EVERY SPOKEN WORD
145 min read · 28,735 words- 0:00 – 3:10
A world-record powerlifter with a “compromised spine”: avoiding triggers to get out of pain
- SMDr Stuart McGill
I, I never put a person's images up on the view box early in the consult. I really try and understand the person, uh, who they are, their personality, and, and then I, I assess them for their physical pain triggers, and only then will I look at the images. And when I looked at the images, I, I was quite horrified. He'd split his sacrum front to back, L5 was heavily fractured, and the discs were, uh, if I use the word obliterated-
- NANarrator
(laughs)
- SMDr Stuart McGill
... uh, that would be, um, quite accurate. So we started to talk, and he was starting to move a little bit better, and, uh, uh, but he had to humble himself right back to getting the movement patterns right and some very, very basic, uh, patterns, athletic patterns. Um, and then, uh, he said, w- in our conversation, he said, "Well, do, do you think I'm gonna get out of pain? Because the surgeons I've s- I've said- seen, th- they, they said I'm done. I, I, I'm not even gonna get out of pain, I've done so much damage to my back." And I said, "Well, I don't know, but let's, let's ... th- here's my best effort and my best suggestion on what to do." Well, believe it or not, he was outta pain in about three weeks, just learning how to avoid the, the triggers. But he said something very curious to me. He said, "Well, I'm gonna get out of pain, and when I get out of pain, I want my, my world record back." And I said to him, I said, "Well ..." and obviously I'm a lot older than he was, and I said, "Well, if you were my son, Brian, I'd give you this advice." I said, "Let's work on getting you out of pain, but I, I, I would seriously consider doing something else with your life. I mean, th- this is a pretty compromised spine. To build you back t- to set a world record again is ... " But he said, "No, I wanna do that." And I said, "All right. Well, if we do it, we'll write a book together." So that was the story behind, uh, uh, the book called Gift of Injury.
- CWChris Williamson
(wind blowing) Ladies and gentlemen, welcome back. This episode is brought to you by The Protein Works. I'm very happy to be supported by them again for this episode. They're giving away over 100 pounds of supplements this week, and all that you need to do to enter is share this episode. I'm absolutely certain it's going to be a massive help to a lot of people, so find a friend that you think would be interested, fire it in a group chat, or feel free to post it on your socials. All that you need to do is then send me a screenshot @chriswillex on whatever social media you want. Find me a screenshot or tag me in your share, and I will pick someone over the next week, and I'll announce that, uh, before next Monday. But onto today's guest, Dr. Stuart McGill. We are getting fully spinal today, aren't we? How are you? Welcome to the show.
- SMDr Stuart McGill
(laughs) Well, I'm, uh, well, Chris, uh, how about you?
- CWChris Williamson
I'm fantastic, thank you. I've been looking forward to this episode for as long as I can remember. Posted it in the gym Facebook group asking if they had any questions, so we've got crowd-sourced questions about spinal health.
- SMDr Stuart McGill
(laughs) All right.
- 3:10 – 7:48
Why “fit” people still get back pain: sitting, underbuilt cores, and mismatched training stress
- CWChris Williamson
It's gonna be a good one today. So first off, I guess, uh, I posted in the group, a perfect example, posted in the group and a lot of people had questions. Why is it that for people who take care of their health and fitness, spines are so problematic?
- SMDr Stuart McGill
(laughs) Well, I could go so many ways with that, uh, question, but I think it's because it's so difficult to do things without a robust back. Think of all the things we, we do. Uh, they all involve, uh, the back. So, uh, I, I guess that's why they're, they're problematic. But, uh, I, I can be a bit more specific, uh, and that is, if we sub-categorized spines in people, we would converge on common patterns. And if we did a little bit of pattern recognition, we'd notice some real cause and effect. Um, for example, athletic groups are really fun to study. Um, there are certain athletes and sports where they just clearly have an underperforming core. They spend a lot of time on other parts of their body, but, uh, the, the demands on their spines simply outpace the, uh, foundation that they've, uh, built, and, uh, they end up with either injury, or pain, or compromised performance, or any of those. But in the general public, why are spines so problematic? Look at our lives. You know, I, I started as a professor 34 years ago. Computers weren't even invented yet. We would spend time walking down halls meeting with our colleagues and, and doing our, our clinic work and our lab work. Within those 32 years, something happened. I became a computer operator. Students no longer wanted to come to office hours. They would send an email, and I'd say, "I don't do emails." (laughs) "Would you better come and we'll have some hands-on..." But, you know, it, it was just, I became a computer operator. Now, that is ... Y- you know, I had a good back, but sitting all day gave me back pain. So th- this is why, uh, I think it's, uh, problematic, to use your words. And then the solution became, well, now you've become a slave to your chair and your computer for eight or 10 hours, now you're going to blow out, uh, all of the stress one hour at the gym.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
So let's compound the biological, uh, perturbation here, and people would start treating their spinal joints, because they were locked up all day at the computer, like ball-and-socket joints, but they're not. Biologically, they're an adaptable fabric made of collagen strands held together with a ground substance.... and they follow different rules. So, you know, uh, the, the, the, there's all kinds of other, uh, downsides to sitting a lot. Your hips get stiff. Well, mobile, powerful hips are one of the secrets of, uh, skillful athletic performance-
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
... and spine-sparing strategies. So, uh, are, are people undoing the chronic adaptations and stress in their hips when they go to the gym? Sometimes, they do the opposite. Uh, I, I guess the final bit, and, and this is coming a bit randomly, uh, in, in a thought pattern between my ears, very few people these days get a competent and thorough assessment of the mechanism of their back pain. So they willy-nilly try untargeted therapies, and, uh, their spines remain problematic, to, to really answer your question. So if a person has a back issue, and they have a thorough, competent assessment, so they understand very precisely what the, uh, pain trigger or mechanism is, they then have a roadmap to guide a strategy to remove the cause, and, uh, secondly, to build a, a foundation to be pain-free and as functional and, and fit as, as they want to be. So it's a bit of a long-winded answer, but those are some random thoughts as to why spines are problematic.
- CWChris Williamson
Well, I guess, first and foremost, spines are a complex system, right? There's a lot going on with your spine.
- SMDr Stuart McGill
Yeah.
- 7:48 – 9:45
Workplace ergonomics myths: there’s no single ‘ideal posture’—the goal is changing positions
- CWChris Williamson
It runs for a lot of your body. There's a lot of interactions going on there, so it wouldn't ever be (laughs) a, a single, a single answer. One of the things definitely, one of the questions I've got down, what are your views on workplace ergonomics? Uh, you know, you've already touched on it.
