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Muscles, McGill says, have to be balanced to keep the spine straight. If exercisers only work out one muscle in the core, there will be an unbalanced load on the spine. McGill compares the spine to a flexible fishing rod surrounded by guy wires that hold it in place. If you pull on all the guy wires with the same amount of force, the spine bears an even load. If you pull just the "wires" closest to the spine, which is analogous to the results of focusing on the transversus abdominis, then the spine buckles.
Experiments in Dr. McGill's laboratory indicate that spine injury is inevitable when people do just the exercises that pull in the belly button or "suck up the gut." The amount of load the spine can bear when the arms are flexed is greatly reduced when exercisers focus exclusively on abdominal muscle strength.
So what muscles need to be exercised to keep a healthy back?
Core exercise should develop all of the muscles surrounding the spine, including but not limited to the abs. Here are the essentials for a core workout:
- No sit-ups. Dr. McGill says they place a devastating load on the disks of the spine.
- Side planks. Raise your upper body as you lie on your side.
- Bird dogs. Get down on all fours, and raise arms and legs on alternating sides.
And while McGill does not recommend sit-ups, he does recommend crunches. Lie down and bend one knee. Place your hands beneath the hollow of your back for support.
Gently lift just your Head and shoulders. Hold for a moment, preferably until you feel a slight release in the muscles in your back—less than a "pop," involving no pain. (Stop if the exercise causes back pain.) Then lie back down in a comfortable position and repeat. Only the first 25 or so repetitions of any of these exercises will actually do you any good, and it is neither necessary nor helpful to do these three exercises more often than three days a week.
Dr. McGill says he sees too many people who have six-pack abs and a ruined back. He is not alone. Doctors at the Department of Public Health and General Practice at the Norwegian University of Science and Technology in Trondheim report that they have found no relationship between the thickness of the abs muscle, or how tightly it can hold down a six-pack, with back pain.
The Norwegian doctors also report that their patients who exercise other core muscles in addition to their abs experience significantly greater pain relief, although the process of healing can take months or years. Core muscles so weak that they "slide" cause the greatest pain.