McGill’s Big 3 - A Simple Guide to Help with Back Pain
The McGill Big 3 are a set of 3 specific exercises, formulated by Professor Stuart McGill, that have been shown to be effective for reducing and preventing low back pain. Although not to be considered the ‘be all and end all,’ these set of exercises are a good place to start for building muscular endurance of the spine, and are generally safe for most individuals to complete without prior training.
Based on numerous biomechanics and clinical studies, these three exercises enhance neuromuscular activation patterns of the spine and aim to increase the stability of the spine whilst only having to apply minimal loads to do so.
Now let’s have a look at what these exercises involve.
The Curl Up
This exercise is a replacement of the classic sit up so many of us incorporate into our workouts. Sit ups, although great for working our rectus abdominus, ignore deeper core muscles that are required for stabilising the spine. A sit up can also be an aggravating movement to perform if one has back pain, especially if discogenic in nature. The curl up is a movement that will strengthen the abdominals without adding extra load to the discs.
Lay down on the ground with one leg straight and the other leg bent at 90 degrees.
Place you hands underneath the small of your lower back with your elbows flat against the ground. Ensure the curve of your lower back remains as neutral as possible.
Place your tongue to the roof of your mouth - this ensures the head remains in a neutral position and allows for nasal breathing.
Draw your naval towards your spine to gently engage the core, then raise your chest, shoulders and elbows off the ground, whilst exhaling.
Hold for 10 seconds
Repeat this 5 times and then alternate legs.
The ideal set and rep prescription is as follows
Set 1: 5 x 10 second holds
Set 2: 4 x 10 second holds
Set 3: 3 x 10 second holds
Set 4: 2 x 10 second holds
Set 5: 1 x 10 second hold
Complete 2-3x weekly
The Side Plank
This exercise can be quite challenging so it is important to build up this exercise through incremental steps as you feel stronger.
Lay on your side with your knees at 90 degrees, resting on your elbow.
Draw your naval towards your spine to gently engage the core. Push the floor away from you with your knees and elbow - this will result in the side of your body lifting off the floor. It is important to think about pushing the floor away from you as this will ensure a straight and rigid torso - which is the goal of this activity.
The progressions of this exercise include completing the movement with
Straight legs and a staggered foot stance
Straight legs with a straight upper limb, pointing towards the ceiling
Straight legs with straight upper limb used to roll body forward slightly.
The ideal sets and rep range for this is:
1 set: 3 x 10 second holds
Repeat 2-3 sets on each side of the body.
The Bird Dog
Also known as superman, this exercise should also be performed with a rigid torso. You want to aim for as little torso movement as possible.
Start on all 4s, in a table top position. Spinal curves should be neutral (not too arched and not too flat). Draw the naval into your spine and gently engage the core.
Extend one arm forward with the extended hand in a fist. This will ensure a strong neural contraction of the upper body.
Extend the opposite leg backwards. Don’t raise the leg too high as this may cause the lumbar spine to overarch.
Again, imagine pushing the floor away from you with your supporting arm and leg.
Avoid rolling of the torso when reaching with your arm and leg.
The ideal sets and reps for this exercise are:
1 set: 2-5 reps of 10 second holds
Repeats 2-5 sets per side of the body.
If you’re looking at the set and rep range for these exercises and it seems overwhelming, instead of just ignoring the exercises, alter the sets to suit you. You will still get benefit from doing these exercises in a smaller dose and then they can easily be incorporated into your daily routine. Whether it be first thing in the morning or, perhaps you add them at the start as part of your gym warm up or as a finisher at the end of a session. All of the above exercises should be done in a controlled manner, this is more important than increasing the sets and reps.
It’s important to note that if any of these exercises exacerbate back pain, stop doing them until you’ve been assessed by a professional i.e. osteopath, physiotherapist, chiropractor.
To see these exercises demonstrated, please see the video below.