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
The, the sedentary nature of us being sat. Is it simply that we're sat for a long period of time, or is it that we're stationary? Uh, is a standing desk a, a solution for this? What, what are your thoughts on the ergonomics of, of workplaces?
- SMDr Stuart McGill
Well, I have several thoughts. I wrote a, uh, an opinion piece, uh, quite a number of years ago for the journal called Ergonomics, and, uh, think of the office where you can, uh, organize it in a way to reduce stress. Uh, you can adjust heights, the way you sit, and these kinds of things. But then I would say, well, is there such a thing as an ideal posture? And I think we would both converge that, no, there isn't. The ideal posture is one that frequently changes, because you migrate stress concentrations in your body through posture change. So, uh, that, that's a little bit of a myth. There are many jobs, by the way, that you can't do ergonomics with. Can you imagine a farmer, a forester, a fisherman, a lumber-
- CWChris Williamson
Bus driver.
- SMDr Stuart McGill
A bus driver, a miner. Very few can do ergonomics. Uh, all they have is the skill to move their body in ways that do not create stress concentrations to the point of pain. So ergonomics, uh, is limited in, in, in many jobs, uh, for sure, and even some of the foundational principles of ergonomics may not be appropriate for certain people in certain jobs, in that there is no ideal. Uh, the ideal is, is a moving target, and that's just the biological reality of it.
- 9:45 – 12:14
“Move well and move often”: finding the right dose of movement between too little and too much
- CWChris Williamson
If you were to prescribe a cadence of movement from seating to standing, or from, if someone was to potentially be able to do their work, what, let's say they were able to do some calls. They were able to walk while they were on a call perhaps with a hands-free kit or something like that.
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
Is moving as frequently as possible, whilst obviously not completely degrading your ability (laughs) to do the work on your laptop or your, or your computer, is that optimal? Is it to move as much as possible and vary the, vary the posture?
- SMDr Stuart McGill
Well, you're on the right track. Now, I would, I think you've gone from one stream- extreme to the other, saying move as much as possible, but, uh, I would say move more, absolutely. So as Greg Cook, uh, who many of your listeners will know, uh, I think he coined the phrase, "Move well and move often." And there's a lot of wisdom to that. Now, what is optimal will be, uh, very specific to the person, uh, for sure. Their age, their past injury history, uh, all of these factors.
- CWChris Williamson
So as-
- SMDr Stuart McGill
But there's no, no, no, no, there's no substitute. You've gotta get up out of the chair and, and move for, uh... You, you think of every system in the body, and every single one of them thrives on movement for optimal health. But that optimum is between not too much and not too little. So moving as often as possible, you're going to need to sit down to have a rest if you do that. (laughs)
- CWChris Williamson
Yeah. Yeah, yeah, yeah.
- SMDr Stuart McGill
But, but you know what I mean. The, the, bi- biology, uh-
- CWChris Williamson
Mm-hmm.
- SMDr Stuart McGill
... has a tipping point, and, uh, there's such a thing as too much, just as there's such a thing as too little. The, the, the trick of it all is to find that medium.
- CWChris Williamson
Totally. I certainly can appreciate, and as you were saying earlier on, the reason that I laughed at when you were talking about people trying to offset a sedentary work lifestyle with intense training-
- SMDr Stuart McGill
(laughs)
- CWChris Williamson
... is that that is the avatar of the person that I was for, for quite a while. I presumed that, uh, a step counter was really the only, only for, like, my mom and my dad. Like, "I don't need to bother myself with a step counter, because I'm going into the gym, and I'm knocking out a 1,000-calorie, 1,500-calorie session in, you know, between an hour and two hours, five, six times a week, and, you know, I'll do..."... a little bit of foam rolling before I start, and that's, that like, I- I don't need to bother about that. Like, that'll undo my,
- 12:14 – 15:38
Diagnosing Chris’s injury: Schmorl’s nodes, endplate fractures, disc height loss, and loaded flexion
- CWChris Williamson
uh, any issues, and at the beginning of last year, I had quite a bit of bad back pain, which I'm still rehabbing through at the moment, and an MRI at the beginning of this year showed, uh, two bulging discs in L5 S1 and a Schmorl's node. Um, that-
- SMDr Stuart McGill
You know what caused that. (laughs)
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
It, it has a very precise cause.
- CWChris Williamson
Please elaborate.
- SMDr Stuart McGill
Well, a Schmorl's node, you weren't born with it. You, you developed it. Now, a Schmorl's node, uh, th- consider the vertebra as a barrel. So the side of the barrel is cortical bone, and the top and bottom of the barrel that interfaces with the disc is a cartilaginous plate. That's called the endplate. Uh, when you lift heavy, and you exceed your biological tolerance, uh, that endplate bulges and it will get a little crater that forms in it. It's actually a fracture, and that's caused by very high pressure in the nucleus, which comes from lifting heavy. So at some point, you lifted heavy to the point where you created that small, uh, fracture. Now, I've had two of them, uh, in, in my life. Uh, one was, uh, hardly noticeable, and the other one was quite symptomatic-
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
... for a couple of years. But, uh, then what happens is the disc loses a little bit of height. Now, you can imagine letting a little bit of air out of your car tire. The tire then starts to bulge a little bit, and it gets a bit sloppy on the road. That's exactly what happens to that joint in the spine now. You lose a little bit of height, and if you keep bending, the collagen is no longer turgid that forms the disc. It's not a ball and socket joint. It's actually strands of collagen kind of glued together. It's basically, it's a biological goo. Now, that goo can be adapted to be softer, which will allow you to have a lot more mobility, like, say, if you, you, you did a lot of yoga, or you exposed your back to high loads without a lot of mobility. Eh, that goo actually gets, uh, more gooey, and, uh, if you, uh, believe in, "Well, I have to, uh, squat as deeply as possible," and that kind of thing, and you have a little butt wink at the bottom, it now becomes a bit more problematic following that Schmorl's node, or that endplate fracture, and, uh, the collagen will keep adapting to that deep squat mobility by becoming, um, uh, li- less gooey, shall we say, in, in the ground substance. It will delaminate and then you will get a disc bulge. So it's a combination of loaded flexion, and, uh, it's accelerated by, uh, lifting too heavy in the first place. So quite often, it starts off with a heavy deadlift, and then, uh, goes on to repeated, um, uh, loaded flexion. How close am I on that?
- CWChris Williamson
Pretty, pretty damn close. I was going to ask you-
- SMDr Stuart McGill
I'm- I'm bang on, aren't I?
- CWChris Williamson
(laughs) Yeah, it's a bang on.
