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Build a Strong, Pain-Proof Back | Dr. Stuart McGill

In this episode, my guest is Dr. Stuart McGill, Ph.D., a distinguished professor emeritus of spine biomechanics at the University of Waterloo and a world expert on spine anatomy and physiology, back pain, and rehabilitation. We discuss the most common sources of back pain, how back pain can be assessed (including self-assessment techniques), and how to design a personalized recovery plan to reduce back pain. We discuss how to train for lifelong fitness, reduce injury risk, and protect your back and joints based on your age and personal goals. We also discuss how to prevent back pain, build core stability, and explain how “McGill’s Big 3” exercises protect and strengthen the back. Dr. McGill, who is exceptionally fit in his late 60s, describes his low-time investment, personal training routine, and the specific exercises he uses for mobility, strength, and cardiovascular fitness. We also discuss controversial issues in the back pain and rehabilitation field, including how pain originates, the biopsychosocial model of pain, and treatments such as platelet-rich plasma (PRP). This episode provides clear, actionable tools to strengthen, prevent, and remedy back pain and injury so you can be pain-free while enjoying sports, exercise, and daily activities at any age. Access the full show notes for this episode: https://www.hubermanlab.com/episode/dr-stuart-mcgill-build-a-strong-pain-proof-back Watch the clip on back pain relief and spine anatomy that accompanies this episode: https://youtu.be/6SSxgAUfFug Demonstration of The McGill Method: https://youtu.be/f7HLP96HVNM *Thank you to our sponsors* AG1: https://drinkag1.com/huberman Helix Sleep: https://helixsleep.com/huberman BetterHelp: https://betterhelp.com/huberman Waking Up: https://wakingup.com/huberman LMNT: https://drinklmnt.com/huberman *Huberman Lab Social & Website* Instagram: https://www.instagram.com/hubermanlab Threads: https://www.threads.net/@hubermanlab X: https://twitter.com/hubermanlab Facebook: https://www.facebook.com/hubermanlab TikTok: https://www.tiktok.com/@hubermanlab LinkedIn: https://www.linkedin.com/in/andrew-huberman Website: https://www.hubermanlab.com Newsletter: https://www.hubermanlab.com/newsletter *Dr. Stuart McGill* Website: https://www.backfitpro.com University of Waterloo academic profile: https://uwaterloo.ca/kinesiology-health-sciences/people-profiles/stuart-mcgill Publications: https://www.backfitpro.com/medical-publications/ Books: https://www.backfitpro.com/books YouTube: https://www.youtube.com/@backfitpro9992 Instagram: https://www.instagram.com/backfitpro X: https://x.com/drstuartmcgill Facebook: https://www.facebook.com/Backfitpro *Timestamps* 00:00:00 Dr. Stuart McGill 00:02:33 Sponsors: Helix Sleep, BetterHelp & Waking Up 00:06:23 What Causes Back Pain?; Genetics, Dog Breed Analogy 00:12:55 Tool: Skeleton & Body Type; Spine Flexibility & Discs 00:20:25 Flexibility & Exercises; Discs & Collagen 00:25:43 Sponsor: AG1 00:27:32 Stress & Tipping Point; Athletic Tradeoffs, Triathletes 00:36:17 Back Pain, Goals & Training Program 00:45:57 Spine Hygiene, Back Pain, Powerlifting 00:53:33 Genetics & Running 00:59:34 Sponsor: LMNT 01:00:46 Rehabilitation & Reducing Volume; Injury 01:07:42 Tool: Training for Lifelong Fitness, Injury & Joints 01:17:40 Pain Types, Biopsychosocial Model of Pain 01:26:15 Coaching, Explosivity & Endurance 01:32:43 Virtual Surgery & Rest, Pain Recovery 01:41:25 Tool: McGill’s Big 3; Building Back Strength & Stability 01:46:39 Inversion Tables & Spine Deloading, Disc Bulge, Tool: Lumbar Support 01:51:09 Tool: Daily Walking; Sitting 01:55:33 Deadlift & Bone Density, Glute-Ham Raise 02:06:20 Training & Age, Osteoporosis, Tool: Deadlift Alternatives 02:16:47 Tools: Biblical Training Week; Spine Stability & McGill’s Big 3; Shrinking & Age 02:24:16 Platelet-Rich Plasma (PRP); Disc Damage 02:27:56 Tools: Biblical Training Week & Strength Exercises, Neck Strength 02:35:24 Tools: Sword Play, Distal Limb Loading, Training for Symmetry 02:42:38 Tools: Biblical Training Week, Mobility & Cardiovascular Exercises, Athletic Panel 02:49:22 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter #HubermanLab #BackPain Title Card Photo Credit: Mike Blabac - https://www.blabacphoto.com Disclaimer & Disclosures: https://www.hubermanlab.com/disclaimer

Andrew HubermanhostDr. Stuart McGillguest
Jul 14, 20242h 52mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

