Low Back Disorders: Evidence-Based Prevention and Rehabilitation

I have had chronic lower back pain for over 25 years. I have been to back specialists, the Back Institute, Acupunturists, Massage Therapists, and many Chiropractors. In addition, I read many books on my problem. I have a classic case of acute lower back pain - degenerative discs and some arthritis. I followed the Back Institute's regimen of exercises for 20 years and my family doctors for 5 years. I now realize I was given the wrong exercises and aggrivated the situation.Two acquiantences recommended Dr. Mcgill's exersises in his book "Lower Back Disorders". I started doing the "Curl Ups", the "Side Bridge" and the "Birddog" exercises. For over one and a half years I have been virtually pain free. I can't believe it. In the past, every year the pain would become so severe I would miss work and be flat on my back. This past year I have been doing extensive renovations around my home and cottage. I have been lifting 70lb. bundles of shingles up ladders, digging trenches, and moving yards of top soil. My back seems very flexible. Generally I feel great. Some days after the extreme physical activity I feel discomfort. This is caused by sore muscles and arthritis in my pelvic region. I have not had any immobility like in the past. Finding Dr Mcgill's book was a miracle for me. I feel like I was "cured". I have highly recommended it to many of my friends.

I've had 42 years of intense back problems and had fusion of the last three lumbar vertebrae and S-1. Prior to reading the book and applying the recommended exercises, I was bedridden up to 20 hours a day for weeks. After trying the FIRST SET of the "Big Three" exercises, I noticed a slight improvement in the back! Within a week, I was hiking in the mountains and two weeks later skiing! Following the book's suggestions has given me a pain-free life of mobility. If you are an exercise traditionalist, prepare for a shock. This book turns the world of back exercises upside down! Almost everything I had learned-and I was a coach-was incorrect and would lead to tissue injury according to research. I should have been born in Missouri, because my mantra is "Prove it to me!" My natural skepticism melted away as Prof. McGill presented scientific evidence to bolster his statements. He lists numerous pages of investigative results to give credence to the findings. Illustrations and commentary explain clearly the proper way to exercise to protect the back as you build endurance in the torso. It is written to address the minutia desired by professionals, but lucid enough in explanations to satisfy the "anatomy-challenged." If you are frustrated with low back pain and its deleterious effect on your personality and living, this book delivers!

This is a superb book that is useful for both clinicians and patients alike. Using methods based on electromyographic measurements published by McGill and his colleagues in many scientific journals, he ascertains which muscles are activated in a variety of exercises. This becomes important for patients who have low back problems and must avoid heavy spine loads both in the fitness center and at work. He lists a variety of commonly prescribed exercises that should be avoided by persons with low back problems: sit ups, pelvic tilts, leg raises, low back extension exercises on machines and hip flexion exercises using the Roman chair. He then recommends a series of exercises that are designed to strengthen back muscles and stabilize the spine while at the same time minimizing spinal compression that could exacerbate back problems: the curl-up, side bridges and "bird dog" leg extensions. This book should be recommended reading for all physical therapists and strength trainers with clients having low back problems and is a must for those suffering from low back pains.

This wonderful text focuses on the all important role of activity, exercise, and fitness in the prevention and treatment of low back disorders. In particular, the clinical publications emerging from Australia and Denmark are reviewed and balanced by scientific investigation of spinal loads with different activities. Professor McGill's book is highly practical and thoroughly evidence-based. This new book fills a void as a perfect cornerstone to the biopsychosocial model of patient reactivation recommended by international guidelines throughout the world (AHCPR, CSAG, DIHTA). Most significantly, the patient reactivation model being advocated by evidence-based experts today is made more clinically relevant as a result of this thoughtful and practical presentation of the "tools of the trade" for presecribing physiologically sound reactivation approaches. This is the ideal complement to simple reassuring reactivation advice being recommended for acute, uncomplicated low back pain patients and more involved cognitive-behavioral strategies being recommended for complex, chronic patients. It is most relevant for those subacute patients who are at risk of becoming chronically disabled. McGill highlights the recent scientific evidence which has unmasked the failure of diagnostic imaging to find the "cause" of back pain. He instead points clinicians towards the often ignored literature about the methods available for establishing the patient's functional diagnosis. This section is of great clinical value since most health care providers perform a limited functional assessment of low back pain patients.Popular concepts such as stability are defined, quantified, and made practical. The author explains how he determines spinal load profiles of routine activities of daily living and common exercises. In turn, many common beliefs about exercise are revealed as based on myth rather than evidence. For example he exposes the myths of lifting with a straight back, the pelvic tilt, performing sit-ups with bent knees, and the prone superman exercise. Other popular approaches such as the use of back belts or abdominal hollowing are discussed from a functional perspective.This book is most valuable to practicing clinicians for his elegant presentation of safe back exercises for subacute back pain patients. These simple exercises are shown along with the evidence demonstrating their safety and value. For instance, the cat-camel, quadruped leg reach, side bridge, and trunk curl are shown as biomechanically safe exercises which can be prescribed as a beginner program for most low back pain patients. Hopefully, randomized, controlled clinical trials will soon follow to further validate such exercises in patient populations. Many sufferers of low back pain are engaged in ardous sport or occupational activities. The book concludes with a section on more advanced exercises that have preventive and conditioning value, although would be inappropriate for the subacute treatment p