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
I was gonna ask you another question. I've not told you about my training history. If I was to present you with the particular symptoms that I've just explained to you now, what methodolo-
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
... what methodology would you predict that I'm following?
- SMDr Stuart McGill
CrossFit.
- CWChris Williamson
100% right.
- SMDr Stuart McGill
Yeah. I know. I see them all the time. (laughs)
- 15:38 – 22:48
Why CrossFit gets predicted: mixed adaptations, fatigue-induced form breakdown, and programming trade-offs
- CWChris Williamson
Why is it... So I read, I read, and I will be linking in the show notes below, an article, uh, article/interview that you did with T Nation.
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
Um, and it was on the, I guess, the common injuries that are associated with CrossFit and a biomechanical breakdown of that.
- SMDr Stuart McGill
Right.
- CWChris Williamson
There will be a lot of CrossFitters who will be lift- listening. There will also be some, some powerlifters, some weightlifters, and some endurance athletes as well.
- SMDr Stuart McGill
Right.
- CWChris Williamson
But I would be interested to hear if you could give a, uh, an explanation of what are the typical injuries and why that you see them with CrossFit, your assessment of the injury to methodology relationship?
- SMDr Stuart McGill
Yeah. Well, it's a fabulous question, but, uh, injuries cluster around specific for- uh, sports and specific training methods, and there's a reason for it. It's the chronic exposure. So, uh, ph- physical exposure to the body causes adaptations. Now that apt- adaptation can be good or it can be bad, but you load the body and the body will adapt. So that's the beginning opening principle. Um, if you go back to that T Nation article, I, I s- I think it was in the title of the first paragraph, I have a love, uh, hate relationship with CrossFit. I mean, I absolutely love CrossFit for the culture, for the supportive community. I love it. I, I, if I was younger, I, I would have been in there 100%. Uh, w- wha- but now let's get into the biological adaptation, and then I can give you a solution. So, um, CrossFit combines adaptations to stimulate mobility, and then the next exercise is asking you to have a tougher collagen. Let me give you an example. So if you start out a routine with 10 burpees, you are creating a high mobility in the back without much load. So burpees on their own are probably not going to, uh, create too much challenge to the adaptation process. You're teaching the spine to be a bit more mobile, but it doesn't pay the price because there's no load. Then the next routine is repeated Olympic lifts. Now we have a problem. There's no margin for bad form. So CrossFit, uh, tries to create an endurable athlete.... a power athlete and a mobile athlete. That's very, very difficult to do in terms of biological adaptations. So by programming 10 Olympic lifts, you know the form is going to deteriorate. Now you're migrating stress. Uh, the first two reps might be all right, and, and interestingly enough, I don't get many Olympic lifters in as back pain patients. They have to go and see the knee and shoulder guys.
- CWChris Williamson
Hmm.
- SMDr Stuart McGill
Those are the joints that, uh, the Olympic lifters are, uh, having trouble with. Not really the ... They've got quite healthy low backs as-
- CWChris Williamson
And they're being very stiff.
- SMDr Stuart McGill
Well, uh, they lock them into much more of a neutral position because the mobility is at the, uh, the hips. And, uh, they're actually a speed power athlete. They're very, very quick. They have good pulsing on and off. They, they relax to catch the bar and the snatch and all of these kinds of things. But let's get back to, uh, the CrossFit programming. Um, the first two lifts might be fine. The third one now, you're starting to get a little bit tired. You're polluting the perfect movement muscle memory of an Olympic lift. So do you see? To be a great Olympic lifter, you would never pollute it when you're tired. But CrossFit's a different sport. It is an endurance. And look, I get the sport. Uh, you know, there's lots of sports that, that aren't necessarily, uh, the best for your long-term, uh, athleticism. That's just, you know, I, I have a lot of MMA athletes.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
I, I, I don't think that's a particularly healthy thing to do for your body.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
But, uh, it's a sport nonetheless, and they come to me asking for help. So of course, I, I, I get, uh, CrossFit athletes as well, and it's my job to try and adapt their body to, uh, be resilient. But we have to make a compromise here. Um, but that's the nature of the programming. So somewhere you have to be between stiffening the spine collagen through, uh, repeated load exposures, heavy load exposures, but you can't move your back. You know, that, that's the difference. So on rep one and two, you might be fine on the Olympic lift, but re- re- rep eight, nine, and ten are, are pretty (laughs) not very nice in, in, in terms of, uh, the bending stresses. And it's at that point where things, uh, fall off the rails in terms of biological adaptations and the collagen starts to ... The fibers ... Not the fibers necessarily, but the ground substance be- be- between them start to, uh, loosen up. And, uh, the fact of the matter is, the nucleus will slowly work its way through the, uh, delaminating collagen and get a disc bulge. So every sport has its, uh, uh, pattern, shall we say, and that certainly is ... Now, if, if I could offer this, and, and I think in that article, I, I did offer a solution at the end, and it comes from let's take the good things from CrossFit and mitigate the things that are not so good in terms of biological adaptation. And, uh, Dan John, if you, you j- have you ever heard of Dan John out of the US?
- CWChris Williamson
No. No.
- SMDr Stuart McGill
Uh, they, they call him the, um, the quirky uncle or something of, of training. He's, he's a fabulous fella. We're, we're both the same age. We're, we're both in our middle 60s.
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
We, we have somewhat of the same, uh, background and whatnot. Um, but Dan is a really wise guy, and he's, he's very clever in that he can say magnificent things in just a few words. But, um, Dan's solution to the burpee Olympic lift, uh, routine would be to do kettlebell swings with a goblet squat, for example.
- CWChris Williamson
Okay.
- SMDr Stuart McGill
So there would be a wonderful substitute in a CrossFit program to, uh, mitigate the biological adaptations that are going to lead to tissue breakdown.
- CWChris Williamson
I see.
- SMDr Stuart McGill
Isn't that a, isn't that an interesting one to think about? So from a biological adaptation point of view, both of those involve a hip hinge, they, uh, involve strength, uh, endurance, and, uh, they're telling the body to adapt in a consistent way, which is not so with burpees and Olympic lifts.
- CWChris Williamson
Hmm.
