Back Mechanic by Dr. Stuart McGill (2015-09-30)

About 15 years ago, I had surgery and drop foot as the result of an L5/S1 disc herniation due to playing sports. Unrelatedly, I also fell on a tennis court and aggravated L3, L4, L5 on the other side of my spine. All of this caused me to have regular, chronic, low grade pain/sciatica, when it wasn’t outright disabling and hard to even move. Both of these injuries have combined to change my life in dramatic ways. To give an example of how limited my life had become, I had not felt safe to life a gallon of milk for 15 years, much less carrying the recycling bin to the curb. I had tried PT many times, with no success and often getting worse by having setback after setback from poor/ignorant guidance from those inexperienced with working on spine health. I am now in my early 50s, and was preparing for a life of continuous, chronic low back pain and resigned to trying to make the best of a bad situation. That’s when I heard the author Stuart McGill in an interview with Peter Attia (available on YouTube). I bought the book immediately (about 9 months ago), and in a word, this book changed my life. It is so good, I believe it may be able to change yours too, which is why I am writing this extensive review. I am in awe of the amount of gratitude I have for this man, and how his life has helped transformed mine. McGill has studied the spine for some 30 years, having had a research lab at the University of Waterloo. He has worked with back pain sufferers from elite athletes to the non-athletic during this time. The summation, of all that work, all that thought, and all that effort is this book: Back Mechanic. And it's done in super-accessible form. In a word, it is a brilliant, dense, concise summary for those of us who suffer from low back pain, to teach us how the spine works, what the spine needs, and presents a roadmap to getting beyond the pain, and onto a happier, functional life. This book is designed to take us through his entire journey of learning, so that you can begin your own journey to back healing and back health and to live pain free, and maybe even be an athlete again, if that is one of your goals. BACK MECHANIC offers a multi-step program, which starts with learning spine essentials and how to stand, sit, walk, bend, so to not aggravate our back even more. Learning correct movement patterns is absolutely essential to the healing journey. McGill, with descriptions and invaluable illustrations, shows us how. From there, there is a self-assessment that helps one understand better their unique situation, adn then we evenutally get to the justly-famed BIG 3. (NB: It does not suffice to watch YouTube videos of the BIG 3, and assume you are able to replace this book. That’s wrongheaded and misguided. There are a few good ones out there, but they do not rise to the level of comprehensiveness that this book offers. There are no shortcuts.) You want to get his book because it is literally chock-full of pearls of wisdom distilled from his decades of research and applied physiology experience virtually on every single page. (This is one reason that makes the book as valuable as it is dense. There’s a lot here!) All this needs to be integrated in your movement patters and ways of thinking about your spine to have the most likely chance of success. If we are to become our own Back Mechanic, we have to go back to school and get an education. And that education takes time. There’s a TON of information here, to understand and integrate. But you have to put in the work., there’s no way around that fact. For me, it was a leap of faith. I said to myself ‘give it 3 months of my best effort, and let’s see what happens.’ (I didn’t have expectations for an outcome, but I wanted to give it sincere effort.) I spent the first 2 weeks slowly reading the first few chapters, just digesting his approach and understanding how he was approaching the spine, while trying to integrate the best movement patterns into my every day (every hour!) life. (McGill has some unconventional approaches and ideas about the spine that are not universally accepted around yoga, pilates, stretching in general.. to name a few. I didn’t have strong opinions on these things, and put my trust in him as my guide, knowing I had to also take responsibility for what I did with myself, both inside and out of the gym.) After about 6-8 weeks of very diligent and careful integration of these words of wisdom, my chronic, low grade back pain that accompanied me every single AM for years upon years.. and often throughout the day - eventually disappeared. Completely disappeared! From there I learned through experience, that using the BIG 3 correctly, actually helped my back feel better (as predicted in the book) even when I entered the gym feeling some discomfort. This was nothing short of miraculous… but it was actually the outcome of McGill’s commitment to excellent vis-a-vis understanding the spine, and my commitment to deeply understanding the principles and guidance he sets forth.. and making them my own. I also own his 2 other major works: Lower Back Disorders (very specialized and science based.. not necessary unless you want to really get as much information about spine mechanics and health as you can_ and Ultimate Back Fitness and Performance (which is a book for athletes who want to understand Back Mechanic more deeply, and to go beyond the BIG 3 and be thinking about core strength playing sports/lifting heavy.). Am I done? Hell no. I still do the BIG 3, 3-4 days a week, and have additional spine health exercises that I do at the gym on other days. Although I’ve been doing the work for nearly 7 months now, I am not actually at the last stages of the BIG 3 yet.. in other words, despite my successes (which are dramatic and life giving), I still have several months to go before I’ve integrated all of the wisdom/exercises outlined in Back Mechanic. That’s when I’ll move on to Ultimate Back Fitness. This is a book to help you in your life.. and it is a book to have for the rest of your life. Thank you Dr. McGill! Those of us whom you have helped over the years, are deeply indebted to your love affair not only with understanding spine mechanics, but to your brave commitment (when taking on conventional wisdom) to share your understandings with the rest of us. It’s an inspiration to us all. Want to change your life by healing your back?… Buy this book, and give yourself a chance to heal.

