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Why Do Our Backs Hurt? | Dr Stuart McGill

Dr Stuart McGill is a professor emeritus at the University of Waterloo and a world expert in back pain. Dr McGill has worked with some of the best athletes in the world across pretty much every sport you can imagine as a spinal specialist, so if anyone can give us some advice about how to cope with back pain, it's him. On today's episode expect to learn why backs are so problematic, how much of back pain is due to lifestyle choices or training methodology, how much of an impact desk work is having on our spinal health and why recovery from a back injury can be so slow and hard to define. Massive thanks to The Protein Works for sponsoring this episode, check out their full range here - https://bit.ly/TPWChrisWillx Extra Stuff: Buy Dr McGill's Book Back Mechanic - https://amzn.to/2ILv037 Check out Dr McGill's Website - https://www.backfitpro.com T-Nation CrossFit Article - https://www.t-nation.com/training/doctors-view-of-crossfit Follow Dr McGill on Twitter - https://twitter.com/drstuartmcgill (but don't expect a response) Check out everything I recommend from books to products and help support the podcast at no extra cost to you by shopping through this link - https://www.amazon.co.uk/shop/modernwisdom #backpain #rehab #crossfit - Listen to all episodes online. Search "Modern Wisdom" on any Podcast App or click here: iTunes: https://apple.co/2MNqIgw Spotify: https://spoti.fi/2LSimPn Stitcher: https://www.stitcher.com/podcast/modern-wisdom - I want to hear from you!! Get in touch in the comments below or head to... Twitter: https://www.twitter.com/chriswillx Instagram: https://www.instagram.com/chriswillx Email: modernwisdompodcast@gmail.com

Dr Stuart McGillguestChris Williamsonhost
Jun 17, 20191h 24mWatch on YouTube ↗

CHAPTERS

  1. 0:00 – 3:10

    A world-record powerlifter with a “compromised spine”: avoiding triggers to get out of pain

    McGill recounts an extreme case: a strength athlete with severe sacrum/L5 fractures and heavily damaged discs. Instead of starting with imaging, he focuses on the person and pain triggers, then uses movement-pattern retraining to remove the mechanisms driving pain.

  2. 3:10 – 7:48

    Why “fit” people still get back pain: sitting, underbuilt cores, and mismatched training stress

    Chris asks why spines are so problematic even for health-conscious trainees. McGill attributes it to modern sedentary exposure, underdeveloped spinal robustness relative to demands, and people trying random, untargeted fixes without understanding the mechanism.

  3. 7:48 – 9:45

    Workplace ergonomics myths: there’s no single ‘ideal posture’—the goal is changing positions

    McGill reframes ergonomics as stress management rather than finding perfect posture. He argues the best posture is the one that changes often, and notes many occupations can’t be ‘ergonomically optimized,’ leaving movement skill as the key protective factor.

  4. 9:45 – 12:14

    “Move well and move often”: finding the right dose of movement between too little and too much

    Chris asks about cadence—standing desks, walking calls, and frequent movement breaks. McGill supports moving more, but emphasizes an individual ‘tipping point’ where too much movement becomes its own stressor.

  5. 12:14 – 15:38

    Diagnosing Chris’s injury: Schmorl’s nodes, endplate fractures, disc height loss, and loaded flexion

    Chris shares MRI findings (bulges at L5/S1 and a Schmorl’s node). McGill explains the biomechanical pathway: heavy loading can fracture the vertebral endplate, reduce disc height, and—combined with repeated loaded flexion—promote collagen delamination and bulging.

  6. 15:38 – 22:48

    Why CrossFit gets predicted: mixed adaptations, fatigue-induced form breakdown, and programming trade-offs

    McGill correctly guesses Chris trained CrossFit, then explains why certain injury patterns cluster there. He praises the culture but critiques programming that combines mobility-demanding moves with high-load technical lifts under fatigue, shrinking margin for error and amplifying tissue stress.

  7. 22:48 – 30:39

    Powerlifting vs CrossFit recovery: bone adaptation needs time (and ‘rest days’ must be real)

    McGill contrasts powerlifting’s longer recovery windows with CrossFit’s high-frequency volume. He explains bone’s piezoelectric adaptation process and why repeated loading too soon can break off the very adaptation you’re trying to build.

  8. 30:39 – 39:16

    MRIs and pain: anatomy vs symptoms, and why context + assessment makes imaging powerful

    Chris describes how seeing his MRI increased rehab compliance, despite claims that imaging doesn’t correlate with pain. McGill argues the issue is not the MRI but the system: radiology reports lack personal/biomechanical context, confusing old scars with active wounds and mislabeling athletic adaptations as disease.

  9. 39:16 – 50:00

    Stiffness vs flexibility: why elite athletes are ‘wound springs’ and static stretching can backfire

    McGill rejects the idea of being both a yogi and a world-class powerlifter, using hamstring stiffness and elastic recoil as performance necessities. He explains how many top performers rely on tuned elasticity and neural pulsing, warning that indiscriminate static stretching may reduce athletic ‘spring.’

  10. 50:00 – 58:50

    The McGill Big Three: how they were chosen, how to do them, and why they relieve pain quickly

    McGill explains the lab-and-clinic origins of the Big Three (curl-up, side plank, bird dog): maximize stability with minimal spinal load. He details programming choices like 10-second holds, introduces proximal stiffness for distal athleticism, and explains the ‘residual neural stiffness’ that can produce immediate relief.

  11. 58:50 – 1:24:24

    Progressing beyond the Big Three: ‘sufficient’ capacity, sport-specific upgrades, and aging considerations

    McGill cautions that progression depends on the person’s goals: many people are ‘done’ with the Big Three if they just want pain-free life function. For higher sport demands he offers examples like ‘stir the pot’ and emphasizes that training should respect recovery, injury history, and age-related priorities like fall resilience.

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