- 22:48 – 30:39
Powerlifting vs CrossFit recovery: bone adaptation needs time (and ‘rest days’ must be real)
- SMDr Stuart McGill
Anyway, there, there, there's just a, a thought for you. But, uh, you mentioned, um, uh, other athletes as well, like powerlifters, for example. Um, they have a slightly different cluster of patterns, uh, for back injury. But generally speaking, they too, uh, begin with, uh, endplate fractures and Schmorl's nodes. But here's the difference. Um, let, let, let's take bodybuilding where you train on Monday to tear down muscle at the micro level. Tuesday, you rebuild the muscle in the kitchen and in bed. In other words, while you're resting. And, uh, Wednesday, you go again and you, uh, repeat the process. Powerlifters, when you examine ... And I've worked with some of the grand old women and grand old men of powerlifting, the very successful ones. You ... The CrossFitters would consider them undertrained because a very heavy, strong powerlifter might do heavy squats on Mondays and, and take five days off. In other words, they allowed all the micro-fracturing at the ... This is at the micro level now, down at the level of the bone osteons or the bone cells.Um, they are damaged. There's no question. But is that damage a good thing or a bad thing? For a CrossFitter, it would be a bad thing 'cause the CrossFitter says, "Oh, on my day off, I only ran 5K." Wait a second, that's not a day off.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
That's more cumulative. So it's crazy to keep stimulating the body to adapt, and then you ne- you don't take the day off to allow the adaptation. But the powerlifter has a much more wise biological adaptation schedule. They'll do heavy squats, or, or s- say it's a pull from the, from the ground, um, a deadlift, for example, and then they take five days off. Now, let's discuss the adaptation of bone. Um, bone is a piezoelectric material, and what that means is when you stress a bone, it builds an electric charge. That electric charge attracts free ions of calcium and magnesium, and it glues it or, uh, chemically bonds it to where the fracture is, or the high stress. But it takes five days for those new ions of basic bone-building material, calcium, magnesium, a- and whatnot, to scaffold on before they break it off again. But what does the CrossFitter do? They train the next day and they break off the adaptation that they were trying to create. So do you see the, the same micro-damage in a powerlifter is a good thing. It stimulated adaptation, but they were wise enough to let the biology over the next five days really build substantial bone strength. That's not typically the way a CrossFitter would train. It's just more is better, and they don't allow sufficient adaptation. So th- these are all very interesting philosophical things to discuss in terms of creating robustness to load and, uh, better athletic performance. But, you know, I, I, I, I get it. I get CrossFit. I, I get why you do it. Um, as I said, I would've been there if, if it was 40 years ago as well.
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
However, I've learned quite a bit about biology in the meantime, and, uh, that's why these, th- th- the training, you know, it may not be so much th- the poor exercises sometimes. It may just be the, um, not paying enough attention to the adaptation schedules of some of these things, and, you know, that's just pure programming. So any organization could change their programming and create a more robust athlete.
- CWChris Williamson
I think there's certainly, in the CrossFit community, there is a addiction to training, um, that classes would tend to run Monday, Tuesday, Wednesday, Thursday off, Friday, Saturday, Sunday off, which means that you're going to be training even if you're just, like, a, a RX class athlete, or even a scaled class athlete. You're gonna be doing five days of training per week. Now, you're not gonna be pushing the same sort of loads, uh, in terms of percentages frequently as a powerlifter, but you're going to be doing an awful lot, and I, I, I do, I get what you mean. The fact that a rest day, for, for anyone who follows Zak George, UK athlete, you'll see his active recovery days that he does on a Thursday, which will be, like, a 40-minute EMOM of rowing, wall balls, and burpees. And that's, that's his active recovery day, but it'll be at a pace that would bin any other normal athlete. It just happens to be that he's a little bit of a freak. So yeah, the, the fact that that's considered a rest day by CrossFitters is, um, when you look at it in the cold light of day is, and probably to other sports as well, especially powerlifters, but then on the flip side, from the kind of cultural perspective, CrossFitters look across at the... In our gym, we have a CrossFit area, weightlifting area, bodybuilding area, and a powerlifting area. So there's, like, every different species of, of strength athlete is kind of moving around within the same place, and some endurance guys as well. And, um, the CrossFitters will look over at the powerlifters and see that they're sat down for five minutes in between lifts, and they'll, they'll be sort of thinking of giving them shit, and then the powerlifters will be looking at the CrossFitters wearing their brightly colored shorts with, like, doing millions of reps and burpees and going out and running in the rain and stuff, and they'll be giving them shit, and it's, it's interesting. It's very in- a very interesting dynamic. I think you'd probably quite enjoy observing, uh, from a bird's-eye view if you could access the CCTV.
- SMDr Stuart McGill
Yeah, Ch- Ch- Chris, that's my world.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
(laughs) I see it every day, so I don't need to see it anymore.
- CWChris Williamson
It's fine. I won't, I won't send you the stream.
- SMDr Stuart McGill
Right, but, uh, I, I, of course, I know exactly what you're talking about. Look, my job is to, uh, try and understand these mechanisms, and then when a person has pain, mitigate them. It's so interesting. Uh, you know, years ago, I would see someone on the way to a back injury, and, uh, you know, you're almost always right. Not always, but almost always right, and, uh, but I learned it's almost impossible to motivate the uninjured. So if they, uh, uh, haven't got back pain yet, uh, who am I to go over and, and give them any advice? Unfortunately, we have to let them, uh, learn the hard way, and then all of a sudden, they're motivated to, uh, listen and, uh, hopefully, uh, we can come up with something that will, uh, address the, the mechanism a bit.
- CWChris Williamson
Well, I can put my hand in the air and say that my rehab was a second thought up until the point at which rehab was all that I could do. Like, when I was still able to train, rehab took a backseat, um, and last year, when my back went for want of a better term, uh, that was when I decided to really pay a lot of attention to my rehab. Now, I did, but then over the space of a month last summer-... flew for 60 hours, did a powerlifting meet in Hawaii, went and trained CrossFit with Michael Casio in Texas, and then came back to the UK and just started all over again, and the same thing happened. I'd been sat on planes, cramped up, pretzeled up into all manner of different, different postures, and then the same, (laughing) same thing happened again. Um, so I-
- SMDr Stuart McGill
So you earned your pain.
- CWChris Williamson
I have... Oh, yeah, I really did. I mean-
- SMDr Stuart McGill
(laughs)
- 30:39 – 39:16
MRIs and pain: anatomy vs symptoms, and why context + assessment makes imaging powerful
- CWChris Williamson
It just... It, it, it's one of those things. Uh, uh, another interesting point on that, in terms of, um, the injury, giving people the motivation to do their rehab, was when I had an MRI scan at the beginning of this year. So I'd been working after... back end of last year, sort of five months or so, working quite hard on my rehab, but was seeing an upper limit in terms of my recovery. I then saw the MRI scan this year. Now, I know that there is a very tenuous link between pathologies that present on scans and pain that presents. A lot of people who do strength sports would present some sort of abnormality if you were to show them an MRI, but many of them may not have pain, and some people with pain may not present on an MRI. But for me to see the fact that there was something actually there, it wasn't just pain, this kind of nebulous, weird, ephemeral thing in the back of my mind, to see that there was something actually there that had been caused th- that was the, the cause of my pain, and also the cause of my... the, uh, due to my training, that really hit home, and the last few months have really stepped up how much I've taken care, how consistent I've been with the big three, and a bunch of other things as well. It's... The MRI was a real kind of like, whoa moment.