Following the protocol in this book has alleviated 100% of my back pain in less than two years, allowing me to return to the outdoor activities that bring me so much joy. Before becoming aware of the book, I tried lots of medical interventions -- including physical therapy, chiropractic, injections, and acupuncture -- without any improvement. The Back Mechanic allowed me to accurately diagnose the source of my pain, helped me understand the basics of spine hygiene, and then showed me how I could effectively build a resilient back. It is now a year and a half later, and I am grateful to be living pain-free and have returned to hiking, climbing, and other activities that I love. Dr. McGill really knows his stuff! The book is well written, easily understood, and beautifully illustrated, giving you everything you need to regain your life.

50 years ago, a football back injury ( spondylosis L5/S1) gave me much to overcome in maintaining the fitness required to compete at the national and world level in my age group in sprint cycling. Weightlifting has carried me very far in this regard, but attempting to “have it all “ has led to injury and overuse , forcing me to live with symptoms related to bulging discs, two annular tears, moderate stenosis, and spondylosis leading to spondylolisthesis, extension intolerance and radiculopathies. I reject the option to correct these conditions with surgery. I recently searched out the most elite sport coaches and asked if there was an expert they recommended that would support a non-surgical, self motivated solution to my ills. Stuart McGill was universally mentioned as the highest regarded spinal rehab authority. From world class cyclists with herniated discs to a world’s strongest man competitor with crushed vertebrae, Stuart McGill has proven his rehab methods can often repair career ending spinal problems and return athletes to winning form without surgery or pain. “The Back Mechanic” is Stuart McGill’s primer for the back-injured masses. The book explains in detail what it takes to return your back to health by your own means. Included is proof for his theories, back myths dispelled, specific methods to strengthen the back, the best way to treat the injuries, and how to avoid movement patterns that got you into this mess to begin with. The book is easy to read. Every word has weight. Every section of his book is equally important. Bits and pieces of what McGill has devised have begun to sneak into rehab culture, but never before so logically laid out with the correct importance and scientific studies to back them up as in this book. Never before has so much of what you thought was true proven to be so wrong. I dug into “The Back Mechanic” and adopted its methodology. After about 3 months, the awareness that my back health was compromised was gone. It now has been 6 months of adhering to “The Back Mechanic” and I can report that my back feels “bulletproof” to everything that upset it before. I am again in the top 1% of strength among serious weightlifters that are my age and weight. I am able to continue my fitness sports without pain. I consider testimonials pretty useless from a scientific point of view. But virtually every athlete who has gone the McGill way has improved enough to continue their sport. What is the alternative? Surgery, drugs, more surgery, giving up what we love? I am convinced that whatever your back problems are, if you are patient and apply yourself, that “The Back Mechanic” is the only book that provides all of the tools to continue doing what you love, athlete or not, young, or old, and with much less chance of needing surgery.

I'll preface by saying I'm not a physical therapist, I have not been diagnosed with disc problems, and I don't have significantly impairing back pain presently. I bought this book first for a friend who had a herniated disc. We're both in our 30's, he told me about his problem and how impaired he'd become. I couldn't get him to a physical therapist but I could send him a copy of this book. He still has some back pain, but he worked to reduce it to a level he could tolerate using the material herein. Now when we talk he doesn't mention his back much, if at all. He installs windows, so his job is very physically demanding. I also purchased a copy to give to a guy I worked for very briefly. He had numerous significant medical issues, not the least of which were spinal problems that limited his time standing and moving about to less than two hours. His heart also wasn't well, and that limits capacity for training one's self. He seemingly felt himself beyond my advice and that of this book, and didn't want to read it. I do not know if he was correct in his determination. I've also read a good bit of this book in attempt to address my postural pains that come and go. I wanted to power through and finish it, but.. my apologies, I really dislike the writing style and organization. Admittedly, I'm not literate enough to expand accurately on that. I'm a 10 year automotive mechanic and the son of a 40+ year HVAC contractor. My passion for automotive is centered on troubleshooting. I think about things in the format of mechanical operation, and I find it necessary to understand function of individual components of a system before tackling systems as wholes. Dr.McGill seems to have the same bend. He admittedly struggled getting his knowledge translated into writing, but found the information so valuable that it had to be done anyways. I have to agree with him. Much of the message herein is identifying problems, isolating them, and developing means to work around them. The ideology is spine preservation through minimizing non-essential movement and capitalizing on the benefits of rigidity/stiffness. He wants to turn crippled people into strong pillars. It is a unique and effective strategy if you can accept the premise: You will not move like you used to. You will have limitations and your minimal pain/pain-free status will be dependent on diligent maintenance. If you can accept that, you're likely to find a way to reduce your pain in this book. TL/DR: This book helps you identify your problem, and teaches you how to get out of or prevent pain by becoming stiff, and how to move about as a stiff person. It is a necessary alternative for those who find themselves unable to address their back problems by other means, and it is in some cases an alternative to surgery (fusing discs), which simply forces stiffness. But supplementing surgery requires discipline, accuracy of diagnosis, and an understanding of the fault. What's missing is an explanation of why flexibility works for some, and why an uninjured person should pursue stiffness v. flexibility. What's wrong is the use of the phrase "...get your swagger back."

