Protect your back by maintaining a neutral spine

I had the opportunity yesterday to talk with a group of trainees about what I've learned (so far) from Dr. Stuart McGill's book Ultimate Back Fitness and Performance (3rd Ed.). I used my reading and yesterday's talk to develop the article below. This is my understanding of Dr. McGill's neutral spine awareness exercises and how to apply them on yourself. You probably know someone who hurt their back while picking up a newspaper, getting up from a chair, carrying something, or doing other simple things. If this has happened to you, you can learn to protect your back and increase your chance of avoiding a recurrence. Give yourself permission to practice some posture skills. Posture may seem so basic that it should just happen, and should not require practice. But this is a misconception. Posture is so basic that if it's done wrong in movement it causes injury, and if it's done wrong at rest it aggravates old injuries or creates vulnerability for new ones. In any skill system, the basics are always worth practicing. Find the neutral spine while standing 1. Stand with your weight on both feet. Put your thumbs on your hips and reach behind you with your fingers. Press the fingertips into the vertical muscles alongside the spine in your lower back. These are the lumbar extensors. Are they soft or hard in your normal standing posture? 2. Tilt your hips slightly forward, feeling the lumbar extensor muscles all the while. The butt pokes back and the back slightly arches; this is lumbar extension. You should feel the lumbar extensors harden. 3. Tilt your hips slightly back (pelvis pokes forward). You should feel the lumbar extensors relax and then stretch slightly. This is lumbar flexion. 4. Now adjust, or level, your hips (still feeling the lumbar extensors with your fingers) until you feel the lumbar extensors soften. They are relaxed, and this is the neutral spine position. 5. Without losing the neutral spine, carefully lower your hands to your sides normally and lift your chest. This should be a comfortable standing posture. It spares the lumbar extensors for other tasks and it helps keep your intervertebral discs healthy. Learn to stand this way. How to practice: Whenever you find yourself standing, such as in line, feel the lumbar extensors and relax them, then carefully remove your hands (without changing hip position) and lift your chest. Learn eventually, through practice, to feel your way into this position without using your hands. Ideally it will become your natural stance. Abdominal bracing: maintain the neutral spine during movement 1. Feel your lumbar extensors with your fingers as described above, and find the neutral spine position. 2. Contract your abdominals as if bracing for a punch. Don't suck them in; clench them. Feel the abs harden and stick out a little. Feel the lumbar extensors harden when the abs harden. 3. Contract the abs hard and you have a girdle of support all the way around your spine from back to front. The abs have three layers; contracting them hard makes all the layers stiffen together, for an extra-stiff or solid effect similar to the layered stiffness of plywood. This is the "abdominal brace." You've locked your ribcage to your pelvis, or locked in the neutral spine. 4. Put one hand on your tummy and one hand flat on your lower back, brace your abdominals again, push your butt back to hinge at the hips, and go down into a squat without letting your spine come unlocked. If your spine unlocks, you'll feel it in the hand that is flat on your lower back. Stand up and correct it and try again. Don't worry about hitting a really deep squat position. Go as low as you can without flexing (bending or rounding) your lower back. The goal is to immobilize the spine and pelvis in relation to each other, or "lock the rib cage onto the pelvis." Mobility comes from the hips and legs and not from the back. How to practice: Try holding the neutral spine with the abdominal brace in different positions, such as (1) kneeling, (2) leaning on a wall, (3) on all fours, (4) while leaning down to lift something off of a chair seat, and (5) while picking something up off of the floor. If you're in doubt whether you're in neutral spine position before you start, then put your hands flat on the tummy and back as described above and do a few knee bends with your back straight and your abs braced before you lift anything or move to a new practice position. Use the glutes 1. Contracting the large muscles in your butt contributes to the solidity of the abdominal brace and further protects your spine when you lift (or when you lift yourself up from a low position). 2. While kneeling, get into the neutral spine position and brace your abs. 3. Contract (stiffen) your glutes without moving your hips. Feel the added rigidity throughout your torso. Do this whenever you lift, especially if you lift something from below waist level. How to practice: While holding the neutral spine with the abdominal brace, fold at the hips and knees to squat down. (It's fine to hold onto something for balance.) Stiffen your glutes and then stand up straight. Do this several times to get the feeling for how to add stiffness to your torso while lifting something or lifting yourself.