- SMDr Stuart McGill
Well, MRIs, if they're used properly, are absolutely fabulous, and you're a ca- you're a case in point. And, and I argue the statement that, uh, MRI evidence does not link to pain. In fact, I would argue the opposite. The problem is an MRI image shows anatomy. And I don't know how old you are, but say you're 30.
- CWChris Williamson
31. Uh, good call.
- SMDr Stuart McGill
Uh, 30, 31. Uh, yeah, you can't fool me. Stu knows. But anyway.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
Uh, if, if, if, uh, eh, what I'm looking at on your MRI is 31 years of life. Now, uh, some of the features that are on the MRI are old wounds. Uh, sorry, old scars. They don't cause pain anymore. Some of them will be fresh wounds. Now, a radiologist has no way of knowing which are wounds and which are scars, what is painful and what is not. However, if you precede the MRI session with a thorough assessment of the person, you know exactly what you're going to see on the MR. So you can do a thorough assessment and you know the pain is coming from whatever, uh, structures, end plates, uh, y- you know, (laughs) compromised nerve roots, uh, sacroiliac joints, or whatever. The assessment will reveal those sources, and then you go look at the MRI scans, and you'll get pretty close to a one-to-one match. So I wouldn't blame the, uh, MRIs of not being linked to pain. It's the system that, uh, prevents them from being linked to pain. Uh, so they become quite powerful after you've already seen the person. But here's the thing. The radiologist has no idea whether that person is a CrossFitter, a powerlifter, or, uh, a sedentary worker at a, uh, 10-hour-a-day computer job. And what I mean by that is, uh, I, I've seen athletes who bring in their MRI reports, and the report says, "Oh, they've got degenerative disc disease." And then I look at the MRIs and I say, "That's a, that's a powerlifter spine. That's not an MR... That, those are sclerotic end plates. That's what... That's the bony callus that an- that a powerlifter has developed and adapted over 20 years of heavy lifting." But the, uh, but the radiologist had no idea whether that was an adaptation to heavy exposure. So now that's healthy.
- CWChris Williamson
Mm-hmm.
- SMDr Stuart McGill
That's exactly what the powerlifter needed to set a world record.
- CWChris Williamson
Yep.
- SMDr Stuart McGill
So, so do you... do, do you see my issue when I hear that MRIs are not linked? It's the system that, uh... and, and the fact that radiolo- I don't think radiologists should be allowed to write a report. They've never seen the person, so they have no context. Now, they're good at looking for cancerous tumors and things like that, but in the world of back pain, that's extremely rare. So to link it to physicality, you've got to know the person first, and, uh, then we can interpret the MRIs, and they can be very helpful for people who are a bit stubborn in the, in the response to, to therapies.
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
So, I mean, you're, you're a perfect case in point. I mean, these people who argue, "Oh, it's a psycho- psycho- psychological, um, issue that people will start to obsess over their MRI." Wait a second. You just gave an example of you've just got psychological relief in understanding that you do have something there, it's not something to ignore, it's time to get on it and treat it, and get your health back. So it, it, it all boils down to just being a good human being and, uh, telling the truth, uh, e- e- respecting that the patient you're dealing with is not a five-year-old. They're a 31-year-old athlete-
- CWChris Williamson
Mm-hmm.
- SMDr Stuart McGill
... who needs to know a strategy to get rid of their pain and get back to what they love, which is training CrossFit with their friends, and I get it 100%.
- CWChris Williamson
Yeah. Uh, I mean-You, you... Totally correct. I was in the gym today watching some of the guys throw down, doing a class work- uh, doing a competition qualifier, and I'm thinking, "Ugh, like, I wish that, I wish that I could go back in there and do that." But previously, before the MRI, I'd have probably been like, "Oh, well, my back feels okay today." Like, "Oh, boys, can I just join in?" And then that would be me, throw... Like, I'll just go, "Oh, no, no, no, it's fine. Like, uh, my back, it'll just be a thing." But then you're right, the MRI really hit home, um, with regards to the fact, no, no, no, no, no, hang on. Like, your spine is something that you're going to need for more than just satiating the CrossFit hunger for the next however long that's your methodology. It's something that you're going to have to have-
- SMDr Stuart McGill
(laughs)
- CWChris Williamson
... functioning effectively for the rest of your life. So take some time, focus on the rehab, and work on that, and then slowly begin to build things back in, which is currently now the strategy and has been, has been for a while. Um, w-
- SMDr Stuart McGill
And it's working, I, I take it.
- CWChris Williamson
So it is. Specifically, I won't bore the listeners with my particular pathology (laughs) in my back. There's some, there's some oddities that I- I can't quite work out, and perhaps once I, uh, we, we get off the call, I might be able to explain them to you. But yeah, there's some, there's some interesting things. However, since I've focused a lot more, since I've taken more care about it, I have seen a... The plateau that I spoke about before the MRI has now been pushed through, and the only real thing which has changed has been, uh, compliance with the rehab plan. And-
- SMDr Stuart McGill
Yeah. What, what people don't realize is just because the pain is gone one day, it doesn't mean their back is healed, and this is the mistake. The underlying adaptations still need to continue to build that robustness back again. So if you've got a disc bulge, it's time to get the, uh, loss of stiffness back into the disc with stabilization exercise and whatnot. And the, the, the... That- that- that's... I hate that word because it, it doesn't mention what specific exercises they should be. But nonetheless, um, uh, you do have to honor that history because, you know, there's some physical therapists these days who say, "Oh, well, uh, just because you have back pain, there's no evidence of tissue damage." And again, I would argue w- w- very vehemently against the opposite. I see the damage, uh, and, uh, I've created it (laughs) in, in the, in the clinic and laboratory, and, uh, we document it, and, uh, we know what to look for. Most radiologists have no idea what to look for and whether they're looking at wounds or scars. So, uh, a- again, just because you're out of pain, behave and, uh, organize a proper adaptation schedule, and really enhance the chance for being successful at gaining your athletic robustness once again.
