The ‘big 3’ exercises for lower back pain

One of the most common things we see, both in the clinic and when speaking to people at outreach events, is lower back pain. The World Health Organisation (WHO) published data suggesting that lower back pain is estimated to affect 60-70% of people at some point in their lives showing that it’s no coincidence. As practitioners we are always looking for new ways and modalities to improve the care and rehabilitation of lower back pain for our patients and one area that is continually researched is corrective exercise.

Stuart McGill, professor and low back pain specialist at the University of Waterloo, determined a key focus area for those with lower back pain was muscular endurance. It is commonly understood that people get aches, pains and injuries when they don’t move correctly and that is often precipitated when they are tired. Therefore McGill coined ‘The Big 3’ to create a balanced stiffening of the core musculature in a spine sparing manner.

McGill Curl Up

Lie on your back and extend one leg whilst one is bent at the knee b. Place your hands behind your back to maintain the neutral arch of the spine c. Pull your head, shoulders and chest off the floor in a singular motion whilst maintaining the neutral arch of the spine for 10 seconds
Slowly lower yourself down and repeat
Perform half of the reps with the left leg bent and half with the right
Side Plank
Lie on your side placing your forearm on the floor and elbow directly below your shoulder
Pull your feet back so that your knees are at a 90 degree angle and place your hand on the opposing shoulder (to make this harder attempt to keep your legs out straight)
Proceed to lift your hips off the floor ensuring to maintain a straight line from your knees to shoulders and hold for 10 seconds
Once completed, lower yourself down and repeat on the other side

Side Plank

Lie on your side placing your forearm on the floor and elbow directly below your shoulder
Pull your feet back so that your knees are at a 90 degree angle and place your hand on the opposing shoulder (to make this harder attempt to keep your legs out straight)
Proceed to lift your hips off the floor ensuring to maintain a straight line from your knees to shoulders and hold for 10 seconds
Once completed, lower yourself down and repeat on the other side

The Bird Dog

Firstly get onto your hands and knees with your knees in line with your hips and hands inline with your shoulders.
Making sure to keep your torso level, raise and extend your left arm whilst extending your right leg and hold for 10 seconds
Slowly go back to the original position and perform on the other side These exercises should be performed in a reverse pyramid style manner meaning that for the first set you should perform higher repetitions and lowering the amount with each additional set. For example, perform 10 reps in the first set, 8 in the second, 6 in the third and so on…

Although exercise can be used as a prevention and rehabilitation technique, it is important to note that you should always consult an appropriate medical professional if you are experiencing lower back pain.