Back Pain & The McGill Big 3
I never thought I’d be one of those people who complained about back pain. I used to listen to people older than me talk about theirs and think, "Sheesh, thank God that’s not me." My younger self naively believed that all the exercise and stretching I was doing would save me from this fate. Unfortunately, I was wrong. It turned out that the very training I was doing would be my downfall.
Like many young men, I gravitated towards weight training as a way to build muscle as I figured that’s what girls liked. I didn’t have a mentor when I started lifting, so my friends and I would watch workout videos online and then try to copy them in the gym, focusing less on technique and more on lifting as much weight as possible. Unsurprisingly, this led to a few minor injuries, but they would usually heal within a week or so. I didn’t really think about the consequences of loading as much weight as I could onto my shoulders and squatting as low as possible. While I understood the importance of technique in running, which had been my main form of exercise growing up, for some reason, my teenage brain didn’t grasp that weight lifting required its own set of technical skills. As a result, I suffered a few painful back injuries from squatting with heavy weight and poor technique. Each time, I would give myself the minimum amount of time needed to recover and often return to training while still in discomfort. Looking back now, I cringe at this approach.
In 2020, I was squatting again, going too low with poor form, when I suddenly felt a sharp pain in my lower back. I knew right away it wasn’t just a simple twinge. Little did I know, I’d just developed what would become a chronic injury. From that point until January 2023, the pain would flare up roughly once a year, usually after I’d fallen awkwardly or twisted my back. But after about a week of rest, it would always disappear. Before returning to training I would now wait for the pain to completely disappear; however there was no consideration for easing myself back into training. I'd be lifting the same weights as if I hadn’t just injured myself a week prior. Not a smart approach.
A major shift in my training came in January 2023, when I started MMA. From my very first session, I noticed a slight recurrence of the pain I’d been experiencing on and off for the last few years, and from that point on, it never really went away. I figured it was just my body adjusting to a new sport—one that involved a lot of physical contact and torque. But fast forward to January 2024, and I was still managing the same aching sensation after every session. In hindsight, I was in denial about having the same pain for a whole year. I think this was because I didn’t want to stop the training, as I was loving it.
However, from January to March of that year, the pain worsened significantly. It had spread into my hip, and every night, I would wake up in severe pain anytime I tried to roll over in bed. During the day, even simple activities like sitting at my desk or turning my head while walking became painful. The constant presence of this pain finally forced me to accept that something was seriously wrong and that I needed to make a change.
Over the past year, I’d tried various remedies to fix my pain. I’d visited multiple physios, got massages, changed my weight training routine, took weeks off from training, tried different sleeping positions, taken painkillers and adjusted my stretching routine, but nothing worked.
As the pain became more severe and constant, I talked to a friend in medical school who suggested I see a doctor. They were sure I’d be sent for an x-ray based on the intensity and chronic nature of my pain. I booked an appointment, and sure enough, I was scheduled for blood work and an x-ray of my lower back. The results showed no clear issues. The doctor did note a slight narrowing of the space between my L5 and S1 vertebrae, which was an indicator of a previous disc injury. Since I’d already tried everything they would normally recommend, they had no new suggestions to alleviate my pain, and so, I was referred to a lower back specialist.
When I had my appointment with the specialist, they conducted a physical exam but found no obvious triggers to my pain, so I was sent for more x-rays and ultrasounds, this time on my hips. Again, there were no clear injuries, so there wasn’t an obvious treatment plan. This was bittersweet—while it was reassuring to know I didn’t currently have a serious injury, it also meant there was no clear solution for my pain. Both doctors did their best, but in the end, all they could offer was to come back in a few months if the pain persisted or worsened. Surgery seemed to be on their minds.
Throughout this process, I’d begun my own research which focused on strengthening and stretching my muscles, assuming it might be a muscular issue. I thought that stronger, more flexible muscles would surely help. But no matter what changes I made to my training, nothing seemed to make a difference.
During my research, I kept coming across something called the McGill Big 3. I glanced at it a few times and dismissed it as too simple to help me. I kept searching for other strengthening or stretching routines that I thought would be more effective. But after months of no progress and feeling desperate, I finally decided to give the McGill Big 3 a try.