- 39:16 – 50:00
Stiffness vs flexibility: why elite athletes are ‘wound springs’ and static stretching can backfire
- CWChris Williamson
(smacks lips) I get you. So we've touched one of the things that you come up with a lot is the relationship between stiffness and flexibility in the spine. Um, would it be possible to have a yogi who's also a powerlifter?
- SMDr Stuart McGill
No.
- CWChris Williamson
(laughs) See, one of the interesting things is this. I, I spoke to Dr. Quinn Henoch, doctor of physical therapy for Jugger-nut Training Systems, about a year ago, and he was talking about what he referred to as mobility myths. So we were going through the typical tools and approaches that people use, um, that you see in a gym, the static stretching, the, the Theragun, the vibrating foam roller, the dynamic stretching, the PNF, and all these different things, and he was talking about the mechanisms that actually occur when, when these things happen. But I, I certainly know that in strength sports, at least in the UK, in my, my experience, I see a lot of static stretching. There's a number of subscription services that you can get that, uh, focus exclusively on static stretching as a way to enhance mobility and to improve your range of motion. But it sounds like you potentially might be doing more damage than good with something like that.
- SMDr Stuart McGill
Well, that wasn't your question. You asked me, could there be a powerlifter and a yogi?
- CWChris Williamson
And a yogi.
- SMDr Stuart McGill
Uh, let, let me say why I said that, and very emphatically. Have you built a world champion powerlifter?
- CWChris Williamson
No.
- SMDr Stuart McGill
Do you know one with loose hamstrings?
- CWChris Williamson
(laughs) No, no.
- SMDr Stuart McGill
Yeah, they don't exist.
- CWChris Williamson
(laughs) Yeah, you're right.
- SMDr Stuart McGill
So yeah, uh, I mean, the, the, the strongest powerlifter ha- has to have tight hamstrings. It's non-negotiable. So there you have it. Now, uh, a powerlifter needs to fight their mobility to get down into a proper deadlift pull. There has to be elastic tension in their body to assist the muscles in, in the pull if you're gonna win the worlds. So, you know, you, you, you can't... Uh, they wear elastic knee wraps, elastic suits, to add even more stiffness to allow even more elastic recoil. So, I mean, but we're going to for the extreme here. Is that healthy, or is that a great athlete, or is that what you want? I mean, that's debatable. But, uh, let's go to the other end. Have you ever worked with a... Uh, I mean, I've, I've had yogis who are on the TV teaching yoga, yoga as, as, uh, patients. I can't really think of too many who are strong. In fact, they can do wonderful squats, their bottom can go right down and touch the ground, but they have difficulty doing a body weight squat to stand back up again.
- CWChris Williamson
Is that so?
- SMDr Stuart McGill
Oh, yeah.
- CWChris Williamson
Ah.
- SMDr Stuart McGill
Now, somewhere, people want to be in the middle. You know, yogis aren't out there on the rugby field, nor is the powerlifter. So that rugby player is somewhere in the middle. The CrossFitter has to be somewhere in the middle, and that's the, uh, expertise of, uh, first of all, the dumb luck of choosing your parents, and then, uh, being as clever as you possibly can in creating the right, uh, adaptation. I mean, I'll ask you some other questions. Uh, the NBA Championships are on right now. You see a lot of people dunking basketballs. Do you think they have loose hamstrings?
- CWChris Williamson
No.
- SMDr Stuart McGill
I'm one of, I'm one of the few who've measured them. No, they're tight. They bounce off springs. So, you know, you- you- you went to this dark place of saying, "Oh, well, we've got ... with their stretching programs, to create more mobility." Be careful now. Go through the great athletes you've measured and tell me who has unlimited mobility. They don't. They're elastic athletes. They're wound up springs. So, you know, you can go through the spectrum from the throwers, to the golfers, to the tennis players, through to the Olympic weightlifters. I'm talking about elastic athletes here. Uh, what a mistake it is to stretch away that elastic athleticism.
- CWChris Williamson
Is that the way it works? Is it a, a, uh, are there, are there two, uh, counter to each other? You've got stretching, and then you've got progressive overloaded ... oh, you've got l- loading, and those two, are they about as antagonistic as you can get?
- SMDr Stuart McGill
Yeah, you, you're talking extremes.
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
Um, uh, maybe in- in- in some people, but, uh, again, my- my world is elite athletes. I have to tune the machine. Uh, I'm tuning elasticity, I'm tuning fascial trains, I'm- I'm tuning muscle pulses. Uh, I would be very judicious in whether or not we would stretch them away with a static stretch. So we might do a static stretch, uh, say, for a rower who now has a lot of posterior annular disc stress. They've just done a rowing session in a boat or on an erg, and I would say, "Good. Lay on your tummy and just breathe." Now, there is a static stretch for a rower. Now, I might do a thoracic extension stretch to give them more elasticity, so they're sliding up the slide on the seat on the boat. They go into compression, and the catch, and then their hips and knees start to extend, and then their spine, as they sit tall, gets a little bit of a whip as their hips explode, and really whump. You can hear that elastic storage and recovery in- in the fastest boats. So, you know, look at the people who throw a baseball 110 miles an hour. Are they heavily mobile? Well, they are asymmetrically mobile on one side-
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
... but they have a hell of an elastic. You know, the first elastic across their hips, the second one across the front of their chest, and the third one in their- in their wrist. You put those three elastics together, and you can throw 110 miles an hour. If you don't, uh, and all you have is mobility, you won't throw a ball very ... Do you know yogis who can throw 110 miles an hour?
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
Do you know a powerlifter who can throw 110 miles an hour?
- CWChris Williamson
Nope.
- SMDr Stuart McGill
Have you measured the great golfers? How strong are they?
- CWChris Williamson
I'm not sure. How strong are they?
- SMDr Stuart McGill
Have you tried ... Well, uh, I've measured them. How- how- how- how much effort ... Have you ever tried to hit a golf ball a long way?
- 50:00 – 58:50
The McGill Big Three: how they were chosen, how to do them, and why they relieve pain quickly
- CWChris Williamson
I wanted to move on to the big three. There will be a lot of people listening who are familiar with them. Um.
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
But I'd love to hear the story of why those movements were chosen and what the mechanisms are that they're actually working on.
