April 29, 2024 • 2hr 8min

Protocols to Strengthen & Pain Proof Your Back

Huberman Lab

In this episode, Dr. Andrew Huberman discusses protocols for strengthening the back and reducing or eliminating back pain. He explains the anatomy and physiology of the spine, including the vertebrae, discs, spinal cord, and surrounding musculature. Huberman then outlines specific exercises and techniques that can be used to build a strong, stable, and pain-free back. The information presented draws from several experts in the field of back health, including Dr. Stuart McGill, Dr. Kelly Starrett, and Dr. Sean Wheeler. Huberman emphasizes that while these protocols are generally safe and effective for most people, those with severe or persistent back pain should consult with a medical professional for proper diagnosis and treatment.

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Key Takeaways

The spine consists of vertebrae (bony segments) with discs in between that allow for mobility. The spinal cord runs through the center.
Many cases of back pain are caused by disc herniation/bulging that impinges on nerve roots exiting the spine.
Dr. Stuart McGill's "Big 3" exercises are highly effective for strengthening the core and back:
- Curl-up
- Side plank
- Bird dog
Other key protocols for back health:
- Strengthening the neck muscles
- Spreading and strengthening the toes/feet
- Belly breathing when at rest
- Activating the medial glutes
- Stretching the psoas muscle
Hanging from a bar and "cobra" push-ups can help relieve back pain by reversing disc herniation in some cases.
Developing awareness of posture and movement patterns throughout the day is crucial for back health.
A strong, stable core and spine allows for pain-free mobility in daily life and sports/exercise.

Introduction

In this episode, Dr. Andrew Huberman discusses protocols for strengthening the back and reducing or eliminating back pain. He explains the anatomy and physiology of the spine, including the vertebrae, discs, spinal cord, and surrounding musculature. Huberman then outlines specific exercises and techniques that can be used to build a strong, stable, and pain-free back.

The information presented draws from several experts in the field of back health, including Dr. Stuart McGill, Dr. Kelly Starrett, and Dr. Sean Wheeler. Huberman emphasizes that while these protocols are generally safe and effective for most people, those with severe or persistent back pain should consult with a medical professional for proper diagnosis and treatment.

Topics Discussed

Back Anatomy and Physiology (7:57)

Huberman begins by explaining the basic anatomy of the spine:

The spine consists of vertebrae (bony segments) with discs in between
Discs allow for mobility of the spine
The spinal cord runs through the center of the vertebrae and discs
Nerves exit the spinal cord between vertebrae to innervate muscles and skin

He emphasizes that understanding this anatomy is crucial for comprehending how back pain occurs and how to address it effectively.

Common Causes of Back Pain (12:07)

Huberman discusses how disc herniation or bulging can lead to back pain:

Discs can bulge or herniate, putting pressure on nerve roots
This impingement of nerves often causes pain, numbness, or tingling
The direction of disc bulging determines which movements aggravate or alleviate pain

"A lot, not all, but a lot of back pain has to do with compression or impingement of nerves at some point along a pathway, sometimes multiple points along a pathway."

McGill's Big 3 Exercises (36:29)

Huberman introduces Dr. Stuart McGill's "Big 3" exercises for strengthening the core and back:

1. Curl-up

Lie on back with one knee bent, hands under lower back
Lift upper chest slightly while maintaining neutral neck position
Hold for 8-10 seconds, repeat 3-5 sets

2. Side Plank

Lie on side with elbow under shoulder, feet stacked
Lift hips off ground, maintaining straight body alignment
Hold for 8-10 seconds, repeat 3-5 sets per side

3. Bird Dog

Start on hands and knees
Extend opposite arm and leg while maintaining neutral spine
Hold for 8-10 seconds, repeat 3-5 sets per side

Huberman emphasizes proper form and gradual progression for these exercises.

Protocols for Back Pain Relief (1:05:37)

Huberman shares two protocols that can help alleviate back pain:

1. Bar Hang

Hang from a bar with toes touching the ground
Creates spinal decompression to relieve pressure on discs
Hold for 10-30 seconds, repeat 2-3 times

2. Cobra Push-ups

Lie face down with legs straight and toes pointed
Push up with arms while keeping hips on ground
Can help reverse disc herniation in some cases
Perform 8-10 repetitions, holding the last rep as long as comfortable

Huberman shares a personal anecdote of how cobra push-ups helped relieve his own back pain caused by a disc bulge.

Additional Protocols for Back Health (1:24:21)

Huberman outlines several additional protocols for strengthening and pain-proofing the back:

1. Neck Strengthening

Place fists on either side of jaw
Push chin down against resistance for 10-second holds
Helps counteract forward head posture

2. Foot and Toe Strengthening

Practice spreading toes apart
Try to lift individual toes
Creates a stable base for the entire body

3. Belly Breathing

Practice diaphragmatic breathing when at rest
Allows for relaxation of core muscles when not exercising

4. Anti-Rotation Training

Perform exercises like curls or tricep extensions with staggered stance
Keep belly button facing forward to engage obliques

Activating the Medial Glutes (1:42:03)

Huberman describes an exercise to activate and potentially release tension in the medial glute muscles:

Lie on side with bottom leg bent, top leg straight
Point toe of top leg down and extend leg back and up
Perform 5-10 repetitions, then hold for 10-20 seconds
Can help relieve low back pain for some people

Psoas Stretching (1:50:59)

Huberman shares a stretch to target the psoas muscle:

Get into a lunge position
Raise arm on same side as back leg
Turn palm to face ceiling and rotate pinky towards head
Hold for 5-10 seconds, then switch sides

"This is something that I do believe everyone can benefit from. I don't care how bendy you are, how rigid you are, how big you are, how lithe you are, how slim you are, this is a wonderful exercise."

Developing Back Awareness (1:57:00)

Huberman emphasizes the importance of developing awareness of posture and movement patterns throughout the day:

Pay attention to how you sit, stand, and move
Notice any imbalances or areas of tension
Make small adjustments to improve alignment and reduce strain

He suggests spending a few minutes each day observing these patterns to identify areas for improvement.

Conclusion

Huberman concludes by emphasizing that while these protocols can be highly effective for many people, those with severe or persistent back pain should consult with a medical professional. He encourages listeners to view the protocols as a "buffet" of options to explore and experiment with based on their individual needs and circumstances.

The overall goal is to create a strong, stable core and spine that allows for pain-free mobility in daily life and during exercise or sports activities. By incorporating these exercises and awareness practices, many people can significantly improve their back health and reduce the risk of future injuries or pain.

Huberman also notes that future episodes will delve deeper into related topics such as posterior chain exercises, laser therapy for back pain, and the potential connections between toe strength and cognitive health.