Protocols to Strengthen & Pain Proof Your Back
Andrew Huberman details protocols to build a strong, pain-free back. He explains spinal anatomy and introduces exercises like McGill's Big 3, bar hangs, cobra push-ups, psoas stretches, and techniques to strengthen the neck, feet, and core.
Deep Dive Analysis
17 Topic Outline
Introduction to Back Health and Pain-Free Movement
Back Anatomy: Spine, Vertebrae, Discs, and Spinal Cord
Neural Pathways, Nerve Impingement, and Disc Herniation
Spine Self-Assessment: Thin vs. Thick Spine Phenotypes
McGill's Big 3: Curl-Up for Abdominal Strength
McGill's Big 3: Side Plank for Core Stability
McGill's Big 3: Bird Dog for Spinal Stabilization
Spinal Lengthening for Disc Compression Relief
Reversing Disc Herniation with Spinal Extension
Understanding Sciatica and Referred Pain
Strengthening Neck Muscles for Upper Spine Stability
Foot and Toe Strength for Spinal Support
Belly Breathing at Rest vs. Bracing During Exercise
Anti-Rotation Training with Staggered Stance
Activating and De-spasming the Medial Glute
Psoas Muscle Stretching for Hip and Spine Relief
Developing Back Awareness and Optimizing Movement Patterns
6 Key Concepts
Spinal Cord
The spinal cord is a long, snake-like extension of the nervous system that runs through the central holes of the vertebrae and discs. It is central nervous system tissue, meaning it does not regenerate significantly after injury, and is protected by the surrounding bones and soft tissues.
Intervertebral Discs
These are soft tissues located between the bony vertebrae segments of the spine, allowing for mobility and some compression. They can bulge or herniate, impinging on nerve roots and causing pain.
Nerve Roots
Bundles of nerves that exit and enter the spinal cord, carrying motor commands to muscles and sensory information from the body. Compression or impingement of these roots by bulging discs is a common source of back pain.
Spine Phenotypes
Individuals tend to have either a 'thin spine' (more flexible, less tolerant of vertical loads, associated with smaller joints) or a 'thick spine' (more rigid, tolerant of vertical loads, associated with thicker joints). Each phenotype has different needs for strengthening and mobility.
Anti-Rotation
The ability to prevent the torso from twisting during movements, which strengthens the obliques and abdominal muscles. This helps stabilize the spine and mimics common daily life movement patterns.
Referred Pain
Pain experienced in one part of the body that originates from an impingement or disruption of a neural pathway or inflammation elsewhere. Sciatica is a common example, where nerve impingement in the lower back causes pain down the leg.
9 Questions Answered
The back consists of the spine (cervical, thoracic, lumbar, sacral, coccyx regions), bony vertebrae, soft intervertebral discs between vertebrae, and the spinal cord which runs through them, protected by these structures.
Herniated (bulging) discs can physically press on nerve roots as they exit or enter the spinal cord, leading to pain, tingling, or numbness in the back and potentially referred areas like the hips or legs.
No, sit-ups or crunches can exacerbate disc herniation by compressing the vertebrae and pushing the disc further outwards, increasing nerve impingement and pain.
Generally, people with thicker wrists, knees, and a barrel chest tend to have thicker spinal segments, tolerating vertical loads better but having less mobility. Those with smaller wrists and joints tend to have thinner, more mobile spines but need more muscular support for stability.
Protocols like hanging from a bar with toes touching the floor (to lengthen the spine) or performing spinal extension exercises like cobra push-ups (to push bulging discs back into alignment) can help alleviate pressure on nerve roots.
Strong feet and the ability to spread toes provide a stable foundation for the entire body, improving posture, walking, running, and overall spinal stability by activating distal neural pathways and supporting the kinetic chain.
During resistance exercise, bracing the abdominal wall by filling the body with air creates a stable core. At rest, however, it's ideal to belly breathe (relaxing abdominals on inhale, contracting on exhale) through the nose.
By placing fists under the jaw and pushing the chin down against resistance for 10-second static contractions, while keeping the tongue on the roof of the mouth, you can strengthen the front neck muscles and improve posture.
Activating and de-spasming the medial glute by lying on your side, extending the top leg with the toe pointed down, and holding the contraction for 10-20 seconds can provide significant relief by stabilizing the pelvis and lower back.
