as an 8 cylinder engine.

[@Coindom65]

What is the difference between a herniated disc and bulging disc?

[@Icenflamesrush]

A herniated disk has ruptured, so the contents inside begin to seep out.

[@Dynamicdiscdesigns]

We have models to help show this. A bulging disc is one where the annulus extends beyond the vertebra...like a bulging tire when it is low pressure. A herniated disc is when the internal components of the disc ( the nucleus ) breaches the outer annulus and 'squirts through'. If you go to Fardon 2014 Nomenclature paper, you can see that described there too. Hope that helps.

[@MegaUtube99]

Okay so how do I prevent back pain?

[@CastorTroy966]

By using your back and supporting it less. The current back pain epidemic is not occurring among the native tribes that spend a similar amount of time sitting by the fire or just resting. The difference between us and them is we support our backs with couches and office chairs while they fidget and adjust themselves while sitting. If you slowly increased the time your back is not supported, your muscles will adopt and strengthen.

[@christinasmith9032]

I’m still not sure :-)

[@Dynamicdiscdesigns]

move and load just below the biological tipping point

[@jfox11000]

I do deadlifts from 135 lbs up to 400 lbs for 5 x 5s and deadlifts are 1 day per week ! Never had back pain in my life

[@charlesgalloway3445]

Have worked as a gardener for 45 years always suffered with lower back pain never been able to get rid of the pain in lower right. Side tight as hell in the morning put it down to a certain movement thats traumerd the muscles

[@jeffjohanson3830]

My advice would be to have a back X-ray and MRI done to see what’s going on before it gets even worse. I’m guessing you’re possibly mid 60’s. No escaping there will be some bad news. I’m 66. Everything is great till it isn’t. Trail runner, ultra runner, mountain biker, XC and downhill skier, hiker to extreme hiker with crazy skills for my age then suddenly not. Woke up almost 8 months ago Labor Day weekend to excruciating pain as a result of a ruptured disc that landed me in the hospital three weeks later and out of work for another five weeks. x-rays and MRI revealed the ruptured disc at L2/3 but also grade 1 spondylolisthesis and slight curvature in my lower spine along with a host of other negative news. My right leg became quite compromised with weakness and muscle atrophy, and would just buckle at a certain angle. More x-rays and another MRI did reveal lessening of the herniation, but my right leg continues to be a problem. I can no longer run, ski, mountain bike, or do the hiking I used to love to do in the white mountains. I’ve seen 4 surgeons and still don’t quite know the next step and exactly the source of what’s causing the weak leg. Also had an EMG test. Compression on a nerve or nerves I’m sure and hopefully not permanent nerve damage. I’m sad and depressed and life quality drastically changed. Sooooo….after all that go have your back checked out so you know what you are dealing with an the next steps to take 🙏

[@charlesgalloway3445]

@@jeffjohanson3830 thanks for your advice I already know what's causing it it's the old bend and twist when I'm hoeing and edging with a strimmer I'm hoping it will ease up when I retire next year

[@andreasbohm1349]

And what about runners who love to lift?

[@dmockracey]

Because we walk upright

[@alexm7310]

L4 & L5 / L5 & S1... searches for a picture!?

[@Dynamicdiscdesigns]

We have models to help show this. Our Professional LxH Model is L4-5 and you can see our L4-Sacrum to see both levels together. These are the bottom two levels of the human spine. Hope that helps.

[@gondwana6303]

Yeah but Peter says do dead lifts - the heavier the better! Right......

[@nayl3476]

😂

[@scottyg5403]

Dr. John Sarno. Healing Back Pain.

[@kevinb7126]

I’ve read his book a few times completely understand the concept but can’t get it to work for me

[@khush1894]

is he really saying that being flexible and lifting heavy for strength is a no no ??

[@sbklvs]

Eliminate calcium from your diet incluring water. It gets into a connecting tissue between spinal disks and pushes water out of it. There fore it dries out and shrinks and problems start. Eliminating calcium can also restore already damaged connecting tissue by reversing the dehydration.

[@chrisbfd]

It's a design flaw..😂

[@Primal391]

Lol, Attia tried to get him to explain it more simply. He precedes to make it much much worse. :)

[@JK-vc7ie]

This guy is full of it.

[@DelenaLearns]

I really dont agree with him. Staying flexible is controlled by the mind. Same with creating core tension. You can do yoga and heavy lifting doing sets in rotation. I do that and it works great. Maybe have better control in your muscles in isolation. I think his advice is good for people that dont ground themselves and contemplate what their body is doing with every movement.

[@Icenflamesrush]

You’re just plain wrong. Please don’t spread misinformation.

[@praxisbeweggrund7778]

please stop that biomechanical BS, the human is much more than biomechanics and so is pain. pain doesn´t always mean injury.....there are too many people around creating fear avoidance behaviour....

[@stevesteve6322]

I find it hard to listen to the boomer stash