After just one try, I felt a slight easing of discomfort. It wasn’t a complete relief, but it was enough to know that it was helping, even in a small way. This glimmer of hope sparked a frenzy of research, and I was soon glued to my laptop, trying to learn everything I could about the McGill method and its creator.
What I found is that the McGill Big 3 consists of three exercises: the Bird Dog, Curl-Up, and Side Plank, named after Dr. Stuart McGill, a leading expert on back pain and rehabilitation. While he didn’t create these exercises, his research has demonstrated their fundamental role in treating back pain, with proven success among his own patients. Olympic medalists, powerlifters, CrossFit athletes, MMA fighters, and NHL, golf, and tennis athletes are among his patients who have benefited from these exercises.
Dr. McGill has published several books on the topic of back pain and rehabilitation. His book, Back Mechanic, has been written for individuals without medical training so that we can take an active role in our own recovery. I bought the book immediately after experiencing the benefits of the McGill Big 3 firsthand. The book is easy to read and provides clear instructions on how to identify your pain triggers, avoid them, and strengthen your back. Its approach focuses more on maintaining good spine hygiene, the practice of maintaining proper posture and body mechanics to protect the spine from injury and degeneration. It involves adopting healthy habits like lifting objects correctly, sitting with proper support, and avoiding repetitive movements that strain the back. I can't overstate how much this book has helped me. Even small tips, like how to sneeze with back pain, have been incredibly helpful, as silly as it sounds. It helped me realize that building stronger muscles alone wouldn’t solve my pain. I needed to correct the habitual poor movements and body positions that were putting strain on my body.
The book helped me analyze the daily movements, both in and out of the gym, that triggered my pain. It showed me which ones to correct or avoid. I realized that flexion and extension in my lumbar spine were causing my pain, likely due to a lack of spinal stability. As a result, I aimed to maintain a neutral spine as much as possible, if not all the time.
I’ve been following these principles daily along with the McGill Big 3, and for the first time in over a year and a half, my pain has significantly and consistently reduced. While I’m not fully recovered, it feels like I’m finally on the right path.
In the hope that it may help others, I’ve outlined below my daily routine, along with some links to Dr. McGill’s website, a podcast where he discusses back pain, and some demonstration videos on how to perform the exercises correctly.
A note regarding my routine below: The number of reps per set I perform is the perfect amount for me. I don’t dread doing them each day and therefore don’t skip it when I can’t be bothered, consistency is key here. Choose a rep range that you know you can stick with every day. Also, try to pick a time of day when you know you’ll always be able to fit these in. For me, it’s typically right when I get home from work, before I start on anything else I have planned for the evening. You can increase the number of reps per set beyond what I do, and extend the time spent holding each rep to a maximum of 15 seconds. It’s advisable to start with the numbers outlined and gradually increase the reps/hold time as you progress. Maintaining the descending scale of 2, as described below, is a good approach.
McGill Big 3
Each exercise is performed in descending reps per set to avoid muscle fatigue. I do three sets of each exercise, holding each rep for a 10 second hold. The first set is for six reps, the second for four, and the third for two. I do each set on both my left and right hand side, so I’m doing 12, 8, and 4 reps total per set. The video below demonstrates this and the correct technique for the exercises. (Note, I find that the Cobra pushup in the demonstration video exacerbates my pain and so I don’t perform this.)
Andrew Huberman Podcast: Strengthen & Pain-Proof Your Back: The McGill Method
Next, I perform 3 sets of 10 reps, of the Hip Airplane, on both my left and right side. The video below demonstrates the technique of performing this mobility exercise for beginners to advanced.
Squat University: The Hip Airplane
Performing this daily routine has vastly improved my pain and discomfort. While there’s never one solution for every problem, if you’ve had similar issues, haven’t found a clear answer and you're serious about your rehab, I highly recommend the book Back Mechanic. It offers significantly more insight than the brief outline of my routine above.
For more info on Dr. McGill and his work, check out his website, Backfitpro, or listen to him on the Andrew Huberman Podcast: Dr. Stuart McGill: Build a Strong, Pain-Proof Back.
Good luck in your recovery journey!