Protocols to Strengthen & Pain Proof Your Back
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- ~6 min
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- 29 Apr 2024
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- 2:08:04
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KEYPOINTS
- 01
Much back pain comes from nerve roots being pressed on as they leave the spine
The spine alternates bony vertebrae and softer discs, with the spinal cord running through the middle. Nerve bundles exit between segments to reach muscles and carry sensation back in. A bulging (herniated) disc, compressed vertebrae or local inflammation can impinge those roots, so much of relieving back pain is about creating space for them and stabilizing the spine so it doesn't happen again.
- 02
Spinal cord tissue does not regenerate, which is why the spine is armored
The cord is central nervous system tissue, like the brain; after injury it mostly scars rather than renewing neurons. Vertebrae protect it while discs let it bend and twist, and the cord itself moves when you lean or rotate.
- 03
Pain is neural and multi-factorial, not only structural
Citing the biopsychosocial model discussed with Dr. Sean Mackey, Huberman notes pain involves prediction, history, psychology and inflammation. That said, feet, toes, pelvis, neck position, spinal erectors and the abdominal wall all shape the environment the spine works in, which is why many protocols here target areas far from the sore spot.
- 04
Your frame hints at whether you have a 'thick' or 'thin' spine
Per Dr. Stuart McGill, people with thicker wrists, knees and ankles tend to have thicker spinal segments: good at handling compression along the spine but less able to twist. Thinner-framed people tend to have thinner, more 'bendy' spines that tolerate less vertical load. McGill's willow versus oak analogy: thin spines should build more surrounding muscle; thick spines may need more work on rotational mobility.
- 05
Get a real diagnosis for severe or persistent pain
Huberman is explicit that a podcast can't diagnose back pain. Overuse imbalances (such as one-sided golf swings), compression injuries and ruptured discs differ, and ruptured discs often need surgery. Epidurals, painkillers and supervised rehab all have their place, and many cases do resolve with time if you avoid the aggravating movement.
- 06
Crunches and sit-ups can worsen a posterior disc bulge
Flexing forward squeezes the front of the vertebra-disc-vertebra 'sandwich' and can push the disc further out onto the nerve. Huberman made his own herniation worse by doing crunches before a physical therapist told him to stop. The curl-up was designed to train the abdominal wall without that flexion.
- 07
McGill's Big 3 favor short, hard holds over long static ones
Curl-up, side plank and bird dog are each done as roughly 8–10 second maximal contractions. Repeating short, intense contractions builds the nerve-to-muscle pathways for strong stiffening better than holding 30–60 seconds. McGill himself says the Big 3 are not exhaustive. Quality matters more than volume, so stop sets once form breaks down.
- 08
Stabilizers far from the spine matter: feet, toes and the front of the neck
Strengthening the deep front neck muscles helps hold the head away from the chest and may support nasal breathing. Being able to spread all your toes and move them independently activates the arch and shin muscles that form a stable base for the pelvis and spine. Huberman credits foot work with ending his shin splints when running.
- 09
Direction of disc bulge determines which exercises help or hurt
Huberman's bulge (around L3–L4) pushes posteriorly, so spinal extension relieves it and flexion aggravates it. Someone whose bulge goes the other way may need different work. Knowing your pattern also guides strength choices: he emphasizes posterior-chain work such as glute-ham raises and Nordic curls.
EXAMPLES
- 01
Huberman's Seattle back injury
Doing weighted reverse bench dips with plates on his lap, he felt something 'go'. By that morning he had sciatica-like pain from his mid-right back into the hip and down the leg, and was walking bent over 20–30 degrees. A physical therapist had him stop crunches and start cobra-style push-ups. The pain was almost gone in two to three days with no medication. He notes there was no control, so it may have resolved anyway.
- 02
Cobra push-up details and the wall version
Lie face down with legs together and toes pointed back, keep your hips on the floor and push up with a neutral head. Do 8–10 reps and hold the last one until you start to shake. People in too much pain for the floor version can stand about six inches from a wall and push the hips toward it. When the same L3–L4 issue flared years later, it settled again quickly with these.
- 03
The Oreo analogy for discs
The cookies are vertebrae and the cream is the disc. Even pressure spreads the cream out in all directions; squeezing one side pushes it out the opposite side; crushing it is like a rupture. Flexion pushes the cream backward, toward the nerves, in posterior bulges.
- 04
Fist trick from Pavel Tsatsouline
Clenching a fist raises contraction strength elsewhere because of bilateral neural wiring. Making a fist on the other hand gives you a harder handshake squeeze. Huberman applies this by planting a fist rather than a flat hand in side planks and bird dogs.
- 05
Medial glute protocol from Jeff Cavaliere
Lie on your side with the bottom leg on the floor. Point the top foot's toe down, touch it in front of you, then sweep the heel back and up. Do 5–10 reps, then hold the last one for 10–20 seconds with a thumb pressed on the top of the glute. Huberman uses it for low-low back pain from sitting, flying or heavy hip-hinge work, and does both sides.
OTHER RELEVANT
- 01
Big 3 dosing
Curl-up: one knee bent, hands under the low-back arch, tongue on the roof of the mouth, chest leads (not the chin), lift 5–10 degrees, 10-second holds. Use a descending ladder of 5, 4, 3, 2, 1 holds with 10–30 seconds of rest, then switch legs. Side plank: start with knees bent 30–40 degrees and progress to straight legs with the top foot in front. Bird dog: reach long and low, without arching, for 8–10 second holds. One or two sets of each takes 5–10 minutes. Huberman aims for once or twice a week.
- 02
Supported bar hang for decompression
Hold an overhead bar with your toes or heels still touching the floor, rather than a full dead hang. Stay 10–30 seconds without twisting, walk around, and repeat two or three times. Inversion tables work on the same logic, but inverting raises eye pressure, so people with glaucoma or a predisposition to it should avoid it.
- 03
Neck and toe drills
Press your fists under both sides of your jaw, tongue on the roof of the mouth, and push your chin down for 10-second static holds: 3–4 reps, 2–5 sets. Practice spreading your toes so none touch, using tissue or toe spreaders if needed, then work on lifting each toe independently.
- 04
Bracing, stagger stance and the psoas stretch
For heavy lifts, brace by filling the trunk with air rather than doing a soft belly breath. For curls and overhead triceps work, use a wide staggered stance with your belly button facing forward to train the abs in real-world positions. McGill's psoas stretch: hold a long lunge, raise the arm on the back-leg side with the palm flat to the ceiling and the pinky rotated toward your head, 5–10 seconds per side.
- 05
Watch your daily posture
The last tool is awareness. Notice rounding while texting, foot position when sitting, and habitual leaning to one side. If you have a posterior bulge, a rolled towel behind your lower back while driving or flying keeps a slight arch. Stop any exercise that makes your pain worse.