This book got me out of pain and on the road to recovery. Dr. McGill makes it as simple as possible while covering all the bases that need to be covered. I had visited 3 different chiropractors, a nurse practitioner and a D.O. The nurse practitioner prescribed meds that really didn't do anything but make my heart race. The DO gave me a pamphlet of exercises that I wasn't sure were all safe for my situation. One chiropractor was making me worse. One gave up, and the third did help get my SI joint moving (it was truly stuck) but he also left me with a left foot paresthesia that persists to this day - almost 3 years later. It was Dr. McGill's book that explained to me what was going on and how to fix it. The core exercise program and the 4 hip mobility exercises helped me get better day by day. I got out of pain and am still making new breakthroughs. If you can read between the lines and have good observational skills, you will begin to understand how many people around you have problems that they are compensating for and probably don't even realize it. Eventually, this can lead to a great deal of pain, especially if a disc is involved in the lumbar spine or any part of the spine for that matter. But problems can show up in any joint in the body due to these imbalances. Muscle pattern imbalances are the root cause of a lot of pain and problems for people. Getting older doesn't necessarily mean that you must lose mobility. But if you don't understand what is going on and learn to correct it, that could be what happens. This book is specific for low back pain, but the basic principles, if you can recognize them, apply to virtually every part of your body that has anything to do with mobility. In short, get this book, especially if you are struggling with low back pain. If I understand Dr. McGill correctly, relying on what others do TO you is a mistake. You must do this for yourself and only YOU can do it. Dr McGill shows you the way. Frankly, I went through a lot of resources online and offline and this book was the best, by far, than anything else I came across or tried. And if you start with this book, you will save yourself a lot of money running around to various professionals hoping they have the answer. There is a good chance they do not. Get this book. It helped me and has helped many others.

I recommend this book highly. I have had back problems on and off since I was fifteen. In recent years I became a fan of the McKenzie method, as the extensions worked very well for me. But about eight months ago I aggravated the back cutting down some trees, and while the extensions provided temporary relief, it didn’t last. Fortunately, I was mostly experiencing an annoying discomfort rather than pain, but symptoms worsened in that they moved to the feet, and I frequently experienced sciatica. I went to the doctor and got an xray and an MRI that were pretty discouraging, and then I learned of this book on a blog hosted by a physical therapist named Chad Reilly. It makes a lot of sense and although I am not a medical professional, it seems to me to be a very intelligent work. One of Dr. McGill’s main points is that back pain has specific and highly individual causes, and the first step is to recognize what is causing your pain and then stop doing it (or start doing it, if something that you’re not doing is the problem). I was already paying a lot of attention to posture, but I started paying much more attention and have been able to make improvements. For example, sitting in some chairs bothered me while sitting in others didn’t. I thought I was sitting the same way in all the chairs, with good lumbar support, but then I noticed that different seat heights made a difference, as did the angle of the seat back, and the kind of work I was doing. Leaning forward just a little was a trigger. I am surprised to see that even small differences matter quite a bit, and now I am usually able to adjust my seated posture so as to eliminate symptoms. I also think that there is overall improvement, as there are longer periods when I don’t think about my back. Months ago if I felt symptoms while sitting, I just thought, “Well, that’s my condition.” Now I think about what it is that’s causing the symptoms and try to make a change. One specific example: Sitting in my living room recliner was bothering me, so I bought an outdoor zero gravity recliner (wide so that my arms are not on the rests) and use a lifesaving cushion because it’s solid and a firm piece of foam for lumbar support—perfect. Now I’m trying to figure out how to modify the living room recliner to mimic the lawn chair. Not quite there, but I’m sitting in it as I write and it’s better than it was. Second, I like the exercises and the gradual approach he recommends, as well as the attention he pays to the individual nature of back problems. I haven’t been doing the exercises long enough, or consistently enough, to know that they are making a difference in symptoms, but they certainly are not making things worse, and in any event they allow me to do some conditioning without aggravating things. I should also mention that there is a section on self-evaluation that makes sense, but I was already pretty sure of what my intolerances are, so I didn’t really go through the evaluation. This reminds me that although it’s not a huge book, there is a lot to it, and I think it is worth reading carefully, and rereading. Two final points: McGill has a number of videos online, and I have found it helpful to watch some of them because he expands some points and clarifies others that I did not fully understand. I find it a very encouraging book, which is important in itself, especially if you are going to be your own Back Mechanic.

I have DDD level 4 in lower back. 5'6" 185lb. 67. Hard work all my life. My back muscles hurt for years with terrible back pain. My son gave me a link on YouTube. I said sounds reasonable. Bought the back Mechanic book on Amazon 35$. Had 2 hernia surgery in Dec 21. Bought the book 4 mo later. I started the books exercises after reading it 3 times along with doing the exercises. I've been doing leg side ways pulls and stretching with hands flat on a table back stretched out, feet flat on floor every morning plus the big 3. I was sore the first few months doing complete sets every day. Then I tried every other day, but found my sweet spot doing proper stretches, I use to stretch wrong, but not now. Then I tried1/2 the big 3 exercise every day instead of the full pyramid. I have found many tricks, mix it up and you may find something that you needed by accident. Started a year ago, I don't miss a day. No pain, I can still lift and some work no pain. Not like I use to be, but what do you expect. I wish I had this knowledge 50 yrs ago about spine heigine when I shoveled corn to feed 200 head of hogs. I just had a book sent to my son. I will continue these till the end as long as they keep working or no longer needed (revelation 21: 3-4). Till then I'll fight to Keep the weight, and eat right. Wish you all well, I've regained my life. Update, Ben doing them a couple years now. I'm much stiffer now, muscles started to cramp so I take off a couple of days a week and it's helped. Mornings are rough , I have both main back muscles that stiffens up over night and get very tight till I start my PT from this book that I set up by trial and error. 7-24. Thanks, update now it's October 2025 I'm 69 . My back muscles started getting tighter after over a year of these exercises I now call my physical therapy or PT, I have backed off from everyday to twice a week, juggling between spine pain and muscle pain, I'm stiffer in the mid section now and them muscles support my spine, my spine seldom hurts cause I adjust frequency of pt. I have been studious with this from the beginning, I'm not a young man but after being almost bed ridden I'm now active without pain. I'm very concerned about keeping the weight off, it's hard but extremely important so I can keep doing my pt. I know with age my energy will drop and make these pt harder to do but so far it's been a second chance for someone who has worked hard 50 years , unlike many in this age, even if you sit at a desk you must strengthen the inner back muscles, had I known this book as a young person I could have taken better care of my spine when everyone was saying hard work won't kill you, they forgot to tell me it will only Make you wish you were dead lol. I have not found or heard of anyone with a better solution for now, this book is not for the lazy person you must be driven to really want to feel better. If you can start your proper stretches ( most stretches damage your spine) in a hot tub you'll feel the stretch without the pain then do your bridges after your warmed up. Thanks

Back Mechanic helped me better understand which movements were aggravating my back and how to modify daily activities. The self-assessment and exercise sections are practical rather than motivational fluff. The downside is that the approach requires careful reading and consistent practice; it is not a quick fix. Anyone with severe or changing symptoms should still seek professional medical evaluation.

ALL GOOD...

Très bon livre. Arrivé très vite et correspond à la description. Après avoir vu une podcast de Stuart Mcgill avec Huberman, j'ai accroché tout de suite. En re-education après une opération, je voulais suivre la méthode Mcgill plutôt que de faire les mêmes erreurs que l'on me fais faire depuis des années.

It took suffering for too long, doing the wrong things, and being discouraged to the point of feeling quite hopeless, to truly appreciate the tremendous value of this book, and the McGill Method. Science, research, and solid advice that can be put into practice immediately. I have read and re-read, I have the paper version and digital to have it at hand, wherever, and purchased the videos to enhance my understanding. I have more work to do, but I feel hopeful again, with pain significantly reduced already. It is so empowering to have the tools to have results myself! This is also written in a way that is engaging, compassionate, and understandable. Thank you Dr. Stuart McGill!

If you are experiencing back pain or it continues to reoccur this book is essential reading. I came across Dr McGill on a podcast and it was (no exaggeration) life changing. Back Mechanic does what it says - it gives you the tools to help yourself and I can now see that certain “good” habits and exercises were actually making me worse. I suspected this, but it is comforting to have a specialist set out why certain exercices are better than others for those with back problems. The book is succinct but comprehensive with clear diagrams and explanations. It also gives more than practical advice, it is filled with positivity and gives hope to those of us who think we will never be better than just ok. I would highly recommend - it is an incredible resource for the money.

Buena utilidad