15 Actionable Insights
1. Seek Professional Back Assessment
If you have severe or persistent back pain, consult a back expert or surgeon for proper assessment and diagnosis, as some conditions may require medical intervention like surgery, epidurals, or painkillers.
2. Self-Assess Spine Type
Determine if you have a ’thick spine’ (thicker joints, barrel-chested, stable vertically) or ’thin spine’ (smaller joints, more bendy) to understand your body’s natural predispositions and emphasize appropriate strengthening protocols.
3. Perform McGill Curl-Up
Lie down with one knee bent, hands under your lower back to maintain its arch, tongue on roof of mouth, and gently raise your upper chest (not chin) for 8-10 seconds, exhaling to contract abdominals strongly; this strengthens the abdominal wall without exacerbating disc herniation.
4. Practice McGill Side Plank
Start on your side with bent knees (or progress to straight legs), supported by a fisted hand, and push your hips off the ground to form a straight plank, actively pushing the floor away from you for 8-10 seconds to build spine stability.
5. Execute McGill Bird Dog
On all fours, extend one arm forward (fist) and the opposite leg backward, keeping your torso parallel to the floor without arching your lower back, while actively pushing the ground away with your planted hand and knee for 8-10 seconds to strengthen spinal stabilizers.
6. Address Posterior Disc Bulge
If experiencing back pain from a posterior disc bulge, perform ‘Cobra’ or ‘Up Dog’ pushups by lying on your stomach and pushing up with your hands while keeping hips on the floor, which helps push the disc back into alignment and relieve nerve impingement.
7. Activate Medial Glutes
Lie on your side, keep the bottom leg on the floor, and with your top toe pointed down, bring your top leg forward, then extend it back with the heel towards the ceiling, holding the final extension for 10-20 seconds to activate and de-spasm the medial glute, which can relieve low back pain.
8. Spinal Decompression Hang
Gently hang from a bar with your toes, feet, or heels lightly touching the floor for 10-30 seconds, creating length along the spine to relieve disc compression and nerve impingement, being cautious not to twist.
9. Maintain Lumbar Arch When Seated
If you have a posterior disc bulge and sit or drive frequently, place a rolled-up towel in the arch of your lower back to prevent rounding and maintain a beneficial spinal alignment.
10. Stretch Psoas Muscle
Perform a lunge with the arm on the same side as the extended back leg reaching overhead, palm parallel to the ceiling and pinky pointing towards your head, to stretch the psoas muscle and relieve hip/spinal tension.
11. Strengthen Front Neck Muscles
Place fists under your jaw and push your chin down against their resistance for 10-second static contractions, with your tongue on the roof of your mouth, to strengthen the front of your neck, improve posture, and support nasal breathing.
12. Enhance Foot & Toe Mobility
Practice spreading your toes independently and lifting each toe separately to strengthen the feet, improve overall body stability, and support the entire kinetic chain up to the spine.
13. Practice Belly Breathing at Rest
When not exercising, consciously relax your abdominals and practice nasal breathing where your belly expands on inhalation and contracts on exhalation, promoting relaxation and optimal respiratory patterns.
14. Incorporate Anti-Rotational Training
During resistance exercises like dumbbell curls or overhead triceps extensions, adopt a staggered stance with one foot forward and insist on keeping your belly button facing directly forward to train anti-rotational core strength.
15. Develop Movement Pattern Awareness
Consciously observe your daily posture, breathing habits, and movement patterns (e.g., leaning, foot placement) to identify and correct imbalances or habits that contribute to back pain or limit mobility.
5 Key Quotes
Back pain is one of those things that, even if minor, and certainly if severe, severely impedes our ability to do most everything, even to just sit still or lay still.
Andrew Huberman
If the spinal cord is damaged, typically there's a lot of scar tissue that forms, but there is no renewal of the neurons that are damaged.
Andrew Huberman
When you hear the word stiffness, you probably think, well, that can't be good. I don't want a stiff back, ah, but you actually want to be able to generate rigidity within your core and spine in order to move your limbs.
Andrew Huberman
If you have back pain, you need a proper assessment and diagnosis. It's really impossible for me in this format to try and diagnose your back pain or for you to try and diagnose your back pain. That would just be irresponsible of both of us.
Andrew Huberman
Pain is always the consequence of a pathway being irritated or a pathway being activated.
Andrew Huberman
8 Protocols
McGill's Big 3: Curl-Up
Andrew Huberman (referencing Dr. Stuart McGill)- Lie down with one knee bent and the other leg extended.
