Flexion is the number 1 cause of disc injuries...

Flexion is the number 1 cause of disc injuries...

“If you were to hit your thumb lightly, but repeatedly, with a hammer, it would eventually become very painful, and soon, the slightest touch would cause pain.” – Stuart McGill, Low Back Disorders: Evidence-Based Prevention and Rehabilitation

The number one cause of low back pain is repeated or sustained flexion. If you add in a rotational component, it’s even worse!

Today, it is agreed across professions that flexion is the number one mechanical cause of disc injuries, whether it’s repeated as in bending over to pick up boxes, gardening in the yard, or sustained (sitting in flexion at work) or even if the lumbar spine is over-utilized in sports without adequate stability.

Simply put – flexion is that slouched posture you are probably in right now while reading this sentence.  There is nothing inherently wrong with flexion, it’s just that we tend to do a lot of it. 

If you have low back pain and it’s a constant problem in your life, then you might want to reconsider traditional core exercises that focus on abdominal flexion movements, such as sit-ups and knees-to-chest, these “often recommended” exercises can actually make the situation worse, especially if the disc is already irritated. Not long ago, sit-ups and flexion exercises were the gold standard treatments prescribed for low back pain sufferers. Today, current research has changed this line of thought.

The new approach (step 3), which has been highly successful, is a strategy that builds the core muscles around the spine while keeping the spine in its neutral position. This reduces the load to the lumbar discs and protects the disc in its optimal position.

Below are 5 steps to a healthier lower back, we are going to discuss Step 3 today and hit upon the other steps in the next series of posts.

5 Steps to a Healthier Lower Back. 

  1. Remove the “Hammer.”  (Improve posture, mechanics, and learn to hip hinge).
  2. Core Bracing – a little stiffness goes a long way
  3. Improve Endurance and Strength of Surrounding Musculature
  4. Improve Soft Tissue and Joint Motion
  5. Chiropractic Manipulation

Step 3 – Improve Endurance and Strength of Surrounding Musculature.

Stuart McGill’s Big 3.  These exercises are designed to build endurance of the “core” muscles that surround the spine while minimizing compressive loads to the spine at the same time. 

1)      Curl-ups – These will challenge the muscles, while at the same time spare the spine of excessive loads. Note that these are not a standard sit-up; rather, one leg is kept straight to reduce spinal load. This exercise is designed to challenge abdominal muscles without flexing the spine.








2) Planks /Side Bridges – An excellent core stability exercise that protects and keeps the spine in its optimal neutral position.








3) Bird Dogs – Excellent for controlled movements, while keeping the spine and hips in their neutral position with a little stiffness.


Stuart McGill’s Big 3 can be found in my free e-book The Stay Active Manifesto and for a more thorough read, especially if you are a mechanical geek like me, you must read Low Back Disorders – Stuart McGill.

These exercises set the base; from here it’s important to progress to more functional movements like squats, single leg squats, or lunges.  However, it’s first important to have a strong core to work from.

Lastly, if you have low back pain, these exercises are a great start, but the other steps are just as important.  Feel free to contact me if you have any questions or would like to set up a consultation to discuss treatment options.

 All the best,

 Cole Ellis