- SMDr Stuart McGill
Right. Well, around, uh, it would have been about 30 years ago, we were starting to create different back injuries on cadavers, uh, in- in the lab. And, uh, when you damage a disc, you lose a little bit of disc height. Now there's micro-movements occurring at that joint. Now you can't see them on an MRI, for example, because it's- it's only under dynamic load that these things are created. But if a person says, "You know, I've got, uh, right-sided back pain, and then a little bit later, my right heel goes on fire, and then later on in the day, I get some left buttock pain." Well, there's an example where the pain triggers are migrating around the back and- and radiating down the legs. It tells you that there's little micro-movements in the joint. It's not a stable pain, in other words, from a single disc bulge that has the same pattern that just shrinks and grows. So we were looking for ways to stiffen out those micro-movements, and, uh, we assessed all kinds of, uh, exercises, but they had to have several criterion. Number one is they had to guarantee stability. Now we were measuring spine stability, so we could measure which exercises created spine stability and which were called spine stabilizers, but they really weren't. So we, uh, started out at that level, and then we chose exercises that had a high reward, low risk. In other words, maximum stiffening, stabilizing, controlling, uh, attributes, but minimal spine load. So the exercises that kept bubbling up to the top were the ones like the bird dog, the side plank, and the curl-up. So consider the bird dog. You can do a Roman chair extension if you like, but it's double the spine load. So that didn't fit sparing your back.
- CWChris Williamson
Mm-hmm.
- SMDr Stuart McGill
That's why we backed off and went, uh, opposite arm, opposite leg. Uh, then other advantages started to emerge. Uh, you know, it's a natural, uh, PNF pattern, uh, across, uh, pattern across the back, and then we would hold for 10 seconds. We learned that one because, uh, you clamp down the capillary bed in- in the muscle, and- and the muscle becomes acidic quite quickly, and you oxygenate and rebalance the pH of the muscle just by sweeping the floor with your hand and knee after 10 seconds, and out you go again. So, you know, there are people who say, "Well, I g- I hold my bird dog 30 seconds," and I say, "Great, I hope you enjoy the pain."
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
It- it- it- it didn't... It wasn't consistent with the science. So we just put layers and layers of investigation and science to try and come up with the best exercises for guaranteeing stability in a spine-sparing way, and then programming them in a way to reduce the risk of- of being unsuccessful. Um, then recently, with, uh, athletes, a strange thing happened. Um, first of all, your listeners need to understand the principle of proximal stability for distal athleticism. So, uh, consider if I was to... say I could bench press 200 kilo. I can't, but say I could. S- there's my bench press muscle, my pec major. So distally to the shoulder joint that flexes my arm around, that's its distal effect. But its proximal effect, if I just contract my pec major, proximally, it bends my rib cage towards my shoulder joint. So one creates a push, and the other leaks it away.
- CWChris Williamson
Yes.
- SMDr Stuart McGill
Do you see the difference?
- CWChris Williamson
Yeah.
- SMDr Stuart McGill
Now, if I create proximal stiffness first, I harden my core, I stiffen my body proximally, now 100% of that muscle activity goes to the push because I've arrested the energy loss or the energy leak, if- if people wanna call it that, or the eccentric contraction, uh, proximally. So now we had to create, um, a more proximal stiffness. So we took Muay Thai fighters, and we trained them with the big three, and then we trained others... Uh, well, not... We didn't train any, uh, one group no differently. They were the control group. Um, but again, we converged and found that once they create more proximal stiffness, they actually had a higher closing velocity with their fist and foot, for arm strikes and hand strikes, and they hit harder. So the more proximal stiffness you have, the faster you can run, cut, and change direction, the harder you strike, uh, a bag that's instrumented, for example, et cetera, et cetera, et cetera. So when athletes say... You know, you've heard a few, uh, quite famous athletes recently say, "You know, I got my back better and I'm back on..."... the, the course or the, the, the arena, whatever it is, because I worked on my core. And, uh, this idea of proximal stability is, uh, it's, it's not a myth. It, it absolutely unleashes faster tennis serves, throws, punches, kicks, uh, running speed, directional change, et cetera. Um, guess what? Those three exercises also bubbled up as, as being quite superior. Now, they won't take you to the Olympics, that's for sure.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
And then we, uh, well, that, that was my, my book, Ultimate Back Fitness and Performance, to write progressions-
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
... that would, uh, then, uh, keep the theme going of, uh, arresting micro-movements, proximal stiffness, and, uh, stiffening appropriately the, uh, flexible rod of the spine for more load bearing, if that's what the athletes need. (inhales deeply) Anyway, uh, those were put together for the sport and, uh, for the athlete. But that's where those exercises came from, and that's how they worked through the evolution over the past 30 years. But the, the, as you know, they're just a small part of the whole back pain puzzle.
- CWChris Williamson
Yeah, for sure. Um, one of the things that I think is, is interesting when we talk about that is that, certainly for me, I f- I actually find an immediate relief when I do the big three.
- SMDr Stuart McGill
Right.
- CWChris Williamson
So it's not, it's, it's not just that there is an over time adaptation that genuinely actually feels like there is a, some sort of relief, uh, to-
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
... to my lower back discomfort when I do them-
- SMDr Stuart McGill
Yep.
- CWChris Williamson
... which I think is really interesting.
- SMDr Stuart McGill
Do you wanna, do, do you wanna know why?
- CWChris Williamson
I certainly do. This is a-
- SMDr Stuart McGill
Yeah. We've measured-
- CWChris Williamson
If there was any man in the world for me to te- to tell me why, it's you. Let's, let's find out.
- SMDr Stuart McGill
Yeah, well, we measured a residual, uh, neural stiffness. So when you do those exercises, your brain remembers them, and your core stays a little bit stiffer. Uh, in some people, it lasts about 20 minutes. In some people, it lasts up to two hours. Now, why does it work on you? It's because I will bet you've got a little bit of, not only do you have a disc bulge, if you have an endplate fracture or a Schmorl's node, you will have lost a little bit of height on that joint. Now, it's lost a bit of height, it's a little bit sloppy, and you've got micro-movements. Doing the big three adds a neural stiffness to the barrel of muscle around that joint that's lost a bit of stiffness. You're arresting the micro-movements, and you feel better. (phone ringing)
- CWChris Williamson
(laughs) Good timing. Um-
- SMDr Stuart McGill
Yeah.
- 58:50 – 1:24:28
Progressing beyond the Big Three: ‘sufficient’ capacity, sport-specific upgrades, and aging considerations
- CWChris Williamson
I've got it, I've got it from, uh, from our coach. I've got it from our coach. It's gonna take me a little bit of time to get through, but links to Back Mechanic and all of Stuart's, uh, Dr. McGill's other books will be in the show notes below if you're interested. Um, one of the questions that I had, uh, in our members group actually when I, uh, posted the fact that I was going to speak to you, and was what's the progression on from the big three? Think someone had been doing them for quite a while and was feeling like they were, um, topping out at the degree of overload or the degree of, uh, hard work that they were doing with them, and they wondered what was next.
- SMDr Stuart McGill
Okay, well, the answer to the question, uh, I need a context for the person. For example, uh, for many people who just want no pain, optimal health, play with their kids, uh, maybe a round of golf, uh, and a, and a little bit of adult activity on Friday night, whatever. If that's what they want, then, uh, they're done. All they need is the big three.
- CWChris Williamson
Mm-hmm.
- SMDr Stuart McGill
That is sufficient. There's this idea on the internet that people need to keep striving for their personal best, et cetera. Uh, a lot of people will be shortening their athletic career by keep trying to push, push, push. So there is a concept of sufficient athleticism, sufficient stability, sufficient strength, sufficient mobility, and that is where their optimal health will lie. However, it's not gonna get you to the, uh, peak of the CrossFit games or the Olympics or anything else. So if I was preparing the average fighter for, uh, a three-rounder in the UFC, so that's five minutes on, one minute off, that's your work-rest schedule, um, I would then say, let's do stir the pot. So they're doing, uh, their feet are on the ground, and their elbows are on a gym ball. And now, they stir through the elbows for five minutes, and they can have one minute off times three. So if you think you're ready for a little progression, there's a, there's a little bit of a calibration for you.
- CWChris Williamson
That must be so uncomfortable. That must be absolutely torturous, that final-
- SMDr Stuart McGill
No, no. Don't, don't give me that.
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
You're a crossfitter, bro. That, that, that's what you live for.
- CWChris Williamson
Yeah, get comfortable being uncomfortable, yeah.
- SMDr Stuart McGill
That's, that's the rush. That's what it's all about.
- CWChris Williamson
That, um, that doesn't s- well, I- I'm, I'll, I'll wait and see. I will post it in the members' group, and the, the guy who, uh, who asked the question, I'll see if he can do the five minutes, five minutes on, one minute off, times three rounds.
- SMDr Stuart McGill
Oh, I've, I've got plenty of other tortures for you, if you want. But, you know, it's, it's interesting. I have a, a, an acquaintance, we'll call him, who is a very, very successful person. I'm sure if I revealed his name, most of your listeners would know of the person I'm talking about. He says, "The measure and the predictability of one's success is how willing they're, uh, how, how willing are they to tolerate d- discomfort." That is, in a nutshell, what he says will separate those... Anyway, uh, I'm sure there's other things as well, but that, that would have been his, uh, and, uh, there's, there's CrossFit to it. So do you see? You see why I love it and I hate it.
- CWChris Williamson
Yeah, absolutely.
- SMDr Stuart McGill
(laughs)
- CWChris Williamson
There's, um, a quote in James Clear's Atomic Habit. It's a book which came out this year. James is a habit expert. I'm not sure if you've read it yet.
- SMDr Stuart McGill
No.
- CWChris Williamson
But if you, if you haven't and if you've got time to read something, you're looking for s- for a holiday read, highly recommended. My favorite book of 2019. Uh, I had j-
- SMDr Stuart McGill
Oh, beautiful.
- CWChris Williamson
I had James on the podcast about three months ago, and he's, he really is, he's the real deal. Um-
- SMDr Stuart McGill
Yeah.
- CWChris Williamson
... and he went and interviewed the coach of a, one of the Chinese weightlifting team's coaches, and he asked him the question, "What makes the difference between the guys who are good and the guys who become the absolute best?" And the coach's answer was that it is the people who can put up with the boredom of doing the same thing day in, day out. And what he identified there was that I think a lot of normal athletes, like myself, look at someone like Matt Fraser or, uh, Adele Beckham or whatever it might be and think, "Well, that person must never get bored. Their training must always be fantastic for them." Anthony Joshua, you see him, he, he is the sort of person who's quite forthcoming about his training online, his training diaries and stuff like that. You see him training a lot, and you think he must, he must just turn up to training and love it every single day. And the coach of this particular weightlifting team said that's not the case at all. He's like, "There's days when my athletes turn up and they don't wanna be there. They don't wanna, they don't wanna have to do yet another set of pulls from blocks or whatever it might be. They don't wanna have to do more back extensions, but they do, and they go through it." And he said that the difference is the person who is able to turn up and follow the program and just stick to the plan and, and grind through those days. Uh, I thought that was really, really interesting and illuminating.
- SMDr Stuart McGill
I agree.
- CWChris Williamson
I'm glad. I'm glad. It, as well, the other thing that I really liked about that was that it, um, it put the power for someone to change their athletic ability in their hands. It's like, look, if, if, if the best crossfitter on the planet, Matt Fraser, gets bored training and he works through it, then it's exactly the same for you. He doesn't have some superhuman level of motivation. He just grits his teeth and does the work. I thought it was nice.
- SMDr Stuart McGill
Yeah. Yeah. Well, I, I don't know Matt Fraser, but, um, he, he, he has to be of that type.
- CWChris Williamson
Cut from that cloth.
- SMDr Stuart McGill
There's no option. Yeah.
- CWChris Williamson
Um, I wanted you to tell the listeners the story behind The Gift of Injury, if you could.
- SMDr Stuart McGill
Well, that was a book. Uh, it's co-authored by Brian Carroll. Uh, so the story is this. Uh, I knew the name Brian Carroll. I'd never met him, but he held, uh, several records in powerlifting. Um, you know, he'd squatted well over 1100 pounds. He'd squatted over 1000 pounds over 50 times in international competition, so he'd been around the block. So I, I knew the name and I knew some of those statistics. I got a phone call one day and, uh, he, uh, it w- he said very politely, "This is Brian Carroll, uh, professor, I've, I've hurt my back. Would you see me?" And I said, "Well, yes." And, uh, he came up and, uh, he was not moving well. And, uh, I thought, "Wow, this is one of the best squatters and he has difficulty getting i- getting in and out of a chair." And it, it seemed as though he'd lost his discipline. Anyway, within, uh, not too long, uh, within an hour, I would say, he was starting to move without, uh, triggering his back pain. And, uh, I said, uh... Oh, and then I, I, I never put a person's images up on the view box early in the consult. I really try and understand the person, uh, who they are, their personality, and, and then I, I assess them for their physical pain triggers. And only then will I look at the images. And when I looked at the images, I, I was quite horrified. He'd split his sacrum front to back, L5 was heavily fractured, and the discs were, uh, if I used the word obliterated, uh, that-
- CWChris Williamson
(laughs)
- SMDr Stuart McGill
... would be, um, quite accurate. Now-
Episode duration: 1:24:24
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Transcript of episode an4MzZ8cKH0