- Place both hands below the lower portion of your back, maintaining the arch.
- Keep your head in a neutral position with your tongue on the roof of your mouth, breathing through your nose.
- Raise your elbows off the ground.
- Lead with the upper chest (not chin/head) to raise the upper torso slightly (5-10 degrees).
- Exhale and contract abdominals strongly for 8-10 seconds.
- Lower back down and relax for 10-30 seconds (or up to a minute).
- Repeat 5 times for the first set, then 4, 3, 2, 1 for subsequent sets, switching leg position between sets.
McGill's Big 3: Side Plank
Andrew Huberman (referencing Dr. Stuart McGill)- Start on your side with knees slightly bent (30-40 degrees angle).
- Place one forearm and hand (in a fist) on the ground, pushing the floor away from you.
- Push hips off the ground to form a straight plank position, ensuring no hip sagging.
- Hold for 8-10 seconds with strong rigidity.
- Rest for 10-30 seconds.
- Repeat for 3-5 repetitions per set, doing 2-3 sets per side.
- Progress by straightening legs, placing the top foot in front of the bottom foot for stability, or adding a forward rotation of the upper body.
McGill's Big 3: Bird Dog
Andrew Huberman (referencing Dr. Stuart McGill)- Get on all fours with hands directly under shoulders and knees under hips.
- Extend one arm forward (hand in a fist) and the opposite leg backward, keeping the body parallel to the floor.
- Push the ground away with the planted hand and knee.
- Ensure the extended leg is not raised too high to avoid arching the lower back; envision one long line from extended fist to extended foot.
- Hold for 8-10 seconds with strong contraction and stability.
- Return to all fours and rest.
- Repeat for 3-5 repetitions per set, doing 2-5 sets per side, or alternating sides.
Spinal Lengthening Bar Hang
Andrew Huberman- Find a sturdy bar or object to hang from.
- Grasp the bar with both hands overhead.
- Allow your legs to drape down, keeping your toes, feet, or heels in light contact with the floor (not a dead hang).
- Focus on creating length along the spine without twisting.
- Hold this position for 10-30 seconds.
- Relax, let go, and walk around briefly.
- Repeat 2-3 times.
Cobra Push-Ups for Disc Herniation
Andrew Huberman (referencing a PT)- Lie face down on the floor with legs together and toes extended backward.
- Place hands on the floor near your shoulders, as if for a push-up.
- Push up with your arms, keeping your hips in contact with the floor, creating an arch in your lower back.
- Keep your head in a neutral position (not looking up at the ceiling).
- Perform 8-10 repetitions of this movement.
- On the final repetition, hold the arched position for as long as possible until slight quaking occurs, then relax.
Front Neck Muscle Strengthening
Andrew Huberman (referencing Dr. Sean Wheeler and Dr. Stuart McGill)- Place your fists underneath the two sides of your jaw (on either side of your chin).
- Position your tongue on the roof of your mouth and breathe through your nose.
- Apply downward pressure with your chin against the resistance of your fists.
- Hold this static contraction for 10 seconds.
- Relax.
- Repeat for 3-4 repetitions, completing 2-5 sets.
Medial Glute Activation and De-spasming
Andrew Huberman (referencing Jeff Cavalier)- Lie on your side with your elbow and forearm on the ground, making a fist with your hand.
- Keep the lower leg (in contact with the floor) against the floor.
- Take the top leg, point the toe down, and bring it out in front of you to touch the floor.
- Extend the top leg backward as far as possible, with the heel pointed toward the back wall and up towards the ceiling, maintaining the downward-pointed toe effort.
- Perform 5-10 repetitions of this movement (forward touch to backward extension).
- On the final repetition, hold the leg in the raised, extended position for 10-20 seconds.
- Optionally, place your thumb at the top of your glutes to feel the muscle activate during the hold.
- Switch to the other side and repeat the process.
Psoas Muscle Stretch
Andrew Huberman (referencing Dr. Stuart McGill)- Get into a lunge position with one leg forward (knee slightly bent) and the other leg extended backward.
- Raise the arm on the same side as the leg that is extended backward.
- Extend the arm overhead with the palm parallel to the ceiling (or sky).
- Rotate your wrist slightly so your pinky finger attempts to point towards your head.
- Reach as much as you can, feeling a stretch from your wrist down past your hip, possibly into the back foot.
- Hold for 5-10 seconds, breathing normally.
- Switch to the other side and repeat the stretch.