Progression and Proper Instruction Matter!

Dr. Stuart McGill is considered one of the top back experts in the world. Dr. McGill recently published a study illustrating the importance of instruction when performing spinal stabilization exercises.

Dr. McGill coins the bird-dog, curl-up, and side bridge moves the "Big 3" for spinal stabilization. Spinal stabilization exercises are used in many, but not all, cases of back pain.

One of the main thrusts of the article was small changes from an instructor can produce much higher muscle activation levels. Dr. McGill used mechanical tests to determine whether small changes in an exercise could change the amount of muscle activation, and his study showed the changes did this was the case.

As Dr. McGill noted, research studies do not generally account for differing levels of skill by the instructor. McGill also noted how the progressions changed the muscle activation levels of the Big 3.

For example, McGill discusses simple bird-dog progressions:

"The challenge according to the activity in various muscles appears to progress as follows: just arm elevation, just leg elevation, both arm and leg (full birddog), then the addition of a conscious abdominal brace, and finally a deliberate slight
abduction of the shoulder with further elevation (fig 11). This final maneuver elevates the left upper back extensors from 23% to 35% MVC."

McGill SM, Karpowicz A. Exercises for spine stabilization: motion/motor patterns, stability progressions, and clinical technique. Arch Phys Med Rehabil 2009;90:118-26.