Protocols to Strengthen & Pain Proof Your Back

Added: Apr 29, 2024

In this episode of the Huberman Lab podcast, Dr. Andrew Huberman discusses the importance of building a strong and pain-free back. He emphasizes the significance of having a healthy back for everyday activities, sports, and overall well-being. Back pain can significantly impact one's quality of life, causing discomfort, limited mobility, and emotional distress.

Key takeaways

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Understanding the anatomy and physiology of the back is crucial for identifying the causes of back pain and implementing effective treatment strategies.

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Neuromuscular components such as the back muscles, spinal erectors, and core muscles are essential for spinal stability and support.

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Proper assessment and diagnosis by healthcare professionals are key to identifying the underlying cause of back pain and determining the most appropriate treatment plan.

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Pain management and treatment can vary widely, from medication and physical therapy to exercises specifically designed to address the root cause of the pain.

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A holistic approach to back health, considering physical, emotional, and psychological factors, can significantly contribute to a pain-free back and overall well-being.

Back Anatomy and Physiology

Huberman explains the anatomy of the back, which includes the spine, vertebrae, discs, and the spinal cord. The spine is divided into cervical, thoracic, lumbar, sacral, and coccyx regions. The discs between the vertebrae provide flexibility and cushioning, allowing for movement and protection of the spinal cord. The spinal cord, a central nervous system structure, extends from the brainstem down through the vertebrae, transmitting sensory and motor signals.

Neuromuscular Components

The back muscles, spinal erectors, and core muscles play a crucial role in providing stability and support to the spine. Motor neurons in the spinal cord innervate muscles for movement, while sensory neurons relay information about muscle stretch and position. Proper alignment and strength of these muscles are essential for a strong and pain-free back.

Pain Management and Treatment

Huberman references Dr. Shawn Mackey, a pain management expert, who discusses various approaches to pain relief, including medication, epidurals, and electrical stimulation. The biopsychosocial model of pain highlights the influence of thoughts and perceptions on pain severity and duration. Understanding the underlying causes of back pain is crucial for effective treatment.

10 Strategies for Building a Strong, Pain-Free Back

Huberman introduces 10 strategies for building a strong, pain-free back, from experts such as Dr. Stuart McGill, Dr. Shawn Miller, and Dr. Kelly Starrett:

1. Proper Assessment and Diagnosis: Individuals experiencing back pain should seek a proper assessment and diagnosis from a healthcare professional. This is crucial for identifying the underlying cause of the pain and determining the most appropriate treatment plan.

2. Focus on Stability: Building stability in the core and spinal erector muscles is essential for protecting the spine and preventing injuries. Engaging in exercises that promote core strength and stability can contribute to a strong and pain-free back.

3. Addressing Neural Compression: Techniques to create space and alleviate pressure on nerve roots, such as addressing herniated discs and reducing inflammation, can help relieve back pain.

4. Foot Positioning: Paying attention to the positioning of the feet and spreading the toes can provide support for the back during movement and at rest.

5. Neck Strengthening: Strengthening the muscles in the front of the neck can contribute to overall spinal stability and alignment, reducing the risk of neck and back pain.

6. Resistance Training: Incorporating resistance training exercises can help strengthen the muscles surrounding the spine, improving overall stability and reducing the risk of injuries.

7. Rehabilitation: For individuals with specific injuries or overuse patterns, targeted rehabilitation exercises can address muscular imbalances and weaknesses, promoting a healthier back.

8. Proper Movement Patterns: Being mindful of movement patterns and posture in daily activities can prevent strain on the back and reduce the risk of injuries.

9. Consultation with Experts: Seeking guidance from experts in back pain and rehabilitation, such as Dr. Stuart McGill, Dr. Shawn Miller, and Dr. Kelly Starrett, can provide valuable insights and personalized recommendations for building a strong back.

10. Holistic Approach: Taking a holistic approach to back health, including addressing physical, emotional, and psychological factors, can contribute to overall well-being and a pain-free back.

Understanding One's Body Type

Huberman emphasizes the importance of understanding one's body type in relation to spine thickness, categorizing individuals into ectomorphic, myomorphic, and endomorphic body types based on joint size and body structure. People with thicker wrists, knees, and ankles are likely to have a thicker spine, while those with smaller joints tend to have a thinner spine.

The Curl-Up

Huberman introduces the concept of "McGill's big three" exercises, which are essential for strengthening the back and promoting spinal health. The first exercise is the curl-up, a replacement for traditional sit-ups that targets the abdominals without straining the spine. By maintaining a neutral head position, utilizing a fist instead of a flat hand for support, and focusing on short but intense contractions, individuals can effectively strengthen their core muscles to support the spine.

The Side Plank

The second exercise is the side plank, which targets the obliques and lateral muscles to improve spinal stability. Starting with bent knees and gradually progressing to straight legs, the side plank challenges the body to maintain a straight line and resist sagging hips. By incorporating variations such as rolling forward to engage rotational muscles, individuals can further enhance spine stability and prevent back pain.

The Bird-Dog

The third exercise in McGill's big three is the bird-dog exercise. This exercise involves extending one arm and the opposite leg while balancing on the other arm and knee, promoting coordination and strength in the back muscles. By emphasizing proper form and alignment, individuals can enhance their overall spinal health and reduce the risk of back pain.

Additional Protocols for Back Pain Relief

In addition to the Big Three exercises, Huberman discusses two protocols that can help alleviate back pain. One method involves hanging from a bar with toes lightly touching the floor to lengthen the spine and relieve compression on the discs. This exercise aims to create space between the vertebrae and reduce nerve impingement.

Another protocol for reversing disc herniation involves performing spinal extension exercises while keeping the hips in contact with the floor. By pushing the hips back and creating an arch in the lower back, individuals can work on realigning the discs and relieving pain. This approach focuses on pushing the disc bulge back into a more vertical alignment within the spinal column.

Personal Experience with Back Pain Relief

Huberman shares a personal anecdote about experiencing severe back pain and finding relief through spinal extension exercises. After initially aggravating his back with incorrect abdominal crunches, he discovered the benefits of performing Cobra push-ups to push the disc bulge back into place. Within a few days of consistently doing these exercises, his back pain significantly decreased, allowing him to resume normal activities.

Different Approaches to Back Pain Relief

Huberman highlights the diversity in approaches to back pain relief, citing examples of individuals who found success with exercises recommended by physical therapists in different parts of the world. They stress the importance of identifying the root cause of back pain, whether it be related to disc herniation, sciatica, or other factors, to tailor the treatment and exercise regimen accordingly.

Strengthening the Neck, Feet and Toes

Huberman introduces simple protocols for strengthening the neck, feet, and toes to promote spine stability. By engaging the muscles in the front of the neck through static contractions and focusing on spreading and independently moving the toes, individuals can improve their overall stability and prevent injuries. Additionally, practicing belly breathing at rest and bracing the core during resistance training exercises like curls or tricep extensions can enhance spinal support and alignment.

Anti-Rotational Exercises for Abdominal Strength

Huberman discusses the benefits of incorporating anti-rotational exercises into resistance training routines to strengthen the abdominals and prevent twisting injuries. By staggering one's stance during exercises like curls or tricep extensions and maintaining a forward-facing belly button position, individuals can activate the obliques and anti-rotation muscles to enhance core stability and reduce the risk of back pain.

Activation and Strengthening of the Medial Glute

The medial glute muscle plays a vital role in stabilizing the hips and pelvis, which can impact lower back pain. Huberman suggests an exercise where you lie on your side, extend your top leg, and activate the medial glute by pointing the toe down and performing repetitions. This exercise can help alleviate pain in the lower back region.

Stretching the Psoas Muscle

The Psoas muscle connects the spine to the pelvis and can become tight from prolonged sitting or poor posture. Huberman recommends a Warrior 2 pose variation to stretch the Psoas muscle. This exercise involves a lunge position with the arm extended overhead and the palm parallel to the sky, providing a deep stretch from the wrist to the heel.

Developing Awareness of Movement Patterns

The final protocol focuses on developing awareness of movement patterns in daily life. By observing posture, foot position, breathing, and movement habits, individuals can identify imbalances and areas of weakness that may contribute to back pain. Adjusting these patterns can help improve overall back health and reduce the risk of injury.

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