Build A Resilient, Pain‑Proof Spine With Precision, Not Generic Exercises

  1. Andrew Huberman and spine biomechanist Dr. Stuart McGill discuss how back pain is a symptom with many different mechanical and psychosocial causes, not a single diagnosis with a one-size-fits-all fix.
  2. McGill explains how genetics, body architecture, and specific loading histories shape what each person’s spine can and cannot tolerate, and why precise assessment is essential before prescribing any exercise.
  3. They dissect popular lifts like deadlifts and squats, the role of McGill’s “Big 3” core exercises, and how to design sustainable training that builds spine stiffness where needed, mobility where appropriate, and avoids crossing each individual’s injury tipping point.
  4. The conversation also covers the biopsychosocial model of pain, how pain rewires movement patterns, the “Biblical Training Week” structure for long-term joint health, and practical strategies for sitting, walking, and everyday movement to prevent or rehabilitate back pain.

IDEAS WORTH REMEMBERING

5 ideas

Back pain is a symptom with many distinct mechanisms; precise assessment must precede any treatment or exercise prescription.

McGill emphasizes that asking for a single exercise for “back pain” is like asking for one exercise for “leg pain.” There are over 100 mechanical and non-mechanical pathways to back pain. Effective treatment starts with a thorough assessment: listening to the full personal story, identifying when and how pain appears (e.g., sitting vs. standing vs. walking), using provocative tests to reproduce pain and isolate the tissue/mechanism, then matching interventions to that specific pain generator instead of applying generic programs.

Genetics and body architecture strongly influence what your spine tolerates; you can’t train a Saint Bernard to be a greyhound.

Analogies like willow branches versus thick sticks and greyhounds versus Saint Bernards highlight that slender, ‘willowy’ spines tolerate lots of bending but not high compression, whereas thicker, ‘redwood’ spines excel under heavy vertical loading but are vulnerable to repetitive flexion. Facet joint angles and disc shapes (ovoid vs. limacon) are genetically set and bias people toward better rotation or better compression tolerance. Training has limits: certain sports (e.g., Olympic lifting, golf, gymnastics) reward specific spinal architectures; pushing against your architecture at high levels raises injury risk.

Stiffness and stability—not maximal mobility—are central to spine health and performance.

Discs are layered collagen structures designed to provide controlled stiffness, not ball-and-socket range in the spine. The body uses stiffness as the main control parameter: you need a flexible column to tie your shoes, but a stiff, stable column to carry loads. Core stiffness provides proximal stability so limb muscles can express force effectively (e.g., pushing a door, throwing, running). Overemphasis on end-range spinal mobility, especially after disc damage, often aggravates pain and undermines performance, whereas properly dosed stiffness training protects joints and improves strength transfer.

Avoid crossing your individual ‘tipping point’ for tissue stress; dose movement and loading in volume and intensity, not just exercise choice.

Every biological system requires stress for optimal health, but beyond a certain threshold—the tipping point—stress accumulates into tissue damage or sensitization. The same exercise (e.g., deadlifts, long walks, jiu-jitsu, sitting) can be therapeutic below the tipping point and injurious above it. McGill often preserves beneficial movements but manipulates volume, frequency, and range—e.g., three 20-minute walks instead of one 60-minute walk, slightly reduced golf swing lateral crunch (95% instead of 100%)—to move people just under their pain threshold while still giving enough stimulus for adaptation.

McGill’s Big 3 core exercises are efficient spine stabilizers, but not a universal cure; they must be contextualized within a full plan.

The Big 3—modified curl-up, side plank, and bird dog—were chosen because lab measurements showed they maximize spine stability with minimal spinal load, preserving capacity for other activities. Done with good form (neutral spine, controlled breathing, emphasis on stiffness rather than motion), they enhance proximal stability and translate to better running, lifting, and everyday movement. However, they are one tool: specific pain patterns (discogenic pain, nerve tension, facet issues) may also require movement hygiene, gait changes, nerve mobilization, or sport-technique adjustments beyond core work.

WORDS WORTH SAVING

5 quotes

Genetics loads the gun, exposure pulls the trigger, and then the psychosocial milieu around the individual influences how they respond to the pain.

Stuart McGill

Every system in the body requires stress for optimal health, but you cannot cross what’s known as the tipping point.

Stuart McGill

The strongest core makes you stronger through your limbs because it creates proximal stability that directs athleticism distally.

Stuart McGill

An injury is really asymmetrically harmful. It’s like Nassim Taleb’s work—losing 50 percent hurts you far more than gaining 50 percent helps.

Stuart McGill

Deadlifting keeps the bogeyman away for some people, but they tend to be very unidimensional in their athleticism.

Stuart McGill

Back pain as a symptom: mechanisms, tipping points, and assessmentGenetics, anatomy, and body type in spine resilience and sport suitabilitySpinal biomechanics: discs, facets, stiffness, stability, and elastic energyMcGill’s Big 3 core exercises and evidence-based back strengtheningDeadlifts, squats, and exercise selection for performance vs. pain riskBiopsychosocial model of pain and virtual surgery/ desensitizationBiblical Training Week: structuring strength, mobility, and cardio